Symptoms of trichomoniasis in women, treatment
Women are the most vulnerable category to contracting trichomoniasis. This infection, affecting the genitourinary system, manifests itself most clearly in the female body. Trichomoniasis is often diagnosed during preventive examinations by a gynecologist, when examining pregnant women for registration. Trichomoniasis threatens with serious complications, including infertility. An untreated infection becomes chronic, its symptoms subside, and later the disease acquires worn-out symptoms.
- What is trichomoniasis and how can you get infected?
- Causes of trichomoniasis in women
- The first symptoms of trichomoniasis after infection
- Signs of chronic trichomoniasis in women
- What is the danger of trichomoniasis for women?
- Diagnosis of the disease
- Treatment of trichomoniasis in women
- Prevention of trichomoniasis
- Which doctor treats trichomoniasis?
What is trichomoniasis and how can you get infected?
Trichomoniasis in women refers to an STD (sexually transmitted disease). The causative agent of trichomoniasis is a unicellular bacterium of the protozoan class. Trichomonas can live in an anaerobic (airless) environment with an acidity of 5.5-6.5 pH. The contents of the vagina or urethra are the optimal environment for the active vital activity of the parasite. According to medical statistics, every tenth person on Earth is infected with trichomoniasis.
The disease is transmitted sexually during traditional unprotected sexual contact. The domestic route of infection is theoretically possible, but extremely rare. Ways of household infection - towels, washcloths, swimwear, common clothing, bed linen.
Causes of trichomoniasis in women
- The period of menstruation and a few days after it, when the vaginal environment changes its acidity;
- Condition after an abortion;
- Childbirth, and as a result - a violation of protection from the injured cervix;
- Sexual intercourse, accompanied by orgasm, when Trichomonas enter the uterine cavity along with cervical mucus.
Forms of trichomoniasis, depending on the duration of the disease and the symptoms manifested:
- "Fresh" urogenital infection (acute, subacute trichomoniasis, asymptomatic form);
- Chronic infection (with minimal clinical manifestations) - trichomoniasis passes into this phase 2 or more months after infection;
- Carriage of trichomoniasis (manifested by atypical symptoms) - revealed by the analysis of vaginal discharge.
Trichomoniasis in women rarely occurs in isolation (in 10% of cases). According to statistics, this infection is very often combined with other STDs: ureaplasmosis, gonorrhea, chlamydia, etc. Trichomonas, as it were, "absorbs" other, smaller viruses and bacteria with its cell, and promotes them into internal organs and tissues.
The form of the disease depends on how strong the immune system is. The range of carriage of trichomoniasis ranges from 2-41%.
The first symptoms of trichomoniasis after infection
The first symptoms of trichomoniasis in women appear 4-5 days after infection. The deadline for the end of the incubation period is 2 weeks. The symptoms of the initial phase of the disease depend on the place of localization of the pathogen - this is the cervix, urethra or vagina.
The main symptoms of trichomoniasis are:
Profuse, frothy vaginal discharge that is yellow-green in color
Unpleasant odor of discharge, when combined with gardnerella it takes on the smell of stale fish
Pain during intercourse
When the process spreads to the urethra, there is pain when urinating, burning, frequent urge
Burning sensation in the vagina, itching, hyperemia of the vulva
Lower abdominal pain (rarely diagnosed)
During a gynecological examination, the doctor sees the cervix, bleeding on contact with mirrors, an inflamed vaginal mucosa. These are symptoms of cervicitis and vulvovaginitis. Inspection of the cervix with a colposcope leads to the conclusion "strawberry cervix", as it has numerous hemorrhages from damage to the capillaries. An additional symptom of trichomoniasis is irritation by secretions on the inner surface of the thighs, the appearance of sores and abrasions on the skin.
Signs of chronic trichomoniasis in women
The transition of trichomoniasis to a chronic form occurs in the absence of treatment. This phase is characterized by the presence of exacerbations and a prolonged course.
Reasons for relapse:
- Decreased immunity due to somatic diseases, hypothermia;
- Ovarian hypofunction;
- Promiscuous sex life;
- Alcohol abuse;
- Gynecological pathologies.
Between periods of relapse, the signs of trichomoniasis are erased. An increase in the volume of discharge, discomfort in the vagina in everyday life and during sexual intercourse is possible. Symptoms of the disease with a relapse of the disease are similar to those of the acute phase.
What is the danger of trichomoniasis for women?
Consequences of the chronic course of the disease:
- Sexual disorders (lack of orgasm, sex drive);
- Oncological process in the tissues of the cervix;
- Pregnancy pathologies: fetal death during gestation or childbirth, premature pregnancy, chorioamnionitis;
- Infertility caused by obstruction of the tubes and inflammation of the appendages.
