Trichomoniasis is a common sexually transmitted infection (STI) caused by a microscopic parasite called Trichomonas vaginalis. This infection is highly treatable with medication. Prompt treatment manages symptoms and prevents complications.
Understanding Trichomoniasis
Trichomoniasis spreads through sexual contact, primarily during vaginal sex. The parasite does not commonly infect other body parts. Many infected individuals (70-80%) are asymptomatic, leading to unknowing spread.
Symptoms typically manifest 5 to 28 days after exposure. For women, common symptoms include foul-smelling vaginal discharge (thin, frothy, white, yellow, or greenish), itching, burning, redness, soreness, or discomfort during urination and intercourse. Men, often asymptomatic, may experience penile irritation, discharge, or burning after urinating or ejaculating.
How Trichomoniasis Affects Fertility
Untreated trichomoniasis can impact fertility in women and men. In women, infection can inflame the reproductive tract, including the cervix, uterus, and fallopian tubes. This inflammation creates an unfavorable environment for conception and increases PID risk. PID can scar and block fallopian tubes, hindering pregnancy.
The parasite can alter the vaginal microbiome, affecting egg quality and fertilization. In some unexplained infertility cases, asymptomatic trichomoniasis has been linked to failed embryo implantation. While not an absolute barrier, persistent infection complicates female reproductive health.
In men, trichomoniasis can affect reproductive health, though its fertility impact is generally less pronounced. Studies show the parasite reduces sperm motility, viability, and normal morphology. It can inflame the male reproductive tract (e.g., urethritis, epididymitis, prostatitis), compromising sperm quality and transport. Proteins secreted by Trichomonas vaginalis also decrease sperm survival and fertilization ability.
Diagnosis and Treatment Approaches
Diagnosis involves medical history and physical exam. Vaginal or penile discharge samples may be collected for testing. A wet mount, a microscopic exam of a fresh sample, quickly identifies the parasite but may miss low numbers.
More sensitive options include nucleic acid amplification tests (NAATs), the gold standard for detecting the parasite’s genetic material from urine or swabs. Rapid antigen tests also provide quick results. If diagnosed, providers often test for other STIs.
Standard treatment involves oral antibiotics, primarily metronidazole or tinidazole. These medications are highly effective (84-98% cure rates). A single 2-gram dose is often prescribed; a 7-day course may also be used. All sexual partners must be treated simultaneously to prevent re-infection. Abstinence for about one week after treatment ensures medication works and symptoms resolve.
Safeguarding Reproductive Health
Preventing trichomoniasis and other STIs involves safer sex. Consistent condom use significantly reduces transmission risk. Limiting sexual partners and mutually monogamous relationships with tested partners also lowers infection risk. Regular STI screening is important for sexually active individuals, as many cases are asymptomatic.
Prompt diagnosis and treatment are crucial if symptoms appear or exposure is suspected. Untreated trichomoniasis increases the risk of acquiring or transmitting other STIs, including HIV. During pregnancy, untreated trichomoniasis is associated with adverse outcomes like premature labor, low birth weight, and premature rupture of membranes. Fortunately, metronidazole or tinidazole treatment is generally safe during pregnancy, preventing these complications. Treating the infection before delivery can also reduce the rare chance of transmitting the parasite to the baby.