Trichomonas vaginalis is a flagellated protozoan responsible for trichomoniasis, the most common sexually transmitted infection (STI) in the world. The WHO estimates that prevalence among women is about 7%. Men are often asymptomatic carriers and the main transmitters of the infection. As a result, male-to-female transmission predominates. In women, transmission most often occurs between the ages of 20 and 45 years .
How is the infection transmitted?
Trichomoniasis is transmitted through all types of sexual intercourse (vaginal, anal, oral), but there is a possibility of infection even through sharing underwear, towels, and sex toys . Perinatal transmission is rare, but there have been cases of trichomoniasis in newborn girls during passage through the birth canal.
What are the risk factors?
Trichomoniasis is associated with a high risk of acquiring or transmitting HIV and is often combined with other STIs, which is an indicator of risky sexual behavior. Risk factors for infection with Trichomonas vaginalis are: multiple sexual partners; unprotected sex; smoking; drug use; low socioeconomic status.
How does trichomoniasis manifest itself?
Only 40% of women with vaginal symptoms are of infectious origin. Two forms of infection can be distinguished. The acute form is manifested by leucorrhoea, yellowish-green discharge, pain during urination, itching and burning. While the chronic or recurrent form is more hidden. The main symptom is itching associated with dyspareunia . Cervicovaginitis with irritative vulvitis and diaper rash.
Discharges during trichomoniasis are yellowish, foamy, strongly adhere to the walls of the vaginal vault. They have a characteristic clinical picture. In fact, when examining the vagina in a mirror with Lugol's reagent, we can detect the so-called strawberry cervix, the appearance of small erythematous spots on the cervix.
Trichomonas infection in men causes mucopurulent or exclusively purulent catarrhal urethritis. Ascending protozoa can lead to prostatitis, epididymitis, decreased sperm motility and viability, which can then cause male infertility.
How to treat trichomoniasis?
Once the diagnosis of trichomoniasis has been confirmed, the attending physician prescribes treatment based on oral metronidazole . A single dose of 2 g of metronidazole orally is effective in 95% of cases, provided that the treatment is administered simultaneously with the sexual partner. It is recommended to abstain from sexual intercourse during therapy until the infection has completely disappeared. In case of persistent infection, the treatment can be repeated and extended (twice a day for 5-7 days). During treatment, it is necessary to avoid drinking alcoholic beverages.
As for local therapy, it is used metronidazole vaginally - 0.75% gel, one application per day for 5 days, or 500 milligram vaginal balls for 5 days.
How to prevent trichomonas infection?
Since the infection is transmitted mainly through sexual intercourse, the main form of prevention is the regular use of condoms during sexual intercourse. Maintaining intimate hygiene and using strictly personal underwear is another fundamental habit that allows you to avoid infections, not only those associated with trichomonas.
It is also recommended to avoid indiscriminate use of vaginal douching, which often leads to changes in the vaginal microbiome .
