Trichomonas if detected, what to do. Trichomonas in women - infection, symptoms and methods of getting rid of parasites. Determination of clinical signs of the disease

Trichomoniasis (trichomoniasis) is an inflammatory disease that affects the genitourinary system of men and women. Its occurrence is provoked by Trichomonas vaginalis, which acts as a protozoan - that is, not a microbe, but a single-celled creature. Trichomoniasis, the symptoms of which are provoked by this creature, unlike microbes, is more adapted to the environmental conditions of the body, as well as to attempts to influence it with antimicrobial drugs.

general description

Often, the disease we are considering is mistakenly defined as gonorrhoea, which is completely incorrect. The fact is that gonorrhea is a different inflammatory disease, although it affects, along with trichomoniasis, the genitourinary system. Grip is nothing more than gonorrhea caused by gonococcus. The transmission of trichomoniasis in question is carried out sexually, and this includes not only contacts in their traditional form, but also anal and oral contacts. It should be noted that trichomoniasis infection in 2/3 of the total reported number of cases occurs as a result of extramarital affairs.

Trichomonas are of three types, being intestinal, oral and vaginal. The first two varieties belong to saprophytes, which, in turn, defines them as microorganisms, the specific effects of which on the body do not lead to the development of certain types of diseases.

Thus, the one that leads to trichomoniasis, that is, the pathogenic Trichomonas, is Trichomonas vaginalis, which, in turn, can also exist in three types of forms. In particular, these are round, amoeba-shaped and rounded forms; in addition to them, there is also an atypical form (or, as it is also defined, cystic), which, despite the overwhelming rejection among scientists, should not be excluded. The most difficult forms of trichomonas to treat are round and cystic, the most aggressive form is the amoeba form.

Trichomoniasis: routes of transmission

Of course, the sexual route of transmission of the disease is the main one, however, other routes should not be excluded, despite the generally insignificant percentage of them. Of the options that will be listed below, the contact and household route of transmission, unlike sexual transmission, has not been clinically proven to date.

Sexual path. In this case, infection occurs as a result of direct genital contact. Other options for sexual intercourse are also not excluded (petting, genital-anal, genital-oral).
Contact with biological fluids. Here, transmission of infection occurs through contact with fluids such as blood, saliva, sperm belonging to the patient. Given this, even kissing can become a way of transmitting infection to a healthy person.
Contact-household variant of infection. Considering the ability of the infection to maintain its own viability in the external environment for several hours, infection is not excluded with such options as using a toilet lid (shared with a sick person, of course), using personal hygiene items, underwear of a sick person (the same applies to a swimsuit , bathrobe, etc.).
Vertical transmission path. This method is relevant at the birth of a child, and there is a particular risk here for newborn girls. As for the possibility of intrauterine infection, it, as well as the features of pregnancy with trichomoniasis, will be discussed below.

Trichomoniasis: features of the course

Length of incubation period of this disease is about two to four weeks after the patient is infected; after this period is over, the first symptoms of trichomoniasis appear. The course of the inflammatory process of this disease is acute; it is also characterized by the appearance of copious discharge in combination with quite pronounced pain.

It should be noted that exclusion of treatment, incorrect determination of measures for it, or insufficient implementation of them on the part of the patient can lead to trichomoniasis in chronic form, which often happens. In this case, inflammation is the basis for subsequent colpitis, urethritis, cervicitis, vulvovaginitis, etc. It would not be out of place to note the fact that trichomoniasis significantly affects the quality of life, disrupting the menstrual and sexual functions of sick patients.

Often, trichomoniasis also contributes to mixed infections, which is especially pronounced in manifestations when combined with gonococci. Microorganisms, releasing the corresponding waste products, provoke the activation of the process of toxic effects carried out against the tissues of the patient’s body. In addition, they have a facilitating effect on the process of penetration of other pathogens into the underlying tissues.

The actual interaction that occurs between Trichomonas and bacteria is extremely important in practice, because when absorbing pathogenic microorganisms, Trichomonas can act as conduits of infection not only to the upper parts of the reproductive system, but even to the abdominal cavity.

Based on modern research, there are all the prerequisites to assume the existence of indirect and direct connections between Trichomonas infection and infertility. Most often, the infection leads to persistent male infertility, which is explained by impaired viability and overall sperm motility.

In some cases, the onset of trichomoniasis manifests itself sluggishly (or torpidly), which is accompanied by minor symptoms or its complete absence. Moreover, with such a course, patients may not even suspect that they have this disease, although even in this case, this does not exclude the appearance of an inflammatory process, just as it does not exclude infection of sexual partners with the disease.

It is noteworthy that the nature of the course of this disease is determined by specific factors, which, in turn, determine the current state of the clinical picture. Such factors, in particular, include the intensity of the impact of infection, the properties characteristic of Trichomonas, the level of acidity of the vagina, as well as the condition of the mucous membranes in combination with the composition of the microflora that accompanies them.

The onset of an acute inflammatory process is predominantly characterized by the appearance of vaginal discharge, as well as discharge from the urethra. It is the discharge arising from the genital tract that is the main and most common symptom of the disease we are considering, and such discharge is noted in about 75% of cases. This indicator is significantly increased among women and, accordingly, slightly decreased among men. Considering that trichomoniasis in women is characterized by greater severity of manifestations, we will begin with the symptoms of this disease in them.

