Trichomoniasis (Trich) is a curable sexually transmitted disease, which is caused by parasitic protozoa called Trichomonas vaginalis. Anyone person who is sexually active is prone to this infection. People with trich may or may not have symptoms, but if it’s left untreated it may cause serious health issues like HIV and other STIs. Trichomoniasis can be cured with medication.
What is Trichomoniasis?
Trichomoniasis is one of the curable STIs. Millions of people are infected by trichomoniasis every year. A one-celled parasite called Trichomonas vaginalis causes this infection. This parasite is carried in sexual fluids (vaginal fluids, semen, or pre-cum) during sexual intercourse. Trich is contagious as most people may not experience any kind of symptoms. According to the Centers for Disease Control and Prevention, only 30% experience the symptoms of trich. This infection can be cured with antibiotics but it may recur again. The best way to prevent this is by having safer sex.
Transmission
The parasite is usually spread either from the vagina to a penis or penis to the vagina. Women who have sex with women can also be infected through vaginal contact. Also, in rare cases, the newborn baby can be infected by his or her mother. Infected people without symptoms can still transmit the infection to others. The lower genital tract – vulva, vagina, cervix, or urethra is infected in women. Whereas in men, the inner part of the penis is affected. This parasite may affect the anus, hands, or mouth. Infection can be transmitted even when people don’t have any symptoms. When the sexual partners are not treated, they end up passing the infection to others.
Trichomoniasis symptoms
Most of the infected women and men have no symptoms. Only 3 in 10 people have symptoms. The signs or symptoms are so mild that people fail to notice it, and this increases the chance of transmitting the infection to others. People may experience symptoms within 5 to 28 days after being infected.
Symptoms in women
- Discomfort with urination
- Vaginal discharge that is green, yellow, or grey
- Itching in or around the vagina
- Genital redness, burning, and itching
- Swelling around your genitals
- Swelling in the groin
- Pain in the lower stomach
- Frequent urination
- Pain during intercourse
- Bleeding after sex
Symptoms in men
- Itching or irritation inside the penis
- White discharge from the penis
- Pain when peeing or during ejaculation
- Swelling or redness around the head of the penis
- Burning after ejaculation
These symptoms may appear between 5 to 28 after exposure. In some cases, they might not appear at all. As symptoms can be hard to notice, the only way is to get tested and treated for it, if necessary.
When a person with trichomoniasis experiences high fever, vomiting, abdominal pain or cramping, testicular pain they must seek immediate health care if they face any of these serious conditions.
Who is at risk?
The risk of contracting trich is higher when people who had multiple sexual partners, had unprotected sex, and people who had other sexually transmitted infections.
Can Trichomoniasis be cured?
Yes, trichomoniasis can be cured with proper medication prescribed by the doctor. Antibiotic medications like metronidazole and tinidazole will help to get rid of the parasite. Even after the treatment, there are possibilities of getting trich again. But, without treatment, this infection may lead to other STIs.
Testing for Trichomoniasis
As only a few people experience the symptoms of trichomoniasis, it is not possible to diagnose the infection based on it. The only way to confirm the infection is by testing for it. The following are the ways to diagnose the infection.
- A pelvic exam
- Use a cotton swab to take a fluid sample from the vagina to look for the parasite under a microscope in women and in the case of men doctor will examine the penis for signs of inflammation or discharge.
- Lab tests like fluid culture are done in some cases. Urine or swab from the vagina or urethra is used to grow in labs.
- DNA tests seem to be the most accurate test. This test uses vaginal swabs or urine to diagnose the parasite.
- Rapid antigen tests and nucleic acid amplification
As trichomoniasis can look like other common infections like chlamydia, gonorrhea, or bacterial vaginosis, the doctor might test for different things.
Before getting tested for trichomoniasis,
- A person should avoid sex.
- As douching washes away the vaginal fluid, it is essential not to douche for at least 24 hours before testing.
