What is trichomoniasis?

Trichomoniasis or "Trich"  is an infection caused by  the organism Trichomonas vaginalis. This is a single celled flagellated protozoan. The  most common clinical presentation of Trichomonas infection  is vaginitis. The American Social Health Association has  estimated that there are about 7.4  million new cases of Trichomoniasis each year in the USA. 

Men and women can be infected by this organism but men rarely exhibit any symptoms. 

It  is more common in uncircumcised men than those  who have been circumcised. The occasional symptoms that men do exhibit with this infection are a mild urethral discharge, urethral irritation and a burning sensation on urination or ejaculation. 

The symptoms in women are much more obvious. There  is usually a profuse, odorous, frothy, greenish-yellow colored vaginal discharge. In addition there  can be an itching of the genital area. There may be increased irritation on urination or during sexual intercourse. Very occasionally the woman may feel some pain in the lower abdominal area.

Although frequently transmitted by sexual intercourse Trichomoniasis may also be transmitted  by sharing a hot tub with an infected person. The use of shared towels, washcloths or bathing suits has also been cited as a source of infection. It is thought  the organism can live for up to forty five minutes outside of the human body. 

It is rare that Trichomonas vaginalis is isolated from men but diagnosis  in a woman is relatively easy. Internal examination with  the use of a speculum sometimes shows small red ulcers on the cervix  or the walls of the vagina. Where these ulcers are seen  on the cervix the condition is sometimes called strawberry cervix. Some of the discharge can be collected on to a cotton tipped swab and place in a suitable agar base carrier medium for transport to the microbiology laboratory. Examination of a wet preparation from the swab will show the characteristic motile Trichomonas. Where only low numbers of infecting organisms are present inoculation of a specialized liquid medium which is examined microscopically at 1 to 2 day intervals for a week can aid diagnosis. 

Treatment of Trichomoniasis is by the use of the drug Metronidazole also known as Flagyl. Con-current treatment of any asymptomatic sexual partners is recommended as they may present a source of re-infection. The assumption being made that if the woman is infected her male partner is also infected. 

Some studies seem to show a correlation of low birth weight or premature babies to mothers who are infected with Trichomonas during pregnancy. There may also be an increased risk of transmitting HIV when someone is also infected with Trichomonas vaginalis. Further studies into these areas are on-going.