Trichomoniasis: symptoms in women

Among the most obvious and pronounced symptoms of the disease we are considering in women are the following manifestations:

redness in the genital area, general swelling;
the formation of small ulcerations and hemorrhages;
the appearance of significant mucous discharge;
the appearance of watery or foamy discharge with a characteristic fishy odor.

The discharge may be characterized by its caustic nature; as for color, it can vary from white to greenish-yellow. Vaginal discharge is often accompanied by a burning sensation in combination with acute pain in the vulva area; itching in the genital area also often appears, the latter, in turn, can even spread to the inner femoral surface. If the itching and irritation is particularly severe, slight vaginal bleeding may occur.

In some cases, patients may complain of pain and burning sensations that occur during urination, and these manifestations may also accompany sexual intercourse.

It is noteworthy that the pain that accompanies inflammation can be felt by patients not only within the genital organs, but also in the lower abdomen or back. As for visible changes in the uterine mucosa and vaginal walls, they are usually absent, unless, of course, we are talking about severe cases in which the inflammatory process in the perineum and vulva can be accompanied by swelling of the labia.

If we talk about the specific symptoms of this disease, they are mostly determined by which particular area of the genitourinary system is affected by Trichomonas. So, for example, if the vagina is affected, then discharge, burning and itching appear, as well as pulling pain in the lower abdomen and pain during sexual intercourse. If you were damaged bladder and the urethra, then the symptoms, accordingly, are reflected in the basic functions inherent in these areas, manifesting themselves in the form of impaired urination and its frequency, as well as in the form of pain that, again, accompanies urination.

Damage to internal organs (ovaries, uterus and fallopian tubes) by Trichomonas occurs extremely rarely. This is explained by the fact that nature has taken appropriate care to provide a kind of barrier from the inside of the cervix, preventing the spread of the urogenital form of trichomoniasis. This barrier is ensured by the circular compression of the muscles produced by the cervix, as well as by the sharpness of the alkaline reaction from the secretion of the uterine cavity itself.

Meanwhile, certain impact factors (childbirth, abortion, menstruation) lead to the fact that the natural inaccessibility of this barrier in relation to infectious effects is lost, as a result of which it is no longer possible to exclude the possibility of Trichomonas entering the uterus. Ultimately due to similar trend process, endometritis may develop - a serious disease in which inflammation of the uterus occurs, followed by the development of a number of serious complications.

If Trichomonas enter the fallopian tubes, a disease such as salpingitis may develop, which often occurs in combination with inflammation of the ovaries, in which adhesions and cystic formations form.

In addition, according to some experts, absorption by Trichomonas various types bacteria (but not their killing by it) is the reason for their transfer to the internal genital organs, as a result of which, with their subsequent release, an inflammatory process of the corresponding nature of the course is formed.

In addition to the specific area of localization of trichomonas, the symptoms of trichomoniasis are also determined by the general state of the patient’s body. In particular, the most acute manifestations of this infection are observed when the patient’s immunity is weakened, as well as when another type of inflammation is present, etc. It is noteworthy that even the entry of Trichomonas into the body leads to negative impact to immune system, which, accordingly, leads to an exacerbation of all those diseases that the patient already has, which is especially important if there are any in the area of the genitourinary system.

Finally, consideration of such a disease as trichomoniasis in women, the symptoms of which we have identified above, determines it is not superfluous to highlight those features that are characteristic of this infection in a single or complex course with other types of infections.

Thus, based on WHO data for a certain period of time, it was revealed that only 10.5% total number Patients are faced with the course of this infection in its single variant, that is, without the addition of other types of infections. For other cases of the disease, there are mixing options up to a certain combination option. The most common companions of this disease (in order from the most common variant to the least) include microplasmas, gonococci, gardnerella, ureaplasma, chlamydia, as well as various types of fungi.

Almost always, trichomoniasis occurs with disturbances in the normal state of the microflora in the vaginal area, as a result of which the content of bifidobacteria required here is subject to decrease, lactic acid bacteria are subject to disappearance, and the growth, accordingly, is due to pathogenic microorganisms. At the same time, an increase is noted in the number of staphylococci, yeast-like fungi, spirochetes, enterococci, etc. As a result of the complex of these processes, the overall picture of the disease becomes noticeably more complicated, this, in turn, affects both the possibility of diagnosing and subsequent treatment of trichomoniasis.

Trichomoniasis in men: symptoms

It is not superfluous, of course, to consider trichomoniasis in men, but it should immediately be noted that they either have very few symptoms of this disease or are completely absent. Be that as it may, even the absence of symptoms of this disease is not at all an indicator of the harmlessness of the existence of an infection in the body.

The asymptomatic course of trichomoniasis in men can provoke, for example, “sudden” prostatitis (the manifestations of which, as you may know, involve damage to the prostate gland), the course of which, in turn, provokes infertility. It is noteworthy that the point in this case is not so much the possible appearance of prostatitis. Thus, the active reproduction of trichomonas in the seminal fluid leads to the release of specific waste products, resulting in inhibition of sperm growth while simultaneously immobilizing them. In addition, naturally, even asymptomatic carriage of the infection by men in this situation determines the possibility of its transmission to their sexual partners.

As for those few manifestations that are still possible with trichomoniasis in men, these may include, for example, painful urination, which is accompanied by characteristic pain and burning. Sudden or frequent urges also appear, this manifestation is especially relevant in the early morning. In some cases, the appearance of foamy white or purulent discharge from the urethra cannot be ruled out, and the appearance of blood is also possible - its admixture is found in the urine, and blood streaks can also be found in semen.

As a result of the development of the inflammatory process against the background of trichomoniasis, pain and burning, discomfort and a feeling of heaviness may be observed in the perineum or in the deeper pelvic area. If the urethra is affected by Trichomonas, inflammation may occur, which is defined as urethritis. If the course of urethritis is prolonged, this subsequently leads to narrowing of the urethra. The ascending nature of the inflammatory process can provoke cystitis or pyelonephritis.

Typically the symptoms acute form Trichomoniasis appears for about 1-2 weeks, after which the clinical manifestations either decrease, disappear, or transition to a chronic form of the disease.

Trichomoniasis and pregnancy, trichomoniasis in children: symptoms

Most experts are of the opinion that trichomoniasis is not a disease that can fatally affect the condition of the fetus, but in any case, trichomoniasis during pregnancy, of course, is an extremely undesirable condition. There are several reasons to explain this.

Thus, trichomoniasis in pregnant women can provoke premature birth, respectively, acting as a factor that increases the risk of such a development of pregnancy. In addition, trichomoniasis can lead to premature rupture of the waters surrounding the fetus.

It should be noted that trichomonas do not reach the fetus through the placenta, but its subsequent passage along the birth canal affected by them determines the possibility of infection with trichomoniasis. Trichomoniasis in a child can be treated within the first week from the moment of birth, but this, in turn, can lead to damage to the immune system, the formation of which as such is, in principle, too early to talk about. And in general, if at the beginning of a child’s life there is a need to use medications, then this is not the best option for him.

Be that as it may, it is much worse if children's body will be exposed to trichomonas, therefore, treatment of this disease must be started early - in the vast majority of cases, a positive result is achieved. In this case, as, by the way, for adults, important role plays a role in subsequent treatment aimed at strengthening the immune system and normalizing the body’s microflora.

The danger of the disease we are considering for a child is not particularly great, but the consequences of its course affect the health of the pregnant woman and the fetus much more seriously. Advanced cases of trichomoniasis can lead to the infection spreading to the uterus, after which it is possible for it to switch to the membranes of the fetus. As a result of inflammation of the latter, an extremely dangerous situation arises, the outcome of which can even be a miscarriage or stillbirth. Meanwhile, this situation occurs extremely rarely, with an advanced disease. This result can be excluded by carrying out appropriate examinations recommended when planning pregnancy in relation to the presence of sexually transmitted infections; trichomoniasis, as you might guess, also applies to them.

It also happens that before the onset of pregnancy, signs of trichomoniasis did not appear in a woman, and the identification of the corresponding symptoms occurred already during pregnancy. A similar result is possible with passive carriage of an infection, which, due to weakening of the immune system (which is typical for pregnant women in general), has already manifested itself in an acute form. This situation requires re-checking the diagnosis with the subsequent prescription of treatment that includes taking into account the pregnancy factor.

Diagnosis

Diagnosis of the disease is based on bacteriological detection of infection after Gram staining of smears, or on their detection in fresh (or native) preparations.

In the latter version, everything is extremely simple: a special isotonic solution is applied to the surface of a glass slide, then a drop of the patient’s vaginal discharge is added, after which the preparation is examined using a microscope. Meanwhile, detection of Trichomonas by this method does not always occur immediately; therefore, the need to repeat this study cannot be ruled out.

As a modern technique for identifying trichomonas in the body, a method of searching for genetic markers is used, in which polymerase is applicable chain reaction(known to most as an abbreviation - PCR).

Treatment of trichomoniasis

Treatment of the disease we are considering requires compliance with several basic principles, these include the following:

treatment of the disease in a simultaneous manner, that is, it implies treatment of both sexual partners;
prohibition on sexual activity during treatment of the disease;
elimination of factors that provoke a decrease in the body’s resistance, which implies the need to cure concomitant diseases, hypovitaminosis and other similar varieties;
the use of anti-Trichomonas drugs in combination with local and general hygiene procedures.

If symptoms characteristic of trichomoniasis appear, consultation with several specialists is necessary: a gynecologist/urologist, as well as a venereologist.

Trichomoniasis is the most common disease on the planet among sexually transmitted infections, as well as the absolute leader among diseases of the urinary system. As of 1999, the World Health Organization provided data according to which every tenth person on the planet suffers from trichomoniasis. Already such figures force us to take a closer look at the disease, studying the causes of trichomoniasis, types, treatment methods and methods of prevention.

What is trichomoniasis

Trichomoniasis is an infectious disease caused by Trichomonas vaginalis. This single-celled microorganism has on its body a wavy membrane and special flagella, which allow Trichomonas to actively move, penetrating into intercellular spaces.
It should also be noted that Trichomonas is an anaerobic creature, which significantly expands its distribution area.
Available disease statistics show that in the vast majority of cases the disease develops in combination with other diseases, the most common of which are chlamydia and. As a monoinfection, trichomoniasis is diagnosed only in every tenth case.
Modern research shows that the spread of this infection is possible only through sexual contact. And only in exceptional cases is transmission of the disease possible through the use of hygiene products or underwear of a carrier of the disease. At the same time, the risk of transmission of infection through sexual contact exceeds 80 percent. No other sexually transmitted infection has such a high transmission rate.

