What is Trichomoniasis Trichomonas: Causes, Symptoms and Complications,Treatment, Prevention

This microorganism, called Trichomonas vaginalis , is mainly transmitted through unprotected sex. Trichomonas infection mostly causes sexual and urinary disorders, such as vaginitis , urethritis and prostatitis . The symptoms of trichomoniasis are generally more evident in women, but there are asymptomatic cases in both sexes.

Trichomonas

Trichomonas vaginalis  is the name of a flagellated protozoan responsible for one of the most common sexually transmitted diseases in the world:  trichomoniasis .

Under the microscope, Trichomonas vaginalis appears as a large, oval-shaped cell with flagella .

Trichomonas Vaginalis: Characteristics

Trichomonas vaginalis does not penetrate inside the tissues, but carries out its pathogenic action by intimately adhering to the epithelial cells. In particular, this PARASITE has the ability to attach itself with its flagella to the walls of the vagina, causing direct damage and altering the  local bacterial flora .

Sites Of Trichomonas Infection

The sites of infection preferred by Trichomonas are the urethra , the prostate and, above all, the vagina . In this regard, Trichomonas has the ability to exploit glycogen , naturally present in the vaginal mucosa , for its development. In this way, the parasite steals glycogen from the lactobacilli , preventing its natural transformation into lactic acid . Consequently, there is an increase in vaginal pH which facilitates the perpetuation of this and any other vaginal infections .

How The Contagion Happens

Trichomoniasis: Mode Of Transmission

Trichomoniasis is a typical infection transmitted through sexual contact, especially if unprotected. Any sexually active person can therefore become infected with Trichomonas . The risk is clearly related to the number of partners and sexual habits. Not surprisingly, then, the widespread occurrence of trichomoniasis among people with different sexual partners or with other venereal diseases .

Another possible mode of contagion occurs through the promiscuous, therefore shared, use of wet towels, sex toys , public toilets or underwear. However, this is a possible but unlikely possibility, given that Trichomonas vaginalis survives for a very short time outside the human body . Indicatively, Trichomonas can live no more than 40-50 minutes outside the body.

To complete the picture, in rare cases, vertical transmission is also possible, i.e. from the mother to the newborn at the time of delivery .

Incubation Period Of Trichomoniasis

The incubation period is quite long and extends from 4 to 28 days.

Symptoms Trichomoniasis

Often, Trichomonas infection does NOT cause any notable symptoms or discomfort.

Where the symptoms occur are clearly different in men and women.

Symptoms Trichomoniasis In Humans

Men are more often asymptomatic carriers and, only in the rare cases in which the infection causes urethritis or prostatitis , can the following be present:

• Irritations to the glans ;
• Little or moderate urethral secretions;
• Burning when urinating and during ejaculation .

Symptoms Trichomoniasis In Women

Compared to men, women are more prone to developing symptoms, since Trichomonas vaginalis infection often causes vaginitis , cervicitis and urethritis .

Thus, the symptomatology of trichomoniasis is characterized by:

• Intense itching or burning in the external genitalia and vagina;
• Greenish-yellow, frothy , and usually foul-smelling vaginal discharge , sometimes with small bloody spots .

As a result, sexual intercourse can be quite painful ( dyspareunia ). Still in women, there may also be urination disorders , such as burning and the need to urinate frequently.

Another rather common finding, identifiable during a gynecological visit , is that of the so-called ” strawberry cervix “. This similarity derives from the typical presence of small reddish spots on the surface of the cervical mucosa and on the vaginal wall.

Furthermore, in the presence of trichomoniasis, a variability of symptoms in the different phases of the menstrual cycle and an exacerbation of symptoms during menstruation have been observed .

Possible Complications Of Trichomoniasis

Trichomoniasis is not just an annoying, unpleasant and irritating disease. Even when it goes unnoticed for years, trichomoniasis can lead to serious complications if not treated properly. In particular, Trichomonas infection can cause:

• Sterility, both in women and men;
• Irritations of the penis and inflammation of the prostate in men;
• Infection of the uterus and fallopian tubes in women.

Also, trichomoniasis looks like:

• Increase the risk of cervical cancer;
• Promote the transmission of HIV .

In regards to pregnancy, Trichomonas infection is associated with:

• Ectopic pregnancies ;
• Premature deliveries ;
• Low birth weight of the baby .

In turn, the newborn can acquire, albeit rarely, the infection during passage through the birth canal and suffer damages of variable severity, ranging from asymptomaticity to conjunctivitis and pneumonia .

Diagnosis

Trichomoniasis: How Is The Diagnosis Made?

The diagnosis of trichomoniasis is obtained with the simple observation of vaginal or urethral secretions under a microscope accompanied by microbiological analysis.

Considering its peculiar characteristics, Trichomonas vaginalis , in fact, is clearly visible in the fresh smear. The culture examination and amplification tests for the search for protozoan DNA, both on the urethral secretion and on the urine , allow the diagnosis to be confirmed. These tests also make it possible to verify any co-infection with other sexually transmitted infectious diseases, such as chlamydia and gonorrhea , with which trichomoniasis is often associated.

Treatment

Trichomoniasis: What Treatment Is Foreseen?

If trichomoniasis is treated promptly, recovery is rapid. Trichomoniasis therapy is based in particular on the intake of specific antibiotics, such as metronidazole .

Alternatively, for metromidazole-resistant infections, tinidazole is prescribed .

After the conclusion of the therapy it is important to avoid the intake of alcoholic beverages for at least 24 hours for metronidazole or 72 hours for tinidazole. In fact, drinking alcohol can give rise to manifestations such as nausea , vomiting , abdominal cramps , hot flashes and headaches .

Tips During Therapy

• It is advisable to combine antibiotic therapy with a probiotic supplement to promote the regrowth of the normal vaginal bacterial flora . Furthermore, it is necessary to abstain from sexual intercourse until the treatment is finished.
• Another very important consideration is that the therapy must also involve the sexual partner or partners. This precaution, to be taken even when the partner does not show symptoms, is important to limit the spread of the disease to other people and avoid the ping-pong effect, i.e. the continuous passage of the infection from one partner to another.
• In sexually active men and women with Trichomonas infection , a follow-up within 3 months of the end of therapy is often recommended, given the high incidence of recurrences in this type of infection.

Prevention

Trichomoniasis: Can It Be Prevented?

The prevention of trichomoniasis is essentially carried out by adopting the rules of the so-called “safe sex”. Among these, the regular and correct use of condoms in every sexual relationship is useful , especially when we are dealing with occasional partners.