Trichomonas in women - how to recognize and treat trichomoniasis?

Trichomoniasis is a disease of parasitic etiology, which has been known since ancient times. The disease is infected through sexual contact and becomes the cause of inflammation of the mucous membrane of the genitourinary tract in representatives of both sexes.

The root cause of the disease is a special type of microorganisms, which in science are called protozoa. In the human environment, there are many species of such protozoa. Some of them live in the aquatic environment, soil, others as parasites in the human body and animal organisms.

Causes of trichomoniasis: features of trichomonas

The content of the article

Trichomoniasis is caused by the bacterium Trichomonas vaginalis. Once in the body, Trichomonas provokes inflammation of the mucous membranes of the genitourinary system. This is one of the most common groups of bacteria that cause sexually transmitted diseases (STIs).

There are no exact statistics, but scientists believe that at the moment there are from 600 million to 1 billion people in the world infected or carrying the bacteria. Every year, more than 50 million cases of Trichomonas infection are registered worldwide.

This is an unusual bacterium. Trichomonas vaginalis is the simplest single-celled organism that forms colonies. By uniting, Trichomonas act as a whole organism. They attack mucous membranes and destroy lactic acid bacteria, which create the normal flora of mucous tissues. In total, three varieties of Trichomonas can be found in the human body, but only Trichomonas vaginalis is a dangerous variety capable of aggressive actions. Therefore, in tests for trichomoniasis, this particular subspecies is isolated.

Colonies of bacteria are localized in the lower genitourinary tract:

• Urethra;
• Vagina;
• Simple.

In the absence of proper treatment, bacteria spread throughout all organs of the genitourinary system, requiring comprehensive and targeted treatment.

General information

According to the latest statistics, trichomoniasis (or, as they also say, trichomoniasis) has “overtaken” gonorrhea in prevalence and is the most diagnosed sexually transmitted infection.

In the photo - the culprit of the disease

Its causative agent, Trichomonas vaginalis, is a representative of the biological group of protozoa and is a unicellular organism in structure.

It lives in the genitourinary tract of sick men and women and is transmitted:

• sexually (in 99% of cases);
• in close household contacts - extremely rarely, since Trichomonas are extremely unstable in the external environment;
• to the child from the mother at the time of birth (read more here).

Are you confident in your partner?

The disease is highly contagious: even with a single sexual act, the risk of infection is 60-70 for men and 80-100% for women. In most representatives of the stronger sex, this STD is asymptomatic, which is why they most often become carriers of Trichomonas.

This is interesting. According to WHO estimates, every tenth inhabitant of our planet suffers from trichomoniasis. Many people don't even know about it. Are you not one of them?

How can you become infected with trichomoniasis: routes of transmission

The main cause of trichomoniasis is classical sexual contact; the disease is not transmitted by kissing. As for the domestic route of infection, such cases in the practice of doctors are very rare and are usually questioned.

The risk of infection through unprotected contact is up to 70%. When using a condom, the risks are minimal, but still remain - 10%. A condom is not an absolute protection, so if Trichomonas is detected, it is imperative to check your sexual partner, even if he does not have any symptoms of the disease.

Household transmission through shared towels, sheets or toilet seats is 98% excluded. Trichomonas are poorly adapted to existence in the open air and can live no more than 15 minutes outside the human body. According to statistics, the percentage of people infected through household contact does not exceed 2% of all infections.

Complications

Until now, this disease was not taken so seriously and in vain.

To date, it has been clinically confirmed that these parasites affect the timing of pregnancy and premature rupture of labor fluid, as well as:

• Early birth;
• Reduced fetal weight at birth;
• Transfer of infection to the child as it passes through the birth canal.

In addition, there are reports that trichomoniasis increases the risk of contracting some serious diseases, including the human immunodeficiency virus (HIV), which causes AIDS.

How carrier status turns into disease

After entering the body, Trichomonas can remain in an incubation state for a long period of time, existing in small quantities on mucous tissues and without causing harm to the host. The development and active reproduction of bacteria occurs only in the event of a violation of the flora of mucous tissues.

In the normal state, the flora of the mucous membranes of the genital organs includes a large number of lactobacilli. Lactobacilli maintain the acid-base level of the environment of mucous tissues, which does not allow pathogenic (hazardous to health) microorganisms to multiply. When the acidity or composition of the flora changes (dysbacteriosis), Trichomonas receive an excellent opportunity for development and reproduction.