According to medical research, chronic trichomoniasis provokes diabetes mellitus, mastopathy, allergies, and oncological processes in the pelvic organs.
Diagnosis of the disease
Since trichomoniasis in women does not have specific symptoms inherent only to this infection, and occurs in a latent form, laboratory research methods are used to clarify the diagnosis.
- Gynecological and urological examination. A method of approximate diagnosis that requires confirmation. An experienced physician may suspect an infection for the following symptoms: frothy discharge in the posterior fornix of the vagina, reddened mucous membrane of the vagina and cervix with a tendency to bleed when touched.
- Direct microscopy. The main method for diagnosing the disease using colored and unstained preparations. Vaginal discharge, fresh urine sediment are used. Against the background of immobile leukocytes and epithelial cells, moving Trichomonas are clearly distinguishable during microscopic examination. The coloring of the preparation is carried out using non-traditional dyes. Conventional staining methods can lead to diagnostic errors.
Cultivation of Trichomonas on special media. The culture method involves the cultivation of Trichomonas in a nutrient medium. Urine or vaginal discharge from the patient is used. A week later, it becomes possible to identify a variety of microorganisms, their resistance to antibiotics. The method is considered the "gold standard" for diagnosing trichomoniasis, despite the long study period.
- Detection of antibodies. When bacteria enters the body, specific antibodies are formed in the human blood. Their definition confirms the presence of the disease. May lead to erroneous results for various reasons.
Serological methods for the determination of antibodies to Trichomonas in the blood:
- Enzyme-linked immunosorbent assay (ELISA) - enzymes are a signal label;
- Latex agglutination reaction - latex fragments impregnated with antigens to the disease are glued together in a special serum, confirming the presence of the disease. The method is auxiliary;
- Detection of antigens. Antigens to Trichomonas are detected after they are labeled with a special fluorescent reagent. The study is carried out using a special microscope;
Polymerase chain reaction. The PCR method is based on determining the presence of Trichomonas protein in the patient's secretions and urine. The analysis takes 45 minutes and is considered expensive but is the most reliable;
- Intradermal test. Trichomonas allergen is injected under the skin, the method is used to screen a large number of patients for trichomoniasis. Inaccurate, rarely used.
Treatment of trichomoniasis in women
When a woman is diagnosed with trichomoniasis, treatment is also given to her sex partner, regardless of whether the man has symptoms. During therapy, a strict ban is imposed on the use of alcohol and spicy foods with spices. Sexual rest is required until tests confirm the absence of infection in the couple.
Medicines for the treatment of trichomoniasis are prescribed by a doctor. Self-medication can lead to the transition of the disease into a latent form and the manifestation of side effects.
Trichomoniasis is treated with 5-nitroimidazole derivatives:
Medicines in the form of tablets must be combined with topical preparations:
- Metrogyl-gel vaginal;
- Suppositories with antitrichomonas action (Terzhinan, Betadin, Klion-D). They are used daily for 1-1.5 weeks.
- Suppositories Osarcid, Osarbon with osarsol to destroy the enzyme system of the bacteria (used in case of intolerance to tablets);
- Streptocide for relieving inflammation.
Disease treatment regimens:
- Fazizhin - 0.15 g 2 times a day for 7 days;
- Tinidazole - 4 pieces of 500 mg at the same time;
- Trichopolum - 500 mg 1-2 pcs. 2 times a day, course duration - 1-1.5 weeks.
Both acute and chronic trichomoniasis in women are treated according to the same scheme. Additionally, the doctor recommends immunomodulators, drugs such as tincture of aloe, aralia, eleutherococcus.
Monitoring the effectiveness of treatment is carried out in women after each menstruation for 3 months.
Prevention of trichomoniasis
The main route of transmission of trichomoniasis to a woman is unprotected sex with an infected person. The everyday route of infection, although theoretically possible, is extremely rare in practice. This is due to the fact that the bacterium is not able to survive in the normal human environment. Drying and temperatures above + 45 ° C are destructive for her. Adapted to life in the genitourinary system, Trichomonas dies in 3-5 minutes under the influence of disinfectants and antiseptics.
Preventive measures against household infection:
- Use of personal hygiene items;
- Thorough cleaning of common areas;
- Compliance with hygiene standards and rules;
- Periodic diagnostics to detect STDs;
- Following the doctor's recommendations in the treatment of genital infections.
In order for the bacterium to retain its ability to reproduce in the external environment, it must get to the place where high humidity and a comfortable temperature will be maintained for some time. Most often these are the conditions of a bathroom, bath, sauna. Through shared bath accessories and hygiene items, infection can spread from a sick person to a healthy person. Children, especially girls, are more at risk of domestic infection with trichomoniasis, receiving it from a sick mother through a shared towel.