- Usage of deodorant sprays or powder on the genitals must be completely avoided.
Treatment for Trichomoniasis
This condition can be treated with medication but it’s unlikely to go away without treatment. The treatment for trich include pills and these pills are considered to be safe for pregnant women too. Antibiotic medications like metronidazole and tinidazole are prescribed by doctors, to get rid of the parasite.
About 20% of people get trichomoniasis again within 3 months of treatment so, it’s better to get tested again to avoid reinfection. When a person is identified with trich, it is important to inform their sex partners about it. Apart from these preventive medications, abstaining from sexual activity until the infection is completely cured is important for the improvement of this condition.
Points to remember while undergoing treatment:
- A person should avoid alcohol while taking metronidazole or tinidazole. (may cause severe nausea or vomiting, a fast heartbeat or heart palpitations, or skin flushing)
- The sex partner or partners must be treated, even if they don’t have symptoms.
- Side effects of the medication include heartburn, metallic taste in your mouth, or vaginal yeast infections.
- Alternative medications are prescribed to the patients, who are allergic to these antibiotics.
- Women should avoid tinidazole while breastfeeding. But metronidazole is safe to use.
- Consult the doctor if you face any other side effects or symptoms while/ after taking treatment.
What happens if trichomoniasis is left untreated?
It is one of the most common sexually transmitted infections in the US. The risk of transmission is higher when an infected person doesn’t get treated for it. This may also increase the chances of spreading or getting other STIs including HIV. When a woman is infected by trich during pregnancy, the baby may be born early or at low birth weight.
Complications of trichomoniasis in women
- Fallopian tube inflammation in women
- Pelvic Inflammatory Disease
- Premature delivery in pregnant women
- Chronic Urinary Tract Infections
- Permanent cervical tissue damage
Complications of trichomoniasis in men
- Permanent bladder tissue damage
- Infertility
- Prostate cancer
- Epididymitis
- Swelling of the testicles
- Prostatitis
Apart from these complications, other risk factors which increase the chances of developing trichomoniasis include history or presence of other sexually transmitted infections, bacterial vaginosis, multiple sexual partners, lower socioeconomic status, multiple sexual partners, and high vaginal pH levels.
Prevention
- Getting tested for trich and other STDs
- Limiting the number of sexual partners
- Avoiding sex for 7–10 days after treatment
- The chances of getting trich are reduced when you use a latex condom
- Avoid douching
- Engage in a monogamous relationship
- Avoid sharing sex toys
Trichomoniasis and HIV
A person with STIs including trich is prone to Human Immunodeficiency Viruses. The viral load increases when a person has both trichomoniasis and HIV. Trich causes genital inflammation which makes it easier for HIV to get transmitted. A person who is taking ART (antiretroviral treatment) has to consult a doctor before taking the medication for trichomoniasis.
Trichomoniasis during pregnancy
In rare cases, babies can be infected by the parasite during delivery. In most cases, babies who contract trich with no symptoms can heal on their own. Babies who experience urinary tract infection, nasal discharge, vaginal discharge (among girl babies), fever, respiratory problems can be treated with antibiotics.
When a woman is infected by trich during her pregnancy, they are given a course of oral metronidazole, which is considered safe for the baby during pregnancy. Their partner should also be treated at the same time, in order to avoid transmission of the infection.
Complications during pregnancy:
- Having a baby with a low birth weight
- Premature labor and delivery
Facts about Trichomoniasis
- In the US, 2.6 million people were infected by trichomoniasis in 2018.
- WHO estimates an incidence of 276 million new cases every year.
- About 2 million women aged between 14 to 49 are infected in the US.
- Older women are more prone to this infection than younger ones.
- Trichomoniasis and Gonorrhea are coexisting infections. Almost 40% of the women who have trichomoniasis have gonorrhea.
- Trichomoniasis can live outside the body for about 45 minutes.
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