Changes in the level of acidity and composition of the flora occur for the following reasons:

• Violation of the rules of personal intimate hygiene;
• Using caustic cleaning agents - only special neutral products can be used;
• Promiscuous sexual intercourse with various partners;
• Lack of hygiene during menstruation - rarely changing tampons and pads;
• Frequent wearing of panty liners;
• Using synthetic, tight-fitting underwear;
• Hormonal imbalances during pregnancy.

Symptoms of trichomoniasis

When trichomonas enter the mucous membrane in an environment that is acceptable for their life, the bacteria secrete mucous substances to attach to the membrane. Also, during the life of bacteria, a specific enzyme is released, which leads to the breakdown of cells of the mucous membrane.

Violation of the mucous membrane provokes inflammation, which gives the following symptoms:

• Swelling of the mucous membranes;
• Redness of the mucous membrane;
• Detachment of the surface layer of cells;
• Subfebrile (from 37.1 to 38 degrees) temperature;
• Unpleasant sensations, itching, burning.

Inflammation is caused by the body's natural defense reaction. The bacterium is attacked by biologically active substances of immune cells, which contribute to irritation of nerve endings. Trichomoniasis manifests itself differently in women and men.

Folk remedies

No matter what “healers” and “healers” say on various forums, it is impossible to cure trichomoniasis (as, indeed, any other intimate disease transmitted from an infected sexual partner to a healthy one) using folk remedies.
It has been said more than once in previous blocks, but it’s worth repeating again: self-treatment at home is unacceptable. Remedies whose properties and recipes were passed down to us from our grandparents can only slightly help official medicine support the body or relieve inflammation from the mucous membranes. But taking them will not get rid of the disease.

Symptoms of Trichomonas infection in women

After Trichomonas enters the female body, the development of the disease begins with damage to the vaginal flora, then the bacteria spread to the urinary ducts, bladder and other mucous tissues of the genitourinary system.

Symptoms of the disease with varying intensity appear 5-7 days after infection; the incubation period of bacteria ends 30 days after entering the body. After this period, pronounced symptoms can be observed.

Trichomoniasis manifests itself in the form of trichomonas colpitis or vaginitis - vaginal dysbiosis, leading to inflammation of the surface layers of the vaginal mucosa.

An infected woman will experience:

• unpleasant-smelling vaginal discharge, discharge has a yellowish tint;
• burning sensation or severe itching on the outer surface of the genitals;
• characteristic pain during urination or sexual intercourse;
• increased sensitivity of the outer walls of the vagina to injury and other factors,
• which is manifested by bleeding and purulent discharge.

With vaginitis caused by Trichomonas, the following symptoms of the disease appear:

• Unpleasant-smelling discharge with a foamy structure. May be yellow or gray, depending on the stage of the disease. Foam occurs due to bacteria that produce gas during their life processes.
• A feeling of severe itching and burning localized in the vaginal area is a sign of inflammation of the mucous membrane.
• Redness of the skin of the labia and around.

Women who are sexually active are susceptible to the disease. Age from 18 to 45 years. Vivid symptoms and vaginitis appear in cases of weakened immunity, leading to rapid dysbiosis of the vaginal flora. With good immunity, the disease can manifest itself with minimal symptoms, or occur in a latent, chronic form. In this case, moments of exacerbation may occur in the period before menstruation.

If symptoms of trichomoniasis are detected, regardless of their intensity, you should immediately contact a gynecologist.

Epidemiology

How can you become infected with trichomoniasis and how is trichomonas transmitted? The source of infection is a sick person or carrier. Infection in the vast majority of cases occurs through sexual contact. Other routes of infection with trichomoniasis are extremely rare:

• Transmission of trichomoniasis through household contact as a result of indirect contact through toilet items, gloves, bedpans, oilcloths and toilet seats, chamber pots, infected linen, etc.
• It is even less common for newborn girls to become infected when passing through the mother’s infected birth canal.

