Trichomoniasis (patient information)

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Overview
Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. It affects both women and men, but symptoms are more common in women. Symptoms in women include a green or yellow discharge from the vagina, itching in or near the vagina and discomfort with urination. Most men with trichomoniasis don't have any symptoms, but it can cause irritation inside the penis. You can cure trichomoniasis with antibiotics. In men, the infection usually goes away on its own without causing symptoms. But an infected man can continue to infect or reinfect a woman until he gets treated. So it's important that both partners get treated at the same time. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading trichomoniasis.

What causes Trichomoniasis?
Trichomoniasis is found worldwide. In the United States, the highest number of cases are seen in women between age 16 and 35. Trichomonas vaginalis is spread through sexual contact with an infected partner. This includes penis-to-vagina intercourse or vulva-to-vulva contact. The parasite cannot survive in the mouth or rectum.

The disease can affect both men and women, but the symptoms differ between the two groups. The infection usually does not cause symptoms in men and goes away on its own in a few weeks.

What are the symptoms of Trichomoniasis?
Women:
 * Discomfort with intercourse
 * Itching of the inner thighs
 * Vaginal discharge (thin, greenish-yellow, frothy or foamy)
 * Vaginal itching
 * Vulvar itching or swelling of the labia
 * Vaginal odor (foul or strong smell)

Men: Occasionally, some men with trichomoniasis may develop prostatitis or epididymitis from the infection.
 * Burning after urination or ejaculation
 * Itching of urethra
 * Slight discharge from urethra

Who is at highest risk?
Women between the ages of 16-35 make up the largest demographic affected by Trichomoniasis. Other at-risk groups include persons with a compromised immune system, sexually active individuals engaging with multiple partners, and sexually active individuals who do not use condoms consistently and effectively.

When to seek urgent medical care?
Call for an appointment with your health care provider if any unusual vaginal discharge or irritation is noted. Also call for an appointment if you suspect that you have been exposed to the disease.

Diagnosis
In women: A pelvic examination shows red blotches on the vaginal wall or cervix. A wet prep (microscopic examination of discharge) shows the infection-causing organisms in vaginal fluids. A pap smear may also diagnose the condition.

In men: The disease can be hard to diagnose in men. Men are treated if the infection is diagnosed in any of their sexual partners. Men may also be treated if they have ongoing symptoms of urethral burning or itching despite treatment for gonorrhea and chlamydia.

Treatment options
The antibiotic metronidazole is commonly used to cure the infection. A newer drug, called Tinidazole may be used.

You should not drink alcohol while taking the medicine and for 48 hours afterwards. Doing so can cause severe nausea, abdominal pain, and vomiting.

Avoid sexual intercourse until treatment has been completed. Sexual partners should be treated at the same time, even if they have no symptoms.

Where to find medical care for Trichomoniasis?
Directions to Hospitals Treating Trichomoniasis

What to expect (Outlook/Prognosis)?
With proper treatment, the outcome is likely to be excellent. Individuals, generally, make a full recovery.

Possible complications
Long-term infection may cause changes in the tissue on the cervix. These changes may be seen on a routine Pap smear. In such cases, treatment should be started and the Pap smear repeated 3 to 6 months later. Treatment of trichomoniasis helps prevents the spread of the disease to sexual partners. Trichomoniasis is common among persons with HIV.

Prevention
A monogamous sexual relationship with a known healthy partner can help reduce the risk of sexually transmitted infections, including trichomoniasis. Other than total abstinence, condoms remain the best and most reliable protection against sexually transmitted infections. Condoms must be used consistently and correctly to be effective.