Trichomoniasis is a condition caused by the organism Trichomonas vaginalis. Infection in women usually produces an offensive, heavy vaginal discharge. It may be accompanied by itching and burning. However, some women may be infected without any symptoms. Men usually do not have symptoms and act a carriers of the infection.
Trichomoniasis is caused by the protozoan Trichomonas vaginalis.
It is estimated that up to one in five sexually active women will contract trichomoniasis during her lifetime. Both men and women can carry the infection, although symptomatic infection is more common in women. Because trichomoniasis is sexually transmitted, male sexual partners must also be treated, even if asymptomatic and no infection is detected.
Trichomoniasis does not pose major long-term risks to the reproductive system.
Microscopic identification from a wet preparation of a vaginal smear is necessary. Trichomoniasis can also be coincidentally found on a Pap smear. Trichomoniasis is rarely found on urethral smears from men, unless a special wet mount specimen is examined microscopically.
Trichomoniasis is treated orally, with the antibiotic tinidazole (Fasigyn) or metronidazole (Flagyl). Nausea is a common side-effect from these drugs, and alcohol should be avoided for 2 to 3 days afterwards as it can cause a severe reaction to occur. These drugs should not be given to pregnant or breast-feeding women.
The use of condoms during vaginal intercourse will prevent the transmission of trichomoniasis.
Sexual practices other than vaginal intercourse will reduce the likelihood of contracting trichomoniasis.
When trichomonal infection is present, it is important to avoid sexual practices involving the genitals during treatment and until a negative test result is obtained. This will aid healing and help to prevent transmission.
Detection of trichomonads in a wet preparation or smear. In males, microscopic examination of centrifuged urine may reveal trichomonads, but this test lacks sensitivity.
metronidazole 400 mg orally twice daily for 5 days
or
tinidazole 2 g orally as a single dose
or
metronidazole 2 g orally as a single dose
In pregnancy
metronidazole 400 mg orally twice daily for 5 days
(ADEC B2)
or
metronidazole 2 g orally as a single dose
(ADEC B2)
or
econazole 150 mg pessaries intravaginally at night for 3 nights
Explain the nature of the infection and provide literature on trichomoniasis.
Counsel about the side effects and potential interactions of any medication given. The patient should not consume alcohol until 3 days after completion of metronidazole or tinidazole therapy.
Regular sex partners need to be examined and treated even if trichomonads are not detected. Men are usually asymptomatic and it is rare for trichomonads to be observed. (Males should not void for 4 hours before examination.)
The patient should not have further sex until the regular partner is treated and cured. In the absence of microbiologic test of cure, this means when therapy has been completed and both the patient and partner are without symptoms.
One week after completion of therapy:
Trichomoniasis(Chinese Version)