Nepal Health Research and Innovation foundation

Trichomoniasis: Everything You Always Wanted To Know

What Is Trichomoniasis? Trichomoniasis or Trich is a common infection of the reproductive organs. It spreads by a sexual contact with the infected person. For this reason, it a type of sexually transmitted infection(STI). Women are invariably at a greater risk. However, it is not exclusive to them only. Men who have an unprotected sex with an infected partner can get it. But the infection in men mostly goes unnoticed. Though a very common condition, not many authentic data are available. Additionally, a higher rate of underdiagnosis further reduces the event of a successful treatment. You should understand that it is curable and preventable STI. What Causes Trichomoniasis? The cause of Trichomoniasis is Trichomonas vaginalis. It belongs to a class of microorganism known as protozoa. This single-celled organism resides in women in their vagina, urethra and the glands there. This is the reason why many of them with an active infection also develop a urethral infection. How To Recognize Trichomoniasis? Identifying trichomoniasis is essentially not an easy task. It is because the signs of trichomoniasis often overlap with those of other conditions. Most commonly, another infection of the vagina, bacterial vaginosis, is really close when it comes to the physical manifestations. If you are a female, watch for the following signs. Following an exposure, they take up to a month to become noticeable. Take an extra care if you indulge in frequent sexual activities.

Yellowish discharge from the vagina which smells bad. Depending on specific cases, the trichomoniasis discharge can be thick and large in amount, or thin and too little.
Inflammation and itching in the areas near the vagina.
Pain or discomfort in the lower region of the abdomen.
Strawberry cervix is another common sign in women. In this, the uterus appears like a strawberry.

On the other hand, most men will not develop any noticeable symptom even if they are harboring the causative organism. Pain during urination and discharge from the penis may indicate an active infection. But further tests can only confirm the diagnosis. When To Seek Help? Not all the cases are dangerous. Nonetheless, there are certain conditions or signs that may be pointing towards a potential health complication. They include:

Pregnancy: A pregnant woman with any abnormal signs should call the doctor immediately. There is no benefit delaying a professional consultation at this sensitive time.
Fever along with lower abdominal pain.

What Are The Tests For Trichomoniasis? Only evaluation of the signs is not enough to confirm the diagnosis. For this reason, the doctors recommend further tests. These include:

Test that includes vaginal swab. They take a sample of the vaginal discharge using a cotton swab. Then, further studies determine if the causative organism is present there.
For male patients, analysis of the first urine in the morning may give a confirmatory result. This is called “first-void” urine analysis.
Another sophisticated test called Nucleic acid amplification test (NAAT) is very sensitive. That way, it gives a more accurate diagnosis. Talk to your doctor if it is suitable for you.

Quick Facts On Trichomoniasis

Globally, it is the most common sexually transmitted disease that is caused by a microorganism other than a virus.
Metronidazole and a similar medication tinidazole are the standard treatments. They are given by an oral route.
According to the Centers for Disease Control and Prevention (CDC), approximately 3.7 million Americans have it. However, only 30% of them report the symptoms.
20% of the patients who have a successful treatment of Trichomoniasis get a second infection within the next few months.
It is more common in women than in men. Additionally, older women are at a greater risk. The age range for women is 14 to 49 years.
Every year in the US, approximately one million new cases are added.
A patient with Trichomonas has 6 times higher risk of getting syphilis compared to a normal person. In the case of HIV, the risk is multiplied by 13 times. Likewise, the risk of PID is increased by 2 folds.
Age, race, and age at the first sex are the top risk factors for Trichomoniasis in men.
There are reports of its transmission to the infant from an infected mother.
Trichomoniasis costs US women approximately $19 million per year. In the same way, the health costs of the potential complications go past the billion dollar mark.

Latest Updates On Trichomoniasis

Women may be naturally in a better position to fight the Trichomoniasis parasite. Researchers at the University of Auckland, New Zealand suggest “lactic acid” in the vagina may provide an inherent protection against T. vaginalis. They believe this could lead to further developments in the treatment of this common STI.
Older women may be at a greater risk than their counterparts in their 20s. In fact, the investigators recommend a routine screening test for all the sexually active women who are 40 years or older.
The Centers for Disease Control and Prevention (CDC) has recently trichomoniasis in the list of the top 5 parasitic infections that require special care. The others in the list are Chagas disease, cysticercosis, toxocariasis, and toxoplasmosis. As a matter of fact, parasitic infections do not garner as much attention as the bacterial and viral infections. Nevertheless, they pose significant health risks and economic burden. The changing health priorities mean we can expect more funding for the research activities and hence better treatment options.

Why Metronidazole And Tinidazole Are Not Working Against Trichomoniasis?