Prevention of trichomoniasis

These factors indicate that to prevent this disease it is necessary to strictly follow a number of recommendations, which, however, do not contain anything supernatural:

culture of sexual relations;
in the presence of non-regular sexual partners, use exclusively barrier contraceptives;
a high culture of intimate hygiene, excluding the use of underwear and hygiene products of other people;
regular medical examinations, which must be completed at least six months.

In addition, there is a fairly effective method of one-time prevention of trichomoniasis after casual sexual contact without the use of a barrier contraceptive. It consists of introducing five milliliters of solution into the vagina and externally treating the genitals with antiseptics. Such actions will reduce the risk of Trichomonas transmission by 70 percent. But at the same time, doctors strongly recommend avoiding situations where such emergency therapy is necessary.

Photo: Twinsterphoto/Shutterstock.com

Prerequisites for the development of trichomoniasis

However, for the development of trichomoniasis there are a number of other prerequisites in a woman’s body:

the postpartum period, when the expansion of the cervical muscles leads to a natural disruption of mechanical protection;
menstrual and postmenstrual periods, accompanied by fluctuations in the acidity of the vaginal contents (for Trichomonas, the optimal acidity of the vaginal contents is the range of 5.5-6.6 pH);
abortion, which provokes changes in the body that contribute to the occurrence of trichomoniasis;
orgasm, during which the uterine cavity is prone to “absorption” of the causative agent of the disease.

Symptoms of trichomoniasis

After entering the body, the first visible manifestations of the presence of infection begin to appear 4-5 days after infection. Depending on the place of penetration of Trichomonas, the symptoms of the disease may differ slightly, but in the vast majority of cases, women experience the following symptoms:

copious foamy discharge, predominantly yellowish or greenish in color;
profuse leucorrhoea from the vagina, which is a pathognomonic (unambiguous) sign of the presence of Trichomonas in the body;
discomfort, often developing into pain when urinating and during sexual intercourse;
redness and swelling (so-called hyperemia) of the vaginal mucosa, which may be accompanied by purulent discharge.

In men, infection with trichomoniasis is accompanied by the following symptoms:

painful sensations when urinating;
in some cases, when the prostate gland is affected by infection, symptoms of prostatitis;
involuntary discharge from the urethra, in some cases bloody.

Although in most cases, trichomoniasis in men is practically asymptomatic, any of these symptoms signals the need for detailed laboratory testing, which can verify the presence of Trichomonas in the body and confirm infection.

Diagnosis of trichomoniasis

Modern medicine suggests four options for diagnosing this disease:

cultural examination, which is recommended in the absence of pronounced symptoms of trichomoniasis;
molecular biological research, which is designated as the most reliable diagnostic method that does not require additional confirmation;
microscopic examination of a preparation stained with a one percent solution of methylene blue. This method is the simplest, but its sensitivity does not exceed 60 percent;
microscopic examination of an unstained specimen, which demonstrates the highest sensitivity in cases of clearly defined infection.

At the same time, progressive medicine in diagnosing sexually transmitted infections, including trichomoniasis, is guided by the principles of the least time and money costs, without compromising the reliability of the research results.
According to this, the algorithm for diagnosing infection in modern clinics is as follows:

1. Gynecological examination with the collection of a native smear, which, although it does not demonstrate high sensitivity, has the qualities of being cheap and quick to determine the result. A positive result for the presence of Trichomonas in this case is sufficient to determine the diagnosis.
2. The presence of signs of trichomoniasis infection and a negative result of the native smear are a signal for more complex testing for antigen detection. As in the first case, if the test is positive, treatment is prescribed, and if it is negative, additional research is prescribed.
3. The final test in this diagnostic protocol is culture. Modern medicine considers this set of procedures absolutely sufficient to diagnose the presence of Trichomonas and does not recommend further action, guided by the above-mentioned principle of rationality.

Treatment of trichomoniasis

In case of laboratory confirmation of trichomoniasis, complex treatment is prescribed, developed according to an individual scheme for each patient.
It mainly consists of the internal use of anti-trichomonas drugs - metronidazole and its derivatives flagyl, ternidazole and others. In combination with these drugs, local treatment may be prescribed in the form of vaginal tablets and suppositories, which on their own do not demonstrate adequate effectiveness, as well as a number of procedures: physiotherapy, immunotherapy, prostate massage, urethral instillation and restorative therapy.

Now two methods of using metronidazole are used: a 3-7-day course of treatment, one tablet (250 mg) twice a day, or a one-time use of a loading dose of the drug - no more than two grams. At the same time, the results of many studies show that the second option is not inferior in effectiveness to the first and it is this option that now prevails in medical prescriptions.

The maximum range of drugs and procedures is prescribed to patients with acute or chronic forms of trichomoniasis, while initial stage the development of infection can often be managed only with anti-trichomonas drugs.

From side effects When using metronidazole, you should note a feeling of dry mouth, change in urine color, and in rare cases, malaise, vomiting and rapid heartbeat. In addition, after taking this medication, you should avoid drinking alcoholic beverages for two days.

There are also cases of partial resistance of the infectious agent to anti-Trichomonas drugs, which is observed in approximately every twentieth patient. In such circumstances, the attending physician changes the dose and duration of use of medications, which mainly has a positive effect.