The greatest significance in the epidemic process is played by sluggish, low-symptomatic forms of the disease and trichomonas carriage, in which there are no signs of inflammation, and trichomonas are not detected in the smear and are detected in the analysis only when the disease relapses in sexual partners. It should be noted that Trichomonas carriage is not an ordinary transient carriage of protozoa, but is a systemic active infectious process with a reaction of T. vaginalis to a pathogenic factor with suppression of the immune response to infection, due to the antigenic affinity of T. vaginalis with certain human tissues. It is Trichomonas carriage that contributes to the active epidemiological spread of the pathogen among sexual partners. According to the survey data, the carriage frequency among the examined women ranges from 10-35% and 5-41% among men.

According to various authors, trichomoniasis occurs as a monoinfection in 3-15% of cases; it is more often observed in combination with other STIs (on average in 86.5% of patients): gonorrhea , chlamydia , candidiasis , mycoplasmosis , etc. Moreover, it has been established that that Trichomonas can be carriers of viruses: herpes simplex, human papillomavirus. After attachment to the vaginal epithelium, T. vaginalis enhances the processes of desquamation and loosening of the epithelium, which contributes to the rapid invasion of bacterial flora with the development of mixed infectious lesions.

The causes of Trichomonas in women/men are the practice of unprotected sex, indiscriminate choice of sexual partners, and alcohol/psychoactive substance abuse.

It is important to consider that Trichomonas vaginalis produce highly immunogenic antigens that can neutralize cytotoxic T lymphocytes and antibodies. Also, trichomonas are characterized by antigenic mimicry (the ability to sorb plasma proteins on their surface), which does not allow the immune system to identify them as foreign organisms. That is, trichomonas infection does not lead to the development of a pronounced immune response, and the detection of serum/secretory antibodies in recovered individuals only indicates a past/existing infection, but is not capable of providing lasting immunity.

The resistance of Trichomonas vaginalis to unfavorable environmental conditions is insignificant. They die quickly (within 10 minutes) at a temperature of 45-50°C and instantly at 60°C. T. vaginalis are more resistant to low temperatures: at temperatures down to –10°C they remain viable for up to 45 minutes. Trichomonas can survive for a long time and do not tolerate drying well, but are viable in a humid environment (sponges/cotton fabrics). They die instantly when surfaces are treated with antiseptic agents. On rubber gloves/gynecological speculum, Trichomonas can remain viable for 5-30 minutes.

Predisposing factors for the development of the disease in women include a shift in pH to the alkaline side, hormonal deficiency, vitamin disorders, and concomitant diseases of the genitourinary tract. The incubation period of urogenital trichomoniasis can vary from two to three days to a month, averaging 10 days.

Symptoms of trichomoniasis in men

During unprotected sexual intercourse, Trichomonas enter the urethra. If the bacteria take root, they may spread deep into the canal to the prostate. When it comes into contact with the prostate, inflammation begins, leading to acute or chronic prostatitis.

In the male body, in most cases the disease is practically asymptomatic. In rare cases, there may be discharge from the urethra and pain when urinating. In cases where the disease affects the prostate gland, the symptoms of Trichomonas can be completely similar to prostatitis.

At the stage of chronic trichomoniasis, urethritis appears, accompanied by the following symptoms:

• Burning in the urethra after urination;
• Mucus or foamy discharge;
• Difficulty passing urine accompanied by pain or tension in the abdomen;
• Feeling of bladder fullness after urination.

Trichomonas is transmitted to men in 65-70% of unprotected sexual contacts with a carrier of the infection. Microorganisms often leave the body naturally. A week after infection, Trichomonas disease is detected in only 30% of men. This is due to the fact that the flora inside the urethra does not meet the conditions necessary for the reproduction of Trichomonas.

In men infected with Trichomonas, trichomoniasis can occur in a latent, chronic form, asymptomatic or with minimal symptoms until exacerbation caused by decreased immunity. In this case, the man will act as a carrier of infection.

Consequences of trichomoniasis during pregnancy

Trichomoniasis during pregnancy has a number of serious consequences. Exposure to bacteria on the organs of the genitourinary system during pregnancy, as well as at the stage of conception, can lead to the following problems:

• Sperm phagocytosis is a reaction of the immune system during an inflammatory process. The concentration of macrophages and neutrophils – cells that ensure the destruction of the source of inflammation – increases. Along with pathogenic bacteria, the immune system also destroys sperm, which leads to male infertility.
• Reduced sperm motility - Trichomonas actively secrete toxic metabolic products that inhibit sperm.
• Miscarriage - due to the effects of Trichomonas, prostaglandins are released into the blood - substances that provoke contractions of the muscular system of the uterus, which can result in spontaneous abortion;
• Premature birth - due to the reason described above, due to the increased tone of the uterus, it is possible to provoke premature birth.

