Trichomoniasis: is there a cure? See symptoms, treatment, prevention

Contents

What is trichomoniasis?

Trichomoniasis is a Sexually Transmitted Disease (STD) caused by the protozoan Trichomonas vaginalis . According to a 2005 WHO report, approximately 152 million people worldwide have the disease.

These high numbers are explained because, as data from the US Center for Disease Control and Prevention (CDC) show, only 30% of people end up developing symptoms, which makes their identification difficult.

The disease itself causes mild symptoms of vaginitis in women and urethritis in men, such as itching, redness and inflammation, however, if left untreated, it can lead to serious complications and even lead to infertility.

Still, it is quite difficult to diagnose the disease in men. They usually only discover the disease and begin treatment after the partner is diagnosed.

Pregnant women have to be even more aware of complications, as it can severely affect the baby, causing consequences such as premature birth .

Fortunately, trichomoniasis is curable. The treatment involves the use of some antibiotics and aims to eliminate the protozoan agent from the body. The best way to prevent it is through the use of condoms , but hygiene measures must also be taken.

It can be found in the ICD-10 through the codes:

A 59 – Tricomoníase;
A 59.0 – Tricomoníase urogenital;
A 59.8 – Other trichomoniasis locations;
A 59.9 – Trichomoniasis, unspecified.

In ICD 11, its code is 1A92.

Learn more about trichomoniasis in the text below!

Causes

Trichomoniasis is caused by a protozoan called Trichomonas vaginalis . Its main route of transmission is sex, but generally it does not affect the mouth or anus, as it hardly survives outside the urogenital system.

The protozoan usually inhabits the vaginal mucosa, the foreskin, the urethra and the prostate, causing it to be transmitted especially in male-female and female-female relationships.

Streaming

Trichomoniasis can be transmitted through unprotected sex with an infected person. It occurs mainly in male-female and female-female relationships, being almost nonexistent in male-male relationships.

In women, the protozoan usually settles in the lower genital tract (vulva, vagina, cervix and urethra), while in men the infection usually occurs in the inner part of the penis, the urethra.

As Trichomona tends to develop infections only in the urogenital region, it is not common for other parts of the body to be involved, such as the hands, mouth or anus.

Although rare, contagion can also occur through contaminated objects, such as towels (especially wet ones) and toilet seats.

During childbirth, so-called vertical transmission can occur. It usually occurs when the mother has been diagnosed and has not been treated properly or has not had the symptomatic form of the infection (therefore, she does not know she is infected).

This type of transmission occurs in approximately 5% of babies born to infected mothers, but it tends to have a spontaneous resolution in the newborn shortly after delivery.

This is because the mother’s hormones act on the surface of the baby’s vagina, allowing colonization of Trichomona . However, this hormonal effect is limited and disappears in a few weeks, making the child’s body able to eliminate the infectious agent.

However, it may still be necessary to treat trichomoniasis during the first 3 weeks of life.

Risk factors

The risk factors for being infected with trichomoniasis are very similar to those of other STDs. Check out:

History of other STDs

Statistically, people who have already been infected by some STD are more likely to be infected by others, such as trichomoniasis. Despite being a generalization, individuals who have already contracted an STD tend to be those who do not use a condom at all during sexual intercourse.

Bareback sex

The most obvious risk factor for trichomoniasis is unprotected sex. Like all other STDs, the disease is transmitted essentially through sex, so protection, whether with male or female (internal) condoms, is essential.

High number of partners

It is a somewhat controversial risk factor, but it has its reasons. It is possible to have numerous partners and have sex with protection every time, however, statistically, if you have more partners, your chances of getting an STD are greater.

Even if you always use a condom, your risks increase, since even the condom is not 100% effective – when used correctly, it has an efficiency of 98%, when placed without greater care, the effectiveness drops to 85%.

Lack of hygiene

One of the routes of transmission of the disease is through the use of wet towels or poorly sanitized toilet seats. Therefore, poor hygiene can be a risk factor for trichomoniasis.

If you don’t wash your towels frequently or clean your bathroom periodically, you may be exposing yourself to the disease for no reason, as an infected friend can visit and contaminate the toilet, for example.

Symptoms

Symptoms of trichomoniasis can go unnoticed most of the time. In fact, it is estimated that only 30% of those infected manifest symptoms, causing patients to only identify that they have the infection when they go for a routine examination, such as the pap smear .

When symptoms appear, they can range from minor irritation to severe inflammation of the genital tract. They usually take 5 to 28 days to appear (due to the parasite’s incubation period), but there are reports of patients who only had symptoms some time after that period.

Men and women experience symptoms differently. Understand:

Symptoms in women

In women, trichomoniasis usually develops vaginitis, causing more obvious and uncomfortable symptoms, such as:

White, gray, yellow or green discharge with a bad smell;
Genital redness;
Feeling of urinary urgency;
Vaginal bleeding;
Itching in the vagina;
Burning sensation;
Inflammation of the genital area;
Pain when urinating or during sex.

