Introduction
Trichomoniasis is a common sexually transmitted infection (STI) caused by a microscopic parasite. Despite being widespread, it often receives less attention than other STIs because many infected individuals have no symptoms. Untreated trichomoniasis can increase the risk of other sexually transmitted infections and lead to reproductive health complications, making awareness and early treatment essential.
What Is Trichomoniasis?
Trichomoniasis is caused by Trichomonas vaginalis, a single-celled protozoan parasite. The organism primarily infects the urogenital tract, affecting:
- The vagina and cervix in women
- The urethra (and occasionally the prostate) in men
The infection is transmitted almost exclusively through sexual contact.
Epidemiology and Global Burden
- Trichomoniasis is one of the most common curable STIs worldwide
- Prevalence is higher in sexually active adults
- Women are more frequently diagnosed than men
- Many cases remain undiagnosed due to lack of symptoms
In low- and middle-income countries, including parts of Africa, trichomoniasis remains underdiagnosed because of limited access to routine STI screening.
Modes of Transmission
Trichomoniasis spreads through:
- Vaginal sexual intercourse with an infected partner
- Sharing sex toys without proper cleaning or protection
The parasite does not survive well outside the human body, so transmission through toilets, towels, or swimming pools is extremely unlikely.
Signs and Symptoms
Approximately 50–70% of infected individuals have no symptoms, especially men.
Symptoms in Women
- Frothy, yellow-green vaginal discharge
- Strong or unpleasant vaginal odor
- Vaginal itching, burning, or irritation
- Pain during urination (dysuria)
- Pain during sexual intercourse
Symptoms in Men
- Mild urethral discharge
- Burning sensation during urination or ejaculation
- Itching or irritation inside the penis
Symptoms may appear 5–28 days after exposure but can occur much later.
Complications of Trichomoniasis
If left untreated, trichomoniasis can lead to:
- Increased risk of HIV acquisition and transmission
- Pelvic inflammatory disease (PID) in women
- Pregnancy complications such as:
- Preterm birth
- Low birth weight
- Chronic genital inflammation
- Prostatitis or urethritis in men
Diagnosis
Diagnosis is based on laboratory testing, which may include:
- Microscopic examination (wet mount) of vaginal fluid
- Rapid antigen tests
- Nucleic acid amplification tests (NAATs) – the most sensitive and accurate
- Urine tests or urethral swabs (especially in men)
Routine screening is recommended for individuals with symptoms or high-risk sexual behavior.
Treatment
Trichomoniasis is curable with appropriate antibiotics.
Recommended Medications
- Metronidazole
- Tinidazole
These are usually given as:
- A single high dose, or
- A multi-day course (often preferred in women)
Important Treatment Notes
- Sexual partners must be treated simultaneously
- Avoid sexual intercourse until treatment is completed and symptoms resolve
- Alcohol should be avoided during and shortly after treatment with metronidazole due to adverse reactions
Prevention
Effective prevention strategies include:
- Consistent and correct condom use
- Limiting the number of sexual partners
- Regular STI screening, especially for sexually active women
- Prompt treatment of infected individuals and their partners
- Avoiding unprotected sex during treatment
Trichomoniasis and Pregnancy
Pregnant women with trichomoniasis are at higher risk for:
- Preterm delivery
- Low birth weight infants
Treatment during pregnancy is considered safe and important, and pregnant women with symptoms should seek medical care promptly.
Public Health Importance
Because trichomoniasis often occurs without symptoms, it contributes significantly to ongoing STI transmission. Improved screening, education, and partner treatment are key components of STI control programs.
When to See a Doctor
Seek medical attention if:
- You notice unusual genital discharge or irritation
- You experience pain during urination or sex
- Your sexual partner is diagnosed with an STI
- You are pregnant and have symptoms suggestive of infection
Conclusion
Trichomoniasis is a common, curable, but often overlooked STI. Although many infected individuals have no symptoms, untreated infection can lead to serious reproductive and public health consequences. Early diagnosis, effective treatment, partner management, and preventive practices are essential to reduce transmission and protect
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