Upon completion of treatment of the disease, the attending physician prescribes a set of three control laboratory tests, which are carried out after the end of the menstrual cycle for three months. And only three “clean” tests indicate complete recovery.

It should also be noted that trichomoniasis is a self-healing infection. Asymptomatic and without diagnosis, the disease lasts from four months to five years, ending with recovery. But for such a development of events, several conditions must coincide:

the course of trichomoniasis in the form of a monoinfection, which, as we remember, is observed in only 10 percent of patients;
a sufficient level of defenses of the body of an infected person;
the patient has no sexual intercourse for a long period.

Consequences and complications of trichomoniasis

Delayed diagnosis and treatment of trichomoniasis can lead to very serious consequences. The progression of the disease into chronic trichomoniasis and further lack of medical intervention often leads to the following problems:

frigidity and lack of orgasms;
impairment of reproductive functions (inflammation of the uterine appendages and obstruction of the fallopian tubes);
the occurrence of malignant processes in the cervix;
complications during pregnancy, causing premature birth or miscarriage.

In addition, a number of scientists argue that trichomoniasis may be an indirect cause of the development of diabetes mellitus, mastopathy, cancer of the female genital organs and allergic manifestations, but there is no reliable laboratory evidence of these assumptions at this time and they require additional research.

Trichomoniasis during pregnancy

It is worth mentioning separately about trichomoniasis during pregnancy. Diagnosis of infection during pregnancy is not a prerequisite for its termination. Although the disease can cause complications during the prenatal period, patients are prescribed a standard course of treatment. The only change from the standard protocol is the need to eliminate the use of metronidazole in the first trimester of pregnancy. That is, the course of treatment for trichomoniasis should be carried out no earlier than the second trimester.

There are also statistics according to which in five percent of cases, trichomoniasis in a pregnant woman is transmitted to her child. But the structural features of the epithelium of a newborn are such that the infection in his body occurs in a mild form and in most cases heals itself.

After incubation period will end, that is, about a month after infection, the patient can detect the first symptoms of trichomoniasis. During the course of the disease, inflammatory processes can occur in an acute form, which is characterized by the identification of such signs as, severe pain and copious purulent-whitish discharge from the genitals.

Determination of clinical signs of the disease

How does trichomoniasis manifest during the primary stage of infection? In most cases, the infection initially proceeds torpidly, depriving the doctor of the opportunity to promptly identify the pathogen and determine its type. In addition, the patient himself may not detect the disease at all, but at the same time inflammatory processes are already beginning to form in the organs of the genitourinary system. A latent carrier of trichomoniasis can cause infection to their sexual partners.

In the acute stage of the disease, the following manifestations are detected: clinical symptoms: discharge of foul-smelling greenish mucus from the urethral canal, vagina or glans penis. How to identify Trichomonas at this stage? The intensity of the discharge can determine the degree of inflammation - they are the most common sign of trichomoniasis, which can be detected in 80% of those who apply for medical care. Among women this statistical indicator is significantly higher, among the male part of infected people it is lower.

Gender differences in symptoms when identifying a pathogen

How to determine trichomoniasis in a woman? It is necessary to pay attention to the following manifestations of a bacterial infection discovered during a gynecological examination: redness of the surface of the genital organs, swelling of the perineum, mucous discharge from the vagina, the presence of erosive ulcers on the mucous surface of the genitals, foamy or watery discharge, with an unpleasant fishy odor (with colpitis). Trichomoniasis is often accompanied by a burning sensation during urination, itching and short-term pain in the groin.

How does Trichomonas manifest itself in men? Infection in men can be detected by the following symptoms: burning and sharp pain when urinating, dysuria, white or foamy discharge from the urethra, and possibly blood in the stool or urine.

Diagnostic methods for determining bacteria

The fundamental data in determining the type and diagnostic identification of a microorganism are the results laboratory tests, for which various biological fluids and scrapings from epithelial tissues are taken from the patient for examination. How to detect Trichomonas using IRA, PCR or ELISA? For analysis, biomaterial is taken from women from the urethra, rectum or vagina. And in men - only from the urethra. A urine centrifuge test is very effective in identifying bacteria.

In medical practice, several methods for detecting a pathogen are described:

The cultural method is characterized by high accuracy of detection of trichomonas, is effective, but requires a lot of time.
Microscopic examination of native preparations - identification of the pathogen by immediate examination of the obtained smears under a microscope.
Microscopic analysis - aimed at identifying the pathogen using specific staining of preparations.
PCR - quick way, which is highly sensitive, helps to detect the DNA of the pathogen even if other diagnostic methods did not detect anything or could not determine the type of infection.
Immunological studies - help to demonstrate labeled antibodies.

Each method has its own advantages and disadvantages, therefore, before identifying trichomoniasis using any of them, be prepared for the fact that none of the tests will give a 100% accurate result.

Trichomoniasis or trichomoniasis is an inflammatory disease of the genitourinary tract in men and women. Caused by the protozoan T.vaginalis (translated as Trichomonas vaginalis). Trichomonas is not a microbe, but a “unicellular animal,” that is, a creature more adapted to antimicrobial drugs and living conditions in the human host.