Such symptoms are more intense and severe during menstruation, as the inflammation caused by the infection worsens a lot during the menstrual and gestational period, causing inflammation of the perineum, large lips and adjacent skin.

When the infection is acute, vulvitis can occur due to the abundant secretions. This symptom can be seen through bleeding in the vaginal and cervical mucosa.

In chronic infection, the symptoms are generally milder and mild, with itching and discomfort during sexual intercourse.

Symptoms in men

When they occur, symptoms in men tend to be milder. They are characterized as urethritis. Understand:

Discharge with unpleasant smell;
Itch;
Burning sensation when urinating or during ejaculation;
Urinary urgency.

How is the diagnosis made?

The diagnosis of trichomoniasis is usually made by a gynecologist or urologist through routine examinations, when the doctor assesses the discharge and the odor that comes from the vagina or the penis.

It is not possible to diagnose trichomoniasis solely on the basis of symptoms, as they are similar to those of other STIs, such as gonorrhea .

Therefore, to confirm the suspicion, the doctor will usually ask you to perform some tests, such as the vaginal pH test.

If, on the one hand, it is easy to have a suspicion in the case of women, for men, it is a little different. It is very difficult to diagnose the disease in men, who end up receiving treatment only when their partner is diagnosed.

In some cases, trichomoniasis is diagnosed from the manifestation of other conditions, such as urethritis ( inflammation of the urethra ), prostatitis (inflammation of the prostate), epididymitis (inflammation of the epididymis) and infertility, some of the complications of trichomoniasis.

Now understand the main tests used for diagnosis:

Pap

Pap smear is one of the most important tests for sexually active women. This is not only because it can identify diseases such as trichomoniasis but also because it detects different types of cancer .

In general, the exam is usually quick and simple to perform. The doctor looks at the inside of the vagina (cervix) and makes a small scraping of the surface, which is sent to the laboratory.

In the case of T. vaginalis , the pap smear has a low sensitivity. The effectiveness is usually 50%, with a high rate of false positives.

Vaginal pH test

Vaginal pH tests seek to detect if there is an imbalance in the woman’s vaginal acidity, which should be between 3.8 and 4.5, while in cases of trichomoniasis, this number is between 5 and 6. The vaginal secretion is collected, from painlessly, and then taken to the laboratory, where tests will be carried out with the sample.

Through the numbers obtained, it is possible to have a better idea of which infectious agent may be causing the discomfort.

Culture exam

The culture exam is confirmatory. In it, a sample of the discharge is collected. This sample is cultured and then observed under a microscope, where the infectious agent can be verified.

Cytology exam

Another confirmatory exam, cytology makes use of a drop of the discharge placed on a slide with saline. Thus, it is possible to observe under the microscope the presence of the infectious agent.

Is there a cure?

Yes , trichomoniasis can be cured . Through the use of antibiotics and chemotherapy, it is possible to eliminate the infection. This treatment, however, does not prevent future infections from occurring.

What is the treatment?

As stated in the previous topic, the treatment aims to eliminate the infection. At first, the patient must abstain sexually, as it is necessary to rebalance the organism and avoid the increase in discomfort and the possible appearance of new diseases.

This measure is also important to maintain the safety of your partners, as this way there is no risk of passing the disease forward.

Then, the use of antibiotics and chemotherapy is indicated, and both the patient and his partner must undergo treatment to eliminate the risk of reinfection. For women, there is the option of taking a single dose oral treatment in conjunction with the use of vaginal cream.

Medicines

The main drugs used to treat trichomoniasis vary between local action (such as ointments) and systemic action (oral). Check out:

Systemic medications

Flagyl ;
Flagyl (injectable) ;
Flagyl (suspension) ;
Helmizol ;
Secnidazole .

Local medications

Colpatrin;
Colpistatin ;
Flagyl (gel);
Flogo-Rosa (gynecological solution) ;
Flogo-Rosa (powder) ;
Gynopac;
Gynopac Pro;
Metronidazole .

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Prognosis

The prognosis for a trichomoniasis infection is usually good. With proper treatment and the correct use of medications, it is possible for the patient to recover well and without major problems.

Complications

If left untreated, trichomoniasis can bring some complications to the patient. Especially pregnant women should be concerned about the disease, as it can bring some complications to the pregnancy. Understand:

Increases risks of HIV and other STIs

Because trichomoniasis can cause genital inflammation, this increases the risk of acquiring HIV and other sexually transmitted infections.

This is because the infection causes an inflammation in the genital region, which consequently leads to a large infiltration of leukocytes (white blood cells that are the “targets” of HIV) in the region, leaving the person more susceptible to infection.

Risk of infertility

Trichomoniasis causes the genital area to inflame and can cause tubal obstruction, which prevents the passage of sperm or eggs. With the block, the person can become infertile.

In addition, the disease causes inflammation of the wall (epithelium) of the vagina and urethra in men, decreasing the motility of sperm. If not treated properly, this process can lead to infertility.

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease happens when the infectious agent, in this case Trichomona vaginalis , spreads beyond the vagina and begins to reach other parts of the sexual organs, such as the uterus, tubes and ovaries, and in severe cases, it can reach the abdomen.