Thus, at the stage of pregnancy planning, it is imperative to be tested for Trichomonas and undergo a course of treatment.

Control tests are required

Currently, there are two indicators of “cure” from trichomoniasis:

• clinical – complete disappearance of symptoms of the disease;
• etiological – eradication of the pathogen from the body.

Get tested even if you feel completely healthy

Even if there are no clinical manifestations of the disease, the patient must undergo a follow-up examination to ensure that trichomoniasis is completely defeated. As a rule, dermatovenerologists recommend re-submitting biomaterial for PCR or bacterial culture.

Negative results from these tests are almost 100% likely to indicate that the disease has been cured.

Diagnosis of trichomoniasis: how to identify trichomonas

You should not lead the disease to complications; to detect trichomoniasis in a timely manner, it is enough to visit a doctor for preventive purposes and take a smear for infections. Well, if you start to experience the first symptoms, you should contact the clinic immediately.

If symptoms similar to trichomoniasis are detected, a specialist (gynecologist or urologist) prescribes tests to identify pathogenic organisms in the flora

Trichomoniasis can be diagnosed at any stage, for this purpose the following are carried out:

• Study of the drug (discharge from the urethra, vagina) at the microscopic level, using the Gram and Romanovsky-Giemsa method;
• Biological and molecular studies NASBA and PCR, etc.

The most accurate way to detect Trichomonas is to go through several stages of testing.

Popular tests for Trichomonas

• Microscopic examination method
  - for diagnosis, biomaterials are taken for analysis. For women - a smear from the posterior vaginal vault, cervical canal, urethra. In men, a scraping is taken from the urethra, prostate secretions and seminal fluid. The study is performed under a microscope. A 0.9% sodium chloride solution is added to the taken materials, after which the microorganisms change color and can be seen during examination. The advantage of the method is its efficiency: research must be carried out within no more than 30 minutes from the moment the material is taken.

Photo by isis325

• The method of cultivating Trichomonas
  is a smear containing biological material from the patient’s body and is placed in a special nutrient medium to accelerate the development of microorganisms. After some time, the flora is examined and if initially there were Trichomonas in the sample, their number increases significantly, allowing us to speak with confidence about the presence of bacteria in the body. The method allows you to diagnose the degree of infection, the stage of the disease, and also identify the most effective drug for killing bacteria.
• PCR method - for research, any biological fluids are taken, from a vaginal smear to a blood test. The study searches for DNA and RNA of pathogenic microorganisms. The advantage of the technique is the ability to detect Trichomonas, even if the disease is asymptomatic or in a chronic stage. The method is the most expensive, but very accurate.

Each method has its own advantages and differs in effectiveness and time to obtain results. Diagnosis is prescribed by the attending physician, gynecologist or urologist after a visual examination.

List of sources

• Kopylov V.M., Bochkarev E.G., Govorun V.M. and others. Urogenital trichomoniasis. Current issues of diagnosis and treatment (a manual for doctors). M., 2001. 40 p.
• Gritsenko V.A., Andreychev V.V. Urogenital trichomoniasis in men: 1. Characteristics of the pathogen and epidemiological features. Bulletin of the Orenburg Scientific Center of the Ural Branch of the Russian Academy of Sciences (electronic journal). 2013. No. 4: 1-14.
• Kisina V.I. Urogenital trichomoniasis - terminology, classification, treatment. Consilium Medicum. 2002. 4 (5): 2-7.
• Dmitriev G.A., Syuch N.I. Urogenital trichomoniasis (clinical and laboratory examination and patient management). M.: Medical book, 2005. 128 p.
• Ravodin R.A., Telichko I.N. Urogenital trichomoniasis: etiology, classification, clinical picture, diagnosis, treatment. Medline express. 2006. 1: 40-46.