Very often, trichomoniasis is mistakenly called gonorrhea, but this is not so. Gonorrhea is another inflammatory disease of the genitourinary tract caused by gonococcus. Trichomoniasis is transmitted sexually - this is not only traditional contact, but also oral and anal.

The incubation period is 3-5 days (from the moment of infection to the appearance of the first signs of disease), but given our era of antibiotics and antimicrobial drugs, as well as their unreasonable prescription, I had to consult patients when trichomoniasis dragged on for up to 3 weeks.

Symptoms of trichomoniasis

Tests for trichomoniasis

If you notice the above symptoms and symptoms of complications, which I will discuss below, “take” your sexual partner and go to the doctor. I believe that initially it was a dermatovenerologist. Why?

1) Neither a gynecologist nor a urologist (if he is a “Specialist”) will treat your other half, and this is important, the problem is common. Very often, treatment is prescribed to a partner without examining him, which is extremely unacceptable.
2) Only a dermatovenerologist can treat a couple and advise when they can begin sexual activity after examination and treatment. If people are treated in different offices, then we often have to deal with the following cases: one sexual partner is cured, but the other is not, one doctor says that you can be sexually active, and the other continues examinations and treatment. This is how a person is designed to follow the path of least “resistance...”.

Sometimes a doctor, when a mini-surgical intervention (for example, cauterization of cervical erosion) or an examination (urethroscopy-hardware examination of the urethra) is needed, may prescribe a consultation with a gynecologist or urologist.

I have come across people who explain the symptoms of trichomoniasis by saying that “I have a cold” (or “got a cold”) and start taking completely unnecessary antibiotics, thereby “silencing” the infection, making life more difficult for themselves and the doctor who will then inevitably treat you.

Remember: Self-medication and self-diagnosis are unacceptable!

And now you are at the doctor. What tests will you need to take? Definitely - these are strokes. Men from the urethra, women from the vagina and urethra. It is best if the stronger sex comes to the doctor with morning urinary retention (urine in the evening, but not urinate in the morning).

Treatment of trichomoniasis

The main group of drugs in the treatment of trichomoniasis are 5-nitromedazoles (Trichopol, Metrogyl, Tiberal..). It should be taken into account that the doses of the drug indicated on the packaging are small and ineffective. Broad-spectrum antibiotics (Unidox, Azitrox, etc.) are used to treat concomitant infections. In the chronic form, immunomodulators (pyrogenal, immunal...), absorbable drugs (Lidase, trypsin, wobenzym), drugs that improve
intestinal flora (hilak-forte, normaza...). Local treatment in the form of baths and infusions into the urethra (chlorhexidine, miramistin....).

Sexual activity and drinking alcohol during treatment are strictly prohibited. It is advisable after treatment, especially the chronic form of trichomoniasis, to undergo a course of treatment with drugs that improve intestinal microflora. A person is considered cured of trichomoniasis if trichomonas are not detected in women - within 2 monthly cycles, in men 2 weeks after treatment and also after a month.

Folk remedies for treating trichomoniasis

Only one folk remedies It is not possible to cure trichomoniasis. Herbal medicine is prescribed only together with basic medications. Mono treatment with folk remedies will only “drown out” the infection. Your doctor may prescribe tampons with onions, baths with calendula, or drink fireweed leaves, but this is only in addition to the main treatment.

Complications of trichomoniasis

Let's look at this situation, if you don't go to the doctor. Here come complications such as:

1) Prostatitis is inflammation of the prostate gland in men. It’s not for nothing that the prostate is called “the heart of a man.” This gland is involved in the function of conception, as it affects the quality of seminal fluid. The main symptoms are pain in the lower abdomen, frequent urination, especially at night.
2) Orchitis - inflammation of the testicle. As a rule, this is an “acute condition” - severe pain in the testicular area, high fever.
3) Salpingo-oophoritis in women - inflammation of the ovaries and fallopian tubes, characterized by pain in the lower abdomen, pain during sexual intercourse.

If you “miss” complications, this is a direct path to infertility, benign and malignant neoplasms of the prostate and uterus. Yes, yes, don't be surprised. Due to the decrease in local immunity, oncoviruses, the causes of oncology, rear their heads. You need to remember that if your sexual partner is diagnosed with trichomonas, but you are not, then both undergo treatment. Do not hesitate to consult a doctor, even for the purpose of prevention, especially if you are sexually active.

Trichomoniasis during pregnancy

An extremely negative effect of trichomoniasis on pregnancy has been established - premature birth, deformities, hypoxia (fetal development with reduced doses of oxygen), infection of the placenta. When the ovaries are damaged, their normal endocrine function is disrupted, and thus the normal course of pregnancy. Trichomonas waste products (toxins) cause fetal cell death. The addition of secondary microorganisms contributes to infection of the placenta and fetus.

You can take 5-nitromedazoles only from the 12th week of pregnancy and in smaller doses. If we do not cure trichomoniasis, then we contribute more or less normal flow pregnancy. Hence the conclusion: before conceiving a child, get your spouse examined for sexually transmitted diseases.

Prevention of trichomoniasis

The best prevention of trichomoniasis is being faithful to your partner. It is not for nothing that in Muslim countries, where there are strict laws, there is a high birth rate. But if casual sex cannot be avoided, then use condoms, but not a single condom, according to American scientists, provides a 100% guarantee against infection. External treatment of the genital organs and infusion of solutions of Chlorhexidine and Miramistin into the urethra are actively used in men. Among women-
toilet the external genitalia with soapy water and candles such as Hexicon.

