Trichomoniasis is a common sexually transmitted infection (STI) caused by a microscopic parasite called Trichomonas vaginalis. This infection is highly prevalent globally, with an estimated 156 million new cases among individuals aged 15-49 years in 2020. Many individuals with trichomoniasis do not experience noticeable symptoms, which contributes to its widespread transmission.
Understanding Trichomoniasis
It is caused by the parasite Trichomonas vaginalis. It is primarily transmitted through unprotected sexual contact, and can also spread through genital touching. The parasite most often infects the lower genital tract in women, including the vagina, vulva, cervix, and urethra, while in men, it typically infects the urethra.
Symptoms, if present, vary and usually appear between 5 and 28 days after exposure, though they may manifest much later. Many infected individuals, up to 70%, may not show symptoms, leading to unknowing transmission. In women, common signs include itching, burning, redness, or soreness of the genitals, a foul-smelling vaginal discharge, and discomfort during urination or sex. Men often remain asymptomatic, but can experience itching or irritation inside the penis, burning after urination or ejaculation, or discharge.
Trichomoniasis and Reproductive Health
Trichomoniasis is not considered a direct cause of infertility like some bacterial STIs that damage fallopian tubes. Its primary impact on reproductive health stems from the inflammation it causes in the reproductive tract. This inflammation, if severe or prolonged, could potentially create a less hospitable environment for conception.
Untreated or chronic trichomoniasis can lead to several indirect complications. It increases susceptibility to other STIs, including HIV, by causing genital inflammation and disrupting protective epithelial barriers. During pregnancy, it is associated with an increased risk of preterm birth and low birth weight. In men, the infection can cause urethritis, prostatitis, or epididymitis. Untreated cases may affect sperm quality or transport, contributing to male infertility, as Trichomonas vaginalis can reduce sperm survival, motility, and fertilization ability.
Treatment and Management
Diagnosing trichomoniasis involves identifying the Trichomonas vaginalis parasite in a fluid sample from the affected area. Initial diagnosis often uses microscopic examination of fluid samples. More sensitive methods, such as nucleic acid amplification tests (NAATs), detect the parasite’s genetic material and are considered highly accurate.
Treatment typically involves oral antibiotic medications, specifically metronidazole or tinidazole. These medications are highly effective. It is important that all sexual partners also receive treatment to prevent reinfection. Individuals should abstain from sexual activity until treatment is completed and symptoms have fully resolved for both themselves and their partners.
Preventive Measures
Preventing trichomoniasis involves practicing safer sex behaviors. Consistent and correct use of condoms during all sexual activity significantly reduces the risk of transmission. However, condoms may not cover all infected areas, so transmission can still occur.
Regular STI testing is also an important preventive measure, particularly for individuals with new or multiple sexual partners. Open communication with sexual partners about sexual health history helps ensure that both partners are aware of risks and can make informed decisions about prevention and testing.