Trichomonas: the sexually transmitted parasite
This little flagellated parasite is a very common sexually transmitted infection (STI) worldwide, mainly causing symptoms in sexually active women.
Trichomonas vaginalis is the most common pathogenic protozoan infection in humans in developed countries. In North America alone, it is estimated that in excess of 8 million new cases are reported annually. The World Health Organization (WHO) estimated that 180 million infections are acquired annually worldwide.
It is spread through contact with vaginal and urethral discharges during sexual intercourse. It is highly unlikely to catch this parasite by means of sitting on a toilet seat as many believe; Trichomonas just does not withstand drying and do not survive very long in the environment outside of the host.
In women, though sometimes asymptomatic, when symptoms are present it is characterized by a profuse, thin greenish-yellow discharge with a foul odor. Other signs of trichomoniasis are small hemorrhages causing reddening on the cervix known as “strawberry cervix”, vaginal itching and an urge to urinate.
In men, most show no symptoms, however it may invade the prostate and seminal vesicles.
Rarely, babies born to infected mothers may contract infection during delivery.
It usually takes about a week after infection before symptoms appear, but many people are symptom-free carriers for years.
Trichomonas often coexists with gonorrhea; in up to 40% of people with gonorrhea have a concurrent trichomonas infection. It is also seen in women that also have bacterial vaginosis. So a full STI check must be done if someone is diagnosed with trichomoniasis.
This infection is typically diagnosed based on finding the motile parasite by microscopic exam of discharge material or by culturing the parasite. It has been seen in PAP smears; however this must be confirmed by a different test.
Trichomonas can be treated with the antibiotic metronidizole or tinidazole. Sometimes treatment may fail and you will usually be treated with the same drug for a longer time at a higher dose. All sexual partners should be treated at the same time to prevent the “ping-ponging” effect of reinfection. You do not build any immunity to this parasite, so you can get reinfected.
What can you do to prevent trichomoniasis? The Centers for Disease Control and Prevention recommends you do the following:
• Abstain from sexual intercourse; or,
• Use a latex condom properly, every time you have sexual intercourse, with every partner.
• Limit your sexual partners. The more sex partners you have, the greater your risk of encountering someone who has this or other STDs.
• If you are infected, your sexual partner(s) should be treated. This will prevent you from getting reinfected.
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