What is trichomoniasis? This is a genital infection that causes inflammation of the genitourinary system. It manifests signs of proctitis, urethritis, colpitis, cystitis, and is often combined with such genital infections as gonorrhea, chlamydia, mycoplasma, candidiasis, and so on.
In the acute stage, this disease is accompanied by profuse vaginal discharge, itching and burning. These symptoms are characteristic of women. As for men, then they have pain when urinating.
In the absence of proper and adequate treatment, trichomoniasis becomes chronic. In the future, this may cause infertility, prostatitis, complicated birth and pregnancy, as well as infant mortality and fetal pathology.
Causative agent of infection
We study further the question of what is trichomoniasis. The causative agent of this disease is Trichomonas (vaginal), which is transmitted mainly through sexual contact.
With the development of this disease in men, the urethra is affected, the seminal vesicles, the prostate, as well as the testes and their appendages are affected. The representatives of the weaker sex Trichomonas multiplies in the vagina, the vaginal part of the cervical canal and in the urinary tract.
Features of the disease
Trichomoniasis in women is found more often than in men. At the same time, it affects the representatives of the weaker sex of the reproductive age (17-35 years old), and during birth it is able to infect a newborn baby (approximately in 5% of cases). Due to the structural features of the epithelial layer in young children, this disease is mild.
Trichomoniasis in men (a photo of the pathogen is presented in this article) does not cause overt symptomatology. In this case, they may be carriers of Trichomonas and not experience pronounced indisposition. This disease can cause the development of non-gonococcal urethritis, chronic epididymitis and prostatitis, as well as contribute to the occurrence of male infertility.
The most common infection with trichomoniasis occurs during sexual intercourse, or rather, with the reluctance to use a condom.
Also, the infection can be transmitted by household, or rather, through contaminated linen, towels, swimsuits, washcloths and more.
How do doctors diagnose a disease like trichomoniasis? Infection with this disease is not a rarity. Very often, trichomoniasis is detected with other STI pathogens. In addition, many experts believe that Trichomonas can contribute to the development of mastopathy, diabetes, allergies and even some cancers.
How does the disease develop?
So, what is trichomoniasis? As mentioned above, the causative agents of this disease are Trichomonas. These are anaerobic single-celled organisms that are widely distributed in nature.
In the patient's body, three types of Trichomonas can parasitize: intestinal, oral and vaginal. The latter is the largest, most active and pathogenic.
Due to the presence of flagella Trichomonas very mobile and active. They are omnivorous and asexual, multiply rapidly, including in the absence of oxygen.
After getting into the human body Trichomonas are fixed in the urogenital system and cause inflammation. Their decay products poison the body of the patient and significantly reduce his immunity.
Such parasites can live not only in the genitals, but also in the systemic blood flow of the patient, where they penetrate through the intercellular spaces and lymphatic pathways through the enzyme - hyaluronidase.
Trichomonas are well adapted to the existence in the human body. According to experts, they can change shape. They also tend to disguise themselves as blood cells, which makes it difficult to diagnose the disease.
We can not say that such microorganisms as Ureaplasma, gonococci, candida, chlamydia, cytomegalovirus and herpes viruses, getting inside Trichomonas, can easily find protection from the effects of drugs and the immune system of the patient.
Motile Trichomonas often spread other bacteria through the patient's urogenital system and his vessels.
Is it possible to get rid of a disease like trichomoniasis? Treatment in women (the drugs will be listed below) and men should be comprehensive. It should be noted that getting rid of this disease is completely extremely difficult. This is due to the fact that the non-protein shell of parasites practically does not respond to the action of antibiotic agents. It can be destroyed only by special anti-cancer drugs.
Trichomoniasis: symptoms in women and men
The incubation period of the causative agent of this infection usually lasts from 2 days to 2 months. If the disease occurs in a latent form, then its first signs can appear only a few weeks after infection. As a rule, this happens when a person’s immune system is not working properly or other chronic diseases are exacerbated.
So how does trichomoniasis manifest in men (the pathogen photo is presented in this article) and women? The clinical manifestations of this disease are different in both sexes. The representatives of the weaker sex talk about severe symptoms, while “male” trichomoniasis exists only in the form of carriage.
Depending on the severity of symptoms and the duration of the disease, trichomoniasis can occur in subacute, acute and chronic forms. The acute stage of trichomoniasis can have symptoms such as:
- erosion or sores on the mucous membranes of the genitals,
- frothy discharges of green or yellow color with an unpleasant odor,
- irritation and redness of the genital mucosa,
- dermatitis on the inside of the thighs,
- itching and burning of the genital mucosa,
- dysuria, urinary discomfort,
- lower abdominal pain
- discomfort during sexual intercourse.