Consultation with a doctor on the topic of trichomoniasis:

Question: Is it possible to become infected with Trichomonas in a bathhouse or public toilets?
Answer: In principle, no. There may be isolated cases and only in close contact. Trichomonas quickly die outside the body.

Question: Can you become infected with trichomoniasis through airborne droplets?
Answer: No

Question: If there was casual sexual intercourse, then when is it better to do prevention?
Answer: Within 3 hours, later it makes no sense.

Dermatovenereologist, 1st category Mansurov Alexander Sergeevich

Trichomoniasis (or trichomoniasis) urogenital is a disease exclusively of the human genitourinary system. The causative agent of trichomoniasis is Trichomonas vaginalis, which is sexually transmitted.

Next, we will consider what kind of disease this is, what are the causes, modes of transmission and symptoms in adults, and also why it is important to carry out a correct diagnosis and start treatment at an early stage so that serious consequences do not arise.

What is trichomoniasis?

Trichomoniasis is a sexually transmitted disease caused by human infection with vaginal trichomonas (Trichomonas vaginalis).

Trichomoniasis affects the human genitourinary system and is caused by a specific pathogen – Trichomonas vaginalis. It belongs to the group of protozoal infections and is characterized by the ability to persist for a long time inside the genitourinary organs, even under unfavorable conditions and the action of various drugs.

Trichomonas infection is present in 30–70% of the total female population, and in almost half of those affected characteristic symptoms diseases are absent or mildly expressed.

The main route of transmission of trichomoniasis - sexual contact and household contact - is not considered in any way, although there is a point of view that infection is possible through freshly used bath accessories, on which fresh discharge of a patient with trichomoniasis could remain.

In men, pathogens are found in the urethra, prostate gland and seminal vesicles, and from secretions - in semen and prostate secretions.
In infected women - in the vagina and Bartholin glands, cervical canal, urethra. Neisseria and chlamydia are often found inside Trichomonas; in these cases, gonorrhea accompanies trichomoniasis, complicating the diagnosis and treatment of the disease.

Features of the pathogen

Incubation period, that is, the time from the moment of infection to the appearance of the first symptoms of the disease ranges from 1 day to 1 month, on average - from 5 to 15 days.

Trichomonas:

quickly lose viability outside human body. A prerequisite for life is the presence of moisture; when dried, they quickly die.
Not resistant to high temperatures (over 40°C), direct sunlight, or antiseptics.

Forms of trichomoniasis:

Fresh – up to two months.
Chronic. It is characterized, as a rule, by a torpid course lasting more than two months.
Carriage of Trichomonas infection. When trichomonas are detected in the laboratory, there are no clinical symptoms of the disease.

Causes of trichomoniasis

In fact, 90% of the population are carriers of Trichomonas, but in most people it does not manifest itself in any way.

How can you become infected with trichomoniasis?

unprotected sexual contact;
a large number of sexual partners;
previously suffered or not fully cured sexually transmitted diseases.

The development of trichomonas in the body is facilitated by hormonal imbalances, metabolic disorders, and a decrease in the body’s immune response. Immunity to trichomoniasis is not developed, so you can become infected again.

Factors contributing to the development of urogenital trichomoniasis:

endocrine system disorders;
metabolic disorders;
hypovitaminosis;
bacterial contamination of the vagina, accompanied by a change in its acidity;
menstruation and postmenstrual period.

First signs

Trichomoniasis, like gonorrhea, is almost impossible to recognize on your own, except for frequent discharge from the genitals. A transparent, large drop is the only symptom inherent in everyone with trichomoniasis.

Indirect signs of trichomoniasis:

pain when urinating (as with gonorrhea);
strong periodic burning sensation;
pain in the lumbar part of the body.

In the acute phase of trichomoniasis, symptoms begin to appear quite pronounced in the form of:

temperature rise;
increase in ESR;
development of leukocytosis.

Symptoms of trichomoniasis in adults

Typically, the incubation period for trichomoniasis lasts from 2 days to 2 months. If trichomoniasis occurs in an erased form, then the first symptoms may appear several months after infection with decreased immunity or exacerbation of other chronic infections.

Trichomoniasis (depending on the severity of symptoms and duration) can occur in acute, acute, chronic forms and as trichomonas carriers.

The main symptoms of trichomoniasis are discharge from the urethra or vagina, the entry point of infection. Among women, this symptom is observed in approximately 8 out of 10, and in men – in half of cases of trichomoniasis.

Among women

With the development of trichomoniasis, women experience characteristic complaints:

discharge from the genitals (abundant, often serous-purulent, foamy - characteristic of trichomoniasis);
itching, burning, pain when urinating;
swelling and hyperemia (redness);
occurrence in the folds of the vaginal mucosa;
pain upon examination, when pressing on the urethra - the appearance of discharge;
macerated skin;

Genital warts often occur simultaneously.

If the disease affects the cervix (endocervicitis), then swelling of the cervix occurs, accompanied by copious discharge. Erosion often occurs.

In men

After the urogenital trichomonas has entered the male body, its vital activity provokes the development of the so-called trichomonas. This infectious and inflammatory disease is accompanied by a number of clinical symptoms:

A burning sensation during urination or after intimacy;
Mucopurulent discharge from the urethral canal, accompanied by discomfort and unpleasant odor;
Formation of compaction (strictures) in the urethral area;
Signs of inflammatory damage to the testicles and their appendages, as well as the prostate gland.

The infected person may be unaware that he is the source of the spread of infection, and transmit Trichomonas to sexual partners or family members.

Therefore, if a man has even the slightest signs of a urogenital infection, he needs to contact a urologist and get tested not only for trichomoniasis, but also for other STIs.

As a rule, the symptoms of the acute form of trichomoniasis appear for about 1-2 weeks, after which the clinical manifestations either decrease or disappear, or transition to the chronic form of the disease.

Complications

Complications of trichomoniasis:

Acute or chronic inflammatory lesions of the genital area in women and men: endometritis, salpingoophoritis, urethritis, etc.
During pregnancy, the risk of miscarriage, premature birth, infection of the fetus, and the development of purulent-septic complications of the postpartum period increases.
Male and female infertility.
Increased risk of contracting other sexually transmitted infections. It has been proven that the presence of trichomoniasis in women doubles the risk of infection with type 2 herpes viruses and human papillomavirus infection, as well.

Diagnostics

Laboratory diagnostic methods are used:

microscopic examination of native smears from the vagina, urethra and cervix (reliable only with rapid microscopy of freshly taken smears);
microscopic examination of Gram-stained smears;
cultural method (seeding mucus and urethral contents on nutrient media, but requires 4 to 7 days);
PCR (polymerase chain reaction) - isolation of Trichomonas DNA from urethral or vaginal discharge (very expensive analysis).

In most cases, trichomoniasis is accompanied by the following infections:

gonorrhea;
chlamydia;
mycoplasmosis;
fungal infections (thrush in women).

This information should be taken into account when prescribing the appropriate course of therapy.

Treatment of trichomoniasis

How to treat trichomoniasis? Treatment requires compliance with several basic principles, these include the following:

treatment of the disease in a simultaneous manner, that is, it implies treatment of both sexual partners;
prohibition on sexual activity during treatment of the disease;
elimination of factors that provoke a decrease in the body’s resistance, which implies the need to cure concomitant diseases, hypovitaminosis and other similar varieties;
the use of anti-Trichomonas drugs in combination with local and general hygiene procedures.

Medicines for trichomoniasis

Before using any drug, be sure to consult your doctor, as... there are contraindications.

Drugs	Instructions
Metronidazole (Trichopol)	On the first day, take 1 tablet 4 times orally, with water. From the second to the seventh day inclusive, take 1 tablet 3 times a day, also orally with water.
Metronidazole	Antiprotozoal, antimicrobial drug. The mechanism of action is an inhibitory effect on the genetic apparatus of bacteria. At the same time, all biological processes cells and microorganism die. Contraindications are: pregnancy hypersensitivity to the drug.
Tinidazole	Take 4 tablets of 500 mg each at once, or 1/3 tablet 2 times a day for 7 days. Contraindications: hematopoietic disorders, pregnancy and lactation period, hypersensitivity to the drug
Klion – D	A combined drug that contains equal parts of metronidazole and miconazole (an antifungal drug). Prescribed in the form of vaginal suppositories, 1 piece at night for 10 days.

There is an approved treatment regimen for chronic trichomoniasis, as well as recurrent and various localizations:

a single daily dose of 2.0 g of Metronidazole for 7-10 days or 500 mg 3 times a day for the same number of days,
Tinidazole - 2.0 g once daily for 3 days.
Highly effective with good tolerability and a small number of possible side effects is Ornidazole, or Ornizol, in a dose of 0.5 g - 2 times a day for 10 days.

Immunomodulatory agents are also used, which also suppress the development of concomitant infections, for example, fungal infections - 3 irrigations of the vagina and cervical area with a 0.04% solution of the drug Gepon in a dose of 5 ml - 1 irrigation each with a 2-3 day interval.

In addition, to reduce the harmful effects of antimicrobial drugs on the intestinal microflora, it is recommended to take medications containing bifidobacteria.

After taking Metronidazole, absolutely prohibited to use alcohol within 24 hours.

If the patient takes Tinidazole, then the duration of abstinence from alcohol is at least 72 hours. If these restrictions are not observed, a person risks experiencing adverse reactions such as dizziness, nausea and vomiting.

Trichomoniasis is considered cured when the pathogen is not detected during diagnosis and clinical symptoms are not observed. Sexual activity is prohibited during treatment. It is necessary to inform your sexual partner about the presence of trichomoniasis and other STDs, about the need for examination and treatment.

The result of treatment for trichomoniasis depends on the normalization of the microflora of the genitourinary system and the body as a whole. In women, a vaccine against inactivated lactobacillus acidophilus is used for this purpose. It is possible to prescribe immunomodulatory drugs.

Prevention

Prevention of trichomoniasis comes down to following the rules to prevent infection with sexually transmitted diseases. Basic recommendations:

use condoms;
be careful when choosing partners;
avoid casual sexual relationships;
Do not share towels, washcloths or other hygiene items.

Please also note that trichomoniasis is easily transmitted during sexual intercourse, so if there is a suspicion of an infection, both partners should be examined at once.

This is all about trichomoniasis in women and men: what kind of disease it is, its causes, what are the first symptoms and signs, features of treatment. Do not be ill!