Its symptoms include:

Fever of 38 ºC or more;
Belly pain when palpated;
Vaginal bleeding outside the menstrual period or after sexual intercourse;
Smelly yellow or green vaginal discharge;
Pain during sex.

Cervical cancer

Cervical cancer affects the lower part of the uterus, called the cervix. In general, the woman has vaginal bleeding as one of the first signs of the change, but the onset of the disease tends to be asymptomatic.

When diagnosed early, cervical cancer or cervical cancer tends to have a good prognosis, in which it is usually necessary to remove the affected tissue through partial or total hysterectomy .

In advanced states, radiotherapy with chemotherapy is usually required.

Complications during pregnancy

Pregnant women should pay more attention to the risks of complications that trichomoniasis can bring, as they can affect both her and the fetus. Understand:

Premature delivery

When the infection happens during pregnancy, Trichomonas vaginalis can contaminate the amniotic fluid (fluid that surrounds the baby), which results in premature labor, due to the rupture of membranes in the pouch with the amniotic fluid.

This situation can cause problems for the baby. It is known that children who are born premature need much closer and differentiated care, as the risk of death is greater, as well as the risk of permanent disabilities, such as cerebral palsy .

Intrauterine infection

As we said earlier, Trichomonas vaginalis can end up causing an intrauterine infection, which happens when the infection reaches the baby while still in the womb.

In these cases, the baby may suffer from infections both in the genital area, as well as in the airways and lungs, which can pose risks after delivery.

How to prevent trichomoniasis?

As with all STDs, there are two ways to prevent trichomoniasis. One concerns the individual and the other concerns the actions that come from society. Understand:

Use a condom

Using a condom is an individual action that prevents you from being contaminated by trichomoniasis and other STDs, but it is also a collective measure, so that if you are infected and do not know it, you will not transmit the disease to other people.

It is also very important that if you know you are infected with trichomoniasis, it is not a good idea to have sex with other people, even with a condom.

As we pointed out earlier, the effectiveness of condoms varies from 85%, when not used correctly, to 98% when used correctly, so, even though they are low, the chances of transmission exist.

Maintain hygiene

Another very important factor for you to prevent trichomoniasis is hygiene. Regularly washing your towels, cleaning the bathroom in your home, paying attention to the use of public toilets, are actions you can take in order not to come in contact with Trichomona vaginalis .

Keeping up-to-date does not only help you avoid trichomoniasis, it improves your quality of life as a whole, as the risk of skin infections, for example, is significantly reduced.

Information campaigns and sex education

Sex is a taboo subject for most people. For this reason, informing them about STDs and their dangers can be a difficult task.

However, no matter how difficult it is to talk about the subject, it is very important that people know that unprotected sex can pose health hazards.

For this reason, information campaigns and sex education classes for young people of reproductive age are a great way to combat the incidence of these diseases in the population.

It is not a question of fomenting fear, as many believe, but of showing the paths to safe, informed and responsible sex.

Sometimes, infection with an STD is inevitable. As stated earlier, there is a chance that the condom will fail. So it is very important that people know what disease they are dealing with, if it has a cure, what treatment and what they should do to prevent it from spreading.

Living together

Approximately 1 in 5 people are infected again by T. vaginalis in the first 3 months after treatment, and among the causes of reinfection is the fact that the partner does not always carry out the treatment together.

In general, in cases where only the person with symptoms takes the medication, the partner is infected but without symptoms, causing trichomoniasis to be transmitted again soon after treatment.

Precisely in order not to be infected by the disease again it is important to learn how to treat it and avoid risk factors. As we saw earlier, it can be transmitted through contaminated objects, so maintaining hygiene, for example, is an important step to avoid accidental contamination.

Another important step is to reduce the frequency of sexual intercourse during treatment and, whenever you have sex, use a condom.

Common questions

Is it possible to acquire trichomoniasis due to low immunity?

Only because of the low immunity does not . Trichomoniasis is an STD. This means that contagion most likely happened because of sexual contact with an infected person (or, in rare cases, by sharing contaminated objects).

What happens is that low immunity can result in a more intense condition of the disease, that is, with worse symptoms.

Is it possible to be contaminated with just 1 relationship?

Yea! Trichomoniasis is transmitted through sexual contact and a single unprotected relationship with an infected person is sufficient for the infection to occur.

How long can an infected person transmit trichomoniasis?

Trichomoniasis is transmitted from the moment the person was infected until the moment their treatment was completed.

As, in many cases, the disease is asymptomatic, it can be transmitted without suspicion, so it is important to always use a condom, as your partner may not even know that you are transmitting the disease.

In cases where the patient is already taking the medication, it is recommended that you do not have sexual intercourse until the end of treatment and the end of symptoms.

Trichomoniasis is an STD that, fortunately, can be cured, but it should still be taken seriously, especially by pregnant women, as it can have consequences for both her and the baby.

Find out more about other STDs here, in the Healthy Minute!