Now you know how trichomoniasis is manifested. Symptoms in women (discharge is the main symptom of infection), listed above, are aggravated before the onset of menstruation.
In childhood this disease is observed infrequently. In girls, trichomoniasis is transmitted in a non-sexual way from a sick mother through household items.
As for men, the disease under consideration occurs in the form of urethritis and is accompanied by slight itching, mucopurulent discharge, burning sensation after urination or sexual intercourse.
How should I treat a disease like trichomoniasis? Treatment in women (photos on this topic can be found in this article) and men should be selected by an experienced doctor. The diagnosis of this disease lies in the detection of the pathogen through various methods.
On examination of women, doctors identify such signs of inflammation as hyperemia and swelling of the vagina and vulva. Also during colposcopy, they may have a sign of “strawberry cervix”. It is characterized by redness of the mucous with focal and point hemorrhages located on the cervix. Also, the patient has epithelial dysplasia and the appearance of atypical cells.
More precisely, trichomoniasis is detected using the following laboratory methods:
- microbiological or cultural method using artificial nutrient media,
- microscopy of the material taken
- PCR diagnostics
- immunological method.
Trichomoniasis in men is more difficult to diagnose. This is due to the absence of severe symptoms.
Treatment of the disease in women
How to cure trichomoniasis? Treatment in women (drugs, reviews will be presented below) is usually carried out by a gynecologist. The treatment regimen for any form of this disease is the same (that is, it does not depend on the absence and presence of manifestations). It should be noted that the treatment of trichomoniasis is carried out simultaneously in both sexual partners, including with negative tests in one of them. Therapy of this disease only in a man or only in a woman is ineffective, since re-infection can occur even after undergoing a full course of treatment.
According to experts, the production of antibodies against Trichomonas does not form a stable immunity. Therefore, after therapy, a person can again become infected with this disease.
Treatment of the disease should be necessarily combined with treatment of other STIs. Therapy for trichomoniasis in pregnant women is determined by the doctor. As a rule, it is carried out only in the second trimester.
Due to the lack of sensitivity of trichomonads to antibiotics, this disease is treated with antiparasitic drugs, or rather, with drugs of the 5-nitroimidazole group. The following are commonly used as them: "Ternidazole", "Tinidazole", "Ornidazole", "Metronidazole", "Nimorazole".
The method of treatment in men
How do men with trichomoniasis are treated? Treatment in women (the drugs were listed above) and men is no different. Both partners are prescribed drugs of the 5-nitroimidazole group.
It should also be noted that in the treatment of the disease under consideration it is strictly forbidden to drink alcohol, since all of the listed drugs cause antabus-like syndrome.
Features of therapy and expert opinion
According to reviews of doctors, if trichomoniasis occurs in a subacute form, then antiprotozoal drugs are used to treat it. As for the complicated and chronic course of this disease, in this case, stimulating therapy is carried out.
Local and symptomatic treatment is applied strictly according to indications.
Also, experts say that when a mixed infection is observed (for example, ureaplasma, chlamydia, cytomegalovirus, gonococcus, candida), an antibiotic is prescribed to patients along with antiparasitic agents.
Trichomoniasis is considered to be completely cured if the pathogen is not detected during the diagnosis and no clinical symptoms are observed.
Sexual contact should be avoided during therapy. You must also inform your partner about the presence of trichomoniasis and other similar illnesses.
The result of the treatment of the disease under consideration depends on the normalization of microflora in the urogenital system. To this end, women are prescribed the vaccine "Solko-Trichovac". It is also possible to use immunomodulatory drugs.
Very rarely, trichomonads show resistance to a specific drug of the 5-nitroimidazole group. But the change in dosage, replacement of the drug or the duration of its reception gives a positive result in therapy.
What bacteria cause trichomoniasis?
