Trichomoniasis

Definition

Trichomoniasis is a sexually transmitted infection that in women can cause a foul-smelling vaginal discharge, genital itching and painful urination. Men who have trichomoniasis typically have no symptoms. Pregnant women who have trichomoniasis are at higher risk of delivering prematurely.

To prevent reinfection with the organism that causes trichomoniasis, both partners should be treated. The most common treatment for trichomoniasis involves taking one megadose of metronidazole (Flagyl). Infection can be prevented by using condoms and spermicide.

Symptoms

Trichomoniasis symptoms for women include:

• A profuse and often foul-smelling vaginal discharge — which may be white, gray, yellow or green
• Genital redness, burning and itching
• Pain with urination or sexual intercourse

Signs and symptoms may worsen during menstruation. But some women infected with trichomoniasis don't have any symptoms. Men infected with trichomoniasis rarely exhibit symptoms, but when they do, it's usually painful urination.

When to see a doctor
See your doctor if you have a foul-smelling vaginal discharge, or if you experience pain with urination or sexual intercourse.

Causes

Trichomoniasis is caused by one-celled protozoa, a type of tiny parasite, that travel between people during sexual intercourse. The incubation period between exposure and infection can range from five to 28 days.

Risk factors

Risk factors include:

• Having multiple sexual partners
• History of other sexually transmitted diseases
• Previous episode of trichomoniasis

Complications

Pregnant women who have trichomoniasis may:

• Deliver prematurely
• Have a baby with a low birthweight
• Transmit the infection to the baby as it passes through the birth canal

Having trichomoniasis also appears to make it easier for women to become infected with HIV, the virus that causes AIDS.

Preparing for your appointment

Your family doctor, gynecologist or a medical practitioner at an urgent care center can diagnose and prescribe treatment for trichomoniasis.

What you can do
Before the appointment, you might want to prepare a list that includes:

• A detailed description of your symptoms, including when they started
• Any sexually transmitted diseases you've had
• The number of sexual partners you've had in the past few years

What to expect from your doctor
Your doctor will perform a pelvic exam and may take a sample of your vaginal fluids for testing.

Tests and diagnosis

The diagnosis of trichomoniasis can be confirmed by looking at a sample of vaginal fluid under a microscope. If the sample is fresh and kept warm, the protozoa are easy to see and will be moving about.

Treatments and drugs

The most common treatment for trichomoniasis is to swallow one mega-dose pill of either metronidazole (Flagyl) or tinidazole (Tindamax). While there are medicated creams or gels that can be inserted in the vagina to treat the infection, taking the medication by mouth is much more effective.

Both you and your partner should receive treatment, and you both should avoid unprotected sex until the infection is cured, which takes about a week.

Side effects of the medication may include:

• Nausea
• Vomiting
• Headache
• Metallic taste
• Dizziness

You shouldn't drink alcohol for 24 hours after taking metronidazole or 72 hours after taking tinidazole, because it can cause severe nausea and vomiting.

Prevention

The methods of preventing trichomoniasis are the same as those for preventing other sexually transmitted diseases — abstain from sex, or use condoms and spermicide.