Trichomoniasis

Answer 1

Definition

Trichomoniasis is a sexually transmitted disease caused by the parasite Trichomonas vaginalis.

Alternative Names

Trichomonas vaginitis; Trich

Causes, incidence, and risk factors

Trichomoniasis is found worldwide. In the United States, the highest number of cases are seen in women between age 16 and 35. Trichomonas vaginalis is spread through penis-to-vagina intercourse or vulva-to-vulva contact with an infected partner. The parasite cannot survive in the mouth or rectum.

The disease can affect both men and women, but the symptoms differ between the two groups. The infection usually does not cause symptoms in men and goes away on its own in a few weeks.

Symptoms

Women:

• Discomfort with intercourse
• Itching of the inner thighs
• Vaginal discharge (thin, greenish-yellow, frothy or foamy)
• Vaginal itching
• Vulvar itchingor swelling of the labia
• Vaginal odor (foul or strong smell)

Men:

• Burning after urination or ejaculation
• Itching of urethra
• Slight discharge from urethra

Occasionally, some men with trichomoniasis may develop prostatitis or epididymitis from the infection.

Signs and tests

In women:

A pelvic examination reveals red blotches vaginal wall or cervix. A wet prep (microscopic examination of discharge) shows the infection-causing organisms in vaginal fluids. A pap smear may also diagnose the condition.

In men:

The disease can be hard to diagnose in men. Men are treated if the infection is diagnosed in any of their sexual partners. Men may also be treated if they have ongoing symptoms of urethral burning or itching despite treatment for gonorrhea and chlamydia.

Treatment

The antibiotic metronidazole is commonly used to cure the infection. An alternative drug is called Tinidazole You should not drink alcohol while taking the medicine and for 48 hours afterwards. Doing so can cause severe nausea and vomiting.

Avoid sexual intercourse until treatment has been completed. Sexual partners should be treated at the same time, even if they have no symptoms.

Expectations (prognosis)

With proper treatment, the outcome is likely to be excellent.

Complications

Long-term infection may cause changes in the tissue on the cervical surface. These changes may be seen on a routine Pap smear. In such cases, treatment should be started and the Pap smear repeated 3 to 6 months later.

Treatment of trichomoniasis helps prevents the spread of the disease to sexual partners. Trichomoniasis is common among persons with HIV.

Calling your health care provider

Call for an appointment with your health care provider if any unusual vaginal discharge or irritation is noted.

Also call for an appointment if you suspect that you have been exposed to the disease.

Prevention

A monogamous sexual relationship with a known healthy partner can help reduce the risk of sexually transmitted diseases, including trichomoniasis.

Other than total abstinence, condoms remain the best and most reliable protection against sexually transmitted diseases. Condoms must be used consistently and correctly.

References

Van Vranken M. Prevention and treatment of sexually transmitted diseases: An update. American Family Physician. 2007 Dec;76(12).

Answer 2

Definition

Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis.

Alternative Names

Trichomonas vaginitis; STD - trichomonas vaginitis; STI - trichomonas vaginitis; Sexually transmitted infection - trichomonas vaginitis

Causes, incidence, and risk factors

Trichomoniasis is found worldwide. In the United States, the highest number of cases are seen in women between age 16 and 35. Trichomonas vaginalis is spread through sexual contact with an infected partner. This include penis-to-vagina intercourse or vulva-to-vulva contact. The parasite cannot survive in the mouth or rectum.

The disease can affect both men and women, but the symptoms differ between the two groups. The infection usually does not cause symptoms in men and goes away on its own in a few weeks.

Symptoms

Women:

• Discomfort with intercourse
• Itching of the inner thighs
• Vaginal discharge (thin, greenish-yellow, frothy or foamy)
• Vaginal itching
• Vulvar itchingor swelling of the labia
• Vaginal odor (foul or strong smell)

Men:

• Burning after urination or ejaculation
• Itching of urethra
• Slight discharge from urethra

Occasionally, some men with trichomoniasis may develop prostatitis or epididymitis from the infection.

Signs and tests

In women:

A pelvic examination shows red blotches on the vaginal wall or cervix. A wet prep (microscopic examination of discharge) shows the infection-causing organisms in vaginal fluids. A pap smear may also diagnose the condition.

In men:

The disease can be hard to diagnose in men. Men are treated if the infection is diagnosed in any of their sexual partners. Men may also be treated if they have ongoing symptoms of urethral burning or itching despite treatment for gonorrhea and chlamydia.

Treatment

The antibiotic metronidazole is commonly used to cure the infection. A newer drug, called Tinidazole may be used.

You should not drink alcohol while taking the medicine and for 48 hours afterwards. Doing so can cause severe nausea, abdominal pain, and vomiting.

Avoid sexual intercourse until treatment has been completed. Sexual partners should be treated at the same time, even if they have no symptoms.

Expectations (prognosis)

With proper treatment, the outcome is likely to be excellent.

Complications

Long-term infection may cause changes in the tissue on the cervix. These changes may be seen on a routine Pap smear. In such cases, treatment should be started and the Pap smear repeated 3 to 6 months later.

Treatment of trichomoniasis helps prevents the spread of the disease to sexual partners. Trichomoniasis is common among persons with HIV.

Calling your health care provider

Call for an appointment with your health care provider if any unusual vaginal discharge or irritation is noted.

Also call for an appointment if you suspect that you have been exposed to the disease.

Prevention

A monogamous sexual relationship with a known healthy partner can help reduce the risk of sexually transmitted infections, including trichomoniasis.

Other than total abstinence, condoms remain the best and most reliable protection against sexually transmitted infections. Condoms must be used consistently and correctly to be effective.

References

Van Vranken M. Prevention and treatment of sexually transmitted diseases: An update. American Family Physician. 2007 Dec;76(12).

Shrestha RK, Englund K. Sexually transmitted diseases. Infectious disease. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2010. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2010:section 8.

Reviewed By

Review Date: 09/11/2010

David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine.