Trichomoniasis in Women – Causes, Symptoms and Treatment

Trichomoniasis is a protozoal sexually transmitted infection that can affect both men and women. It usually does not cause significant symptoms and resolves spontaneously in men. In women, however, it persists and can affect the unborn child. Trichomoniasis increases the susceptibility of a person to contract viral infections like HIV. However, with proper preventative measures, the risk of contracting trichomoniasis as with most other sexually transmitted infections is greatly reduced. Asymptomatic partners should also be treated as the person may be a carrier and can infect or re-infect others.

Causes of Trichomoniasis

Trichomoniasis is caused by the single-celled parasite (protozoan) Trichomonas vaginalis. It is transmitted through sexual contact, particularly vaginal intercourse. It can also be transmitted among homosexual women bu vulva-to-vulva contact. Since the parasite cannot survive in the mouth or rectum it is not seen with oral or anal intercourse respectively. The parasite has a flagellum which is a tail-like protrusion that allows it to travel around the tissues of the vagina and urethra. It directly injures the tissue and causes the formation of tiny ulcers. As with most sexually transmitted infections, the risk of contracting trichomoniasis increases with having multiple sexual partners and unprotected sex. Those with a history of STDs including trichomoniasis are also at a greater risk. The infection is more commonly seen in females under the age of 35 years.

Signs and Symptoms

Trichomoniasis is similar in clinical presentation to other genitourinary infections. The signs and symptoms include :

  • Abnormal vaginal discharge with a foul-smelling odor.
  • Itchy and burning genitals
  • Redness and swelling of the external genitalia.
  • Pain during intercourse.
  • Painful urination.

Some women are asymptomatic meaning that there are no signs and symptoms. The infection can extend all the way to the cervix where it causes inflammation (cervicitis) and may pass beyond the endocervical canal. In pregnant women this can lead to serious complication and cause preterm labor.

Diagnosis of Trichomoniasis

There are several methods to diagnose trichomoniasis. This includes a microscopic evaluation of a vaginal swab, pH testing, Pap smear and a culture. This allows for the Trichomonas vaginalis parasite to be identified and the infection differentiated from bacterial and fungal infections that may cause similar symptoms. Women with untreated Trichomonas vaginalis infection are at a greater risk of contracting viral infections like HIV. Therefore it is advisable to conduct HIV testing.

Treatment of Trichomoniasis

The antibiotic metronidazole and antiparasitic drug tinidazole are usually sufficient for successfully treating trichomoniasis. Systemic treatment through oral administration of these drugs is the most effective measure although there are topical applications for trichomoniasis. Alcohol should not be used when taking these drugs as it can cause severe adverse effects similar to those seen with certain drugs used for treating alcohol addiction. Patients need to be educated on effective measures to prevent infection or re-infection not only of trichomoniasis but also of other sexually transmitted infections. Sexual partners should also be treated to prevent re-infection.

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