Treatment of trichomoniasis: comprehensive treatment

The simplicity of the structure of Trichomonas is deceptive - these are the oldest bacteria, coexisting with humans for millions of years. This is due to their resistance to drugs. Treatment of trichomoniasis is prescribed by the doctor individually for each patient, based on the results of his examination. The wellness course must be carried out comprehensively, in three stages, and until complete recovery, otherwise the disease, after some time, will be able to manifest itself again. Monitoring of cure is mandatory.

• Antimicrobial drugs taken orally or intravenously are used to treat the infection. In some cases, combined use of drugs in various forms is required to provide local and general effects.
• When using strong antibiotics, women may develop thrush; the gynecologist should take this into account and, if necessary, prescribe vaginal suppositories to combat the fungus and special preparations containing lactic acid bacteria. Drugs can be prescribed in the form of suppositories or douching solutions.
• Treatment must be supplemented with local treatment: tampons, baths, urethral and bladder installations, suppositories.
• In cases of acute form, the course of treatment requires additional procedures, such as prostate massage, physical and immunotherapy, and instillation of the urinary canal. In any case, you should not self-medicate.

The general course of treatment lasts from 2 weeks to 1 month, depending on the effectiveness of the selected drugs and the patient’s immune system. Under no circumstances should you self-medicate. An error in choosing a drug and insufficient dosage will lead to stimulation of the bacteria’s immunity to the drugs used, which in the future will only complicate treatment.

If the patient has a regular sexual partner, he should also be examined by a specialist and, if necessary, undergo a course of treatment.

Medications

Trichomoniasis (symptoms in women will help the doctor determine the extent of the spread of pathological processes) is treated under the supervision of a gynecologist, venereologist or urologist. Therapy is selected after a full examination, based on the results obtained, taking into account the individual characteristics of the patient.

The specialist prescribes antimicrobial agents. If there are no serious contraindications, you can use traditional methods. In some situations, physiotherapeutic procedures are indicated. It is important that both partners undergo treatment.

Treatment of trichomoniasis involves the use of the following drugs:

Symptomatic therapy involves taking painkillers and antispasmodics if the disease disrupts a woman’s normal functioning. Along with antibacterial drugs, patients are prescribed hepatoprotectors and bifidobacteria to restore beneficial microflora.

Sexual intimacy during treatment is contraindicated.

It is recommended to strictly observe the rules of personal hygiene and change towels and linen every day. It is necessary to exclude bad habits (alcohol and cigarettes) during therapy; they interfere with the effects of antibacterial drugs. The doctor also advises you to follow a diet. Avoid fried, salty and fatty foods.

If you violate the specialist’s recommendations, the risk of relapse of trichomoniasis increases. After therapy, control diagnostics are carried out to fully ensure the positive effect of the treatment.

Diet and restrictions

Also, while taking medications, the specialist will recommend a diet and introduce some restrictions. In particular, recommendations may be of the following nature:

• Eliminate fried, fatty, spicy foods from the diet;
• Add fermented milk products that help restore lactobacilli;
• Strictly refrain from intimacy, since during treatment the flora is most vulnerable and there is a risk of getting an additional infection or fungus.

Following these recommendations will speed up treatment and achieve the best result with minimal discomfort to the body.

Trichomoniasis can be prevented: preventive measures

To prevent the disease, you must adhere to simple rules in intimacy and lead a healthy lifestyle:

• Be careful during sexual intercourse, do not be promiscuous, it is better to choose a single partner - mutual trust and honesty are the best cure for sexually transmitted diseases;
• Use a condom during sexual intercourse, use contraception correctly;
• Follow the rules of intimate hygiene - taking a shower and changing linen every day, using soap made from natural ingredients;
• Timely treatment of any urological diseases that provoke vaginal dysbiosis.
• Be examined annually by a gynecologist or urologist, and consult a specialist when the first alarming symptoms appear.

By adhering to these simple rules, you can avoid most sexually transmitted diseases and reduce the risk of dysbacteriosis and related infections.

Prevention

The two main rules for preventing sexually transmitted infectious diseases are limiting the number of sexual partners and using a condom.

If unprotected sex was with a casual partner, it is necessary to treat the genitals with miramistin or chlorhexedine (0.05% aqueous solution) at the first opportunity. This is not recommended to be done regularly - frequent douching with these solutions can lead to vaginal dysbiosis. Sexually active people without a regular partner should regularly visit a dermatologist-venereologist.