Failure to comply with the dosing instructions: Treatment failure is more likely if you do not follow the instructions from your doctor. Intake of lower doses causes low blood levels. As a result, you may not achieve the desired results.
An infection that returns after a recovery from the first event: Recurrent infection does not respond well to metronidazole.
No treatment of sexual partners: Treating your partner is of paramount importance to avoid a reinfection. In fact, both you and your partner should get the treatment at the same time.
Drug resistance: There is an increasing evidence that treatment-resistant strains of Trichomonas vaginalis are growing at an alarming rate. Particularly, it may happen if you use the prescribed medicine irrationally.

What Are Your Options If Trichomoniasis Does Not Respond To Metronidazole? Currently, no vaccine is available to prevent trichomoniasis. In addition, the increasing events of drug resistance have surely raised a question about the future invasion of this common infection. The US FDA does not approve any other oral medication to treat it. Here are some alternative options:

Paromomycin and furazolidone by the oral route. Regrettably, the rate of their absorption in the digestive tract is low. As a result, you may not be able to achieve an effective blood concentration of the drug.
Povidone iodine solution which is given by intravaginal route.
Few studies show nitazoxanide may be an option for the patients who have not benefitted from metronidazole or tinidazole. It works against a wide range of parasites and virus. It is available in the form of an oral tablet or a suspension. Again, the problem is with its reduced absorption from the digestive tract.

Key Takeaways Treating a resistant infection is a mounting challenge for the clinicians. To make things worse, some patients are allergic to metronidazole or other medications in the same class. Other highly effective medications such as povidone iodine are not available for oral consumption. In addition, the absorption profile of nitazoxanide is weak. Therefore, talk to your doctor about the problems, if you have any. They can suggest alternatives on the basis of their experience and availability of the resources. Finally, the situation also sheds light on the need for an effective alternative oral therapy for Trichomoniasis. Can You Prevent Trichomoniasis? The only way to keep away from it is to abstain from all the sexual activities. Naturally, this is not the best solution to the problem. Consider the following measures if you are sexually active.

Use a latex condom every time you have sex. Make sure to use it properly. Unfortunately, this approach does not provide a complete protection. The parasite can infect other areas of the body that the condom does not cover.
Cut down on the number of the sex partners. Instead, keep the sexual activities limited to only trusted partners.

Home Remedies For trichomoniasis As a matter of fact, there are no home remedies for Trichomoniasis. Nonetheless, you may consider some measures if they suit you. In any case, do not use them for a long time or in combination with the locally applied medications. Discontinue them if the symptoms worsen or you have a trouble. Here are some home remedies you may try:

Tea tree oil: It may work by virtue of its antimicrobial property. Dilute it with olive or almond oil first. Then apply a little amount on the vagina. If you have irritation, stop using it completely.
Bergamot essential oil: Add a few drops in the warm water bath.
Garlic: Taking a garlic clove or its pill regularly helps to strengthen your immunity. However, if you have any chronic illness or medications for them, consult your doctor in advance. In fact, there are many known interactions between garlic and prescription as well as OTC medications.
Yogurt: It is a natural probiotic containing a healthy dose of beneficial bacteria. For this reason, it enhances your immune functions. Make sure to take a cup every day.
Stay hydrated: Increase your water intake to make the immune cells active.
Eat citrus fruits like lemon, orange, and grapefruit. They are rich in Vit. C which is an immune booster.

In addition, do not use vaginal douching. It may cause more damages to the vaginal tissues. Also, avoid sharing towels and other washcloths. How Do You Get Trichomoniasis? You can get Trichomoniasis if you have an unprotected sex with the infected person. However, the risk still persists even if you use a condom during the intercourse. In an infected woman, the parasite may be found in the vulva, vagina, cervix, or urethra. Likewise, males have it inside their penis. When any infected person has sex with another healthy person, the parasite can pass into the latter. In addition, it may also infect other body parts like hands, mouth, or anus. Whether or not you will get an infection after the exposure depends on a multitude of the factors. They include age, general health status and of course, your immune function. Indeed, a person with a healthy immune function is always less likely to catch an infection. Complications Of Trichomoniasis

Increased risk of catching HIV/AIDS: The higher risk corresponds to the damages in the protective barrier in the vagina. Moreover, you may also be more susceptible to other STIs. They include gonorrhea, chlamydia, and bacterial vaginosis.
A 2016 study published in the SAGE Open Medical Case Reports suggests it can also cause pharyngitis in some cases. However, the cases are not very serious. In fact, it responds to the treatment with oral Metronidazole.
If you do not treat it in a timely manner, you may get a more serious condition. This is known as Pelvic Inflammatory Disease (PID). In turn, PID may lead to infertility. Infected women may also develop fertility problems even if they do not have PID.
Chances of low birth-weight baby and/or premature delivery. This is when you become infected during the pregnancy.
In men, an untreated Trichomoniasis may result in the inflammation of the tube that carries sperm. This is called epididymitis. Additionally, some patients may develop prostatitis. This refers to the inflammation of the prostate gland. A few studies also link it with prostate cancer.