- Compliance with personal hygiene. Carrying out regular bath procedures and washing significantly reduces the possibility of infection with trichomoniasis. This is especially important for the prevention of infection in everyday life;
- Use of personal hygiene items. Towels, underwear, washcloths are the most likely way of transmitting bacteria from a sick person to a healthy one. They should only be individual. Items available for disinfection with soap and hot water are washed after each use (linen, towels). Ironing with a hot iron will complete their disinfection, since Trichomonas dies at + 100 ° C in a few seconds. The washcloth should also only be individual, after use it must be dried;
- Carrying out regular cleaning. Wet cleaning with disinfectants and regular ventilation reduce the concentration of Trichomonas on various surfaces. The causative agents of the disease lose their activity and die;
- Periodic examination for sexually transmitted diseases. In order not to become a source of domestic infection with trichomoniasis, you should regularly check for the carriage of STDs. Detection of a hidden infection will help to quickly cure it without infecting others;
- Correct treatment of existing genital infections. Treatment of both sexual partners, careful implementation of the doctor's recommendations will help get rid of trichomoniasis as soon as possible. The course of antimicrobial therapy is calculated by the doctor depending on the intensity of infection and the presence of complications. During the treatment of trichomoniasis, women are prohibited from drinking alcohol and having sex. The success of treatment is assessed by the results of analyzes carried out several weeks after therapy.
Conditions in which trichomoniasis infection will never occur:
- Through a handshake. The bacterium cannot enter the body through the skin; it dies in the external environment. The main way of introducing Trichomonas is the mucous membranes.
- Through the blood. In human blood, Trichomonas cannot survive. That is why contact with the blood of a sick person is not dangerous if he does not have blood-borne diseases associated with trichomoniasis.
- During unconventional sex. Anal and oral sex are associated with the gastrointestinal tract, in which Trichomonas is unable to exist. This does not apply to other STD pathogens that enter through the gastrointestinal tract.
- During the kiss. The infection is not transmitted through the oral cavity, since the environment in it is unfavorable for the life of Trichomonas.
Prevention of infection through sexual contact is the most effective way to prevent trichomoniasis.
Protective measures against trichomoniasis:
- Abstaining from promiscuous sexual relations;
- Refusal from unprotected sex, using a condom;
- The use of bactericidal solutions to disinfect the genitals after accidental contact;
- Regular express diagnostics of genital infections;
- Avoiding genital intercourse with a partner you are not sure about. This preventive measure guarantees the safety of a woman from contracting trichomoniasis. In theory, non-traditional types of sex are considered safe in this regard. However, both with anal and oral sex without protection, you can acquire a genital infection that accompanies trichomoniasis. For HPV, chlamydia, gonorrhea and other infections, gastrointestinal conditions will not interfere with entry into the body;
- One healthy sexual partner who does not have sexually transmitted diseases reduces the risk of contracting trichomoniasis to zero. A complete STD test can take 2-3 months. For complete confidence, it is advisable to use a condom during this period;
- Choosing a barrier method of contraception. The most common way to protect a woman from trichomoniasis is by a man using a condom. There are rules for the use of this method of contraception, allowing you to achieve maximum protection. A condom is a disposable item, the packaging with which must not be opened with sharp objects. After the end of intercourse and the removal of the condom, the genitals should not be in contact with the partner. A slipped or torn condom must be replaced, preferably by treating the genitals with a bactericidal solution.
Drug prevention. If there is a questionable sexual contact in terms of safety, or sex with a partner known to have an STD, drug prophylaxis can be carried out in a dermatovenerologic dispensary. The doctor will introduce drugs to protect against the possible introduction of genital infectious agents into the body: trichomoniasis, gonorrhea, chlamydia, syphilis, etc. This prophylaxis does not work against HPV, genital herpes, and HIV viruses.
The use of bactericidal agents. To treat the genitals, thighs, perineum in case of dubious contact or in violation of the integrity of the condom, bactericidal preparations are used:
A full guarantee that a latent course of trichomoniasis does not occur in the body can be given by a regular check for the presence of an infectious agent. Such a diagnosis at an early stage will help to easily get rid of the disease, not become a source of infection for a partner, and prevent complications.
Which doctor treats trichomoniasis?
For examination and treatment of trichomoniasis, women turn to doctors of the following specialties:
At the first appointment, the doctor will conduct a visual examination of the genitals, take time to collect anamnesis, and prescribe the necessary laboratory examination of blood and other biological material. In women, vaginal discharge is analyzed, in men - the secretion of the prostate gland and discharge from the urethra.
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.