According to estimates by the World Health Organization (WHO), approximately 170 million people worldwide are infected with Trichomonas each year.
Trichomoniasis is therefore one of the most common sexually transmitted diseases. Men are affected by trichomoniasis less frequently than women, who account for 70 percent of new infections, with 120 million cases per year. In Germany, trichomoniasis is not a reportable disease.
The causative agent of trichomoniasis is a parasite called Trichomonas vaginalis. This single-celled flagellate, measuring 25 µm long and 15 µm wide, colonizes the genital tract, particularly the female vagina.
Trichomonads are single-celled parasites that infect the urinary and reproductive tracts and can cause inflammation in the affected areas @ timonina /AdobeStock
The parasites prefer a moist environment and a moderately acidic or neutral pH. This allows them to survive for long periods in a woman’s vagina and urethra.
In men, the trichomonad pathogen is found primarily in the urinary tract and the prostate. In such cases, medical professionals also refer to the parasite as Trichomonas urogenitalis.
Trichomonas is transmitted through direct mucosal contact with an infected person during unprotected sexual intercourse.
People who also have other sexually transmitted infections, such as chlamydia, syphilis, or HIV, are at high risk of contracting trichomoniasis.
Infection through the sharing of towels, unchlorinated bathwater, or during a visit to a sauna is possible but rare.
It takes one to three weeks from the time of infection with the trichomoniasis pathogen until the first symptoms appear. This is followed by purulent inflammation of the mucous membranes in the genital area and urinary tract. These symptoms are usually accompanied by itching and a burning sensation in the genital area, as well as a foul-smelling discharge.
Women, in particular, suffer from these characteristic symptoms of a trichomoniasis infection.
In women, a trichomoniasis infection often leads to inflammation of the vagina and urethra.
These manifest as:
- Severe burning
- Unpleasant itching
- Redness
- Swelling in the vaginal area
- Pain when urinating and during sexual intercourse
- Frequent urge to urinate
- Yellowish-green, foamy vaginal discharge with an unpleasant odor resembling rotten fish
- Mild lower abdominal pain
In men, the pathogens colonize the urethra, under the foreskin, or in the prostate. There, they cause inflammation.
However, trichomoniasis often progresses without noticeable symptoms in men. As a result, men are often carriers of the trichomoniasis pathogens without realizing it.
If an infected man does experience symptoms, they may include the following:
- A mild burning sensation during urination and ejaculation
- Itching in the genital area
- Purulent discharge from the urethra
If a trichomoniasis infection is suspected, those affected should definitely see a doctor. The appropriate specialist is a dermatologist and venereologist, or a urologist or gynecologist.
They will first perform a urological or gynecological examination. The doctor can often make a preliminary diagnosis of a trichomoniasis infection based on the characteristic symptoms alone.
In addition, the doctor will take a swab of the urethral discharge from a man or the vaginal discharge from a woman. This is followed by microscopic and laboratory testing.
Under the microscope, Trichomonas parasites are usually recognizable by their pear-shaped form, flagella, and wriggling movement.
Laboratory sample for suspected Trichomonas infection @ luchschenF /AdobeStock
Treatment usually involves specific antibiotics. Options include medications such as:
- Metronidazole
- Ornidazole
- Tinidazole, and
- Nimorazole
The patient should generally take these in tablet form over a period of one week. To prevent reinfection with Trichomonas, the partner should also undergo treatment.
Patients should abstain from sexual intercourse during treatment for trichomoniasis. After completing the course of antibiotics, the doctor will perform a follow-up swab test to determine whether the treatment was successful.
With consistent treatment for trichomoniasis, the cure rate is very high, at 95 percent.
Since immunity does not develop after successful treatment, reinfection with trichomoniasis is possible. Untreated trichomoniasis infections can become chronic and lead to severe inflammation of the genital organs.