The causative agent of trichomoniasis is a microorganism that belongs to the simplest, the genus Trichomonas. This is a small unicellular microorganism, has several flagella that provide mobility. In humans, several types of Trichomonas are parasitic - intestinal, oral (poorly understood) and urogenital trichomonas. This microorganism is the cause of chronic inflammatory pathology of the urogenital tract of a person. In the environment, urogenital trichomonas is unstable and dies within an hour. The microorganism is destructively affected by direct sunlight and dry air, antiseptics in normal concentration. Due to the instability in the environment, the main route of penetration of Trichomonas into the human body is infection during sexual intercourse, with direct contact of mucous genital organs. The main feature of Trichomonas, which complicates their treatment, is their high genetic variability and ability to develop antimicrobial resistance. Also, the majority of urogenital trichomonads are intracellular parasites, which also complicates diagnosis and etiological therapy. Trichomonas produce a number of substances that are factors of aggression and determine the pathogenicity (tendency to cause a pathological reaction) of the pathogen, these include:
- Proteases and hyaluronidase - enzymes that break down the molecular bonds of the proteins of the cell matrix, facilitate the penetration of Trichomonas into the deeper layers of tissue.
- Fibronectin is a specific proteinaceous substance that ensures the attachment of Trichomonas to the cells of the human urogenital system.
- Antitrypsin is a substance that protects Trichomonas from phagocytosis and enzyme splitting of cells of the immune system (macrophages and leukocytes).
- Hemolytic factor - causes the destruction of red blood cells in the area of parasitism Trichomonas.
Different subspecies of pathogens of urogenital trichomoniasis, the number and ratio of aggression factors are different, which determines the severity of the course and manifestation (appearance of clinical symptoms) of pathology.
How is trichomoniasis transmitted?
The main source of infection in urogenital trichomoniasis is a sick person (including asymptomatic pathology) and a carrier of Trichomonas. Infection of a healthy person occurs through direct contact of mucous genital organs (glans penis or vagina), since the infection is very unstable in the external environment (isolated cases of contact-household transmission of infection are described when using one towel in a sauna). Infection occurs through unprotected sex (without using condoms). Infection of the human population is high, which is associated with significant variability of the microorganism, the development of its antimicrobial resistance and the asymptomatic course of the pathology of the urogenital tract. It is believed that the infection in women is slightly higher than in men.
How does the disease develop?
The entrance gate for infection is the mucosa of the genital organs. Penetration occurs through the head of the penis in men or the vagina in women. Then gradually Trichomonas multiply and due to the action of factors of aggression spread to the organs of the genitourinary system. In men, they are parasitic in the prostate gland, bladder, testicles. In women, the vestibule and the vagina itself, the excretory glands of the external genital organs, the labia minora, the uterus, the ovaries and the tubes are mostly affected. In the field of trichomonad parasitization, a focus of inflammatory infiltration develops, consisting of cells of the immune system and the microorganisms themselves. Trichomonas partially parasitic inside the cells of the immune system, which complicates the process of treatment and the formation of an immune response. Therefore, after infection, the immunity is not formed and re-infection is possible.
Symptoms of trichomoniasis
Depending on the reactivity of the human body and the subspecies of Trichomonas, urogenital trichomoniasis may be asymptomatic or with the development of a manifest clinical picture. The incubation period of this infectious pathology ranges from one week to a month. It is characterized by certain sexual differences.
Symptoms of urogenital trichomoniasis in women
The main symptoms of the manifest form of urogenital trichomoniasis are:
- The appearance of vaginal discharge - they usually have a yellow or white color, are opaque and have an unpleasant odor.
- Hyperemia of the external genital organs - redness due to the inflammatory reaction, accompanied by increased blood flow to the site of Trichomonas parasitism.
- Itching in the vagina, large and small labia.
- Dyspareunia - painful sensations during sex.
- Dysuria - soreness and burning sensation when urinating.
- Chronic pain in the abdomen.
The severity and combination of the onset of symptoms in each woman is different.
Symptoms of urogenital trichomoniasis in men
In men, urogenital trichomoniasis is asymptomatic. In the case of the development of a manifest clinical form of this infectious pathology, several major symptoms develop:
- Discharge from the urethra (urethra), which may have a yellowish tint or white color.
- Urination is accompanied by the development of pain or a burning sensation in the region of the bladder and urethra.
- Symptoms of prostatitis (inflammation of the prostate gland) - abdominal pain in the bladder, a violation of ejaculation (often in the form of premature ejaculation), difficulty urinating.
Of all the symptoms in the development of the manifest form of urogenital trichomoniasis, the symptoms of acute or chronic prostatitis most often develop in men.
The main complication of urogenital trichomoniasis is a chronic lifelong infection. This, in turn, can lead to the gradual development of male or female infertility associated with persistent inflammation of the tissues of the urogenital system. In women, urogenital trichomoniasis can provoke adhesions in the tubes, followed by the inability to become pregnant or the development of ectopic pregnancy. Развитие урогенитального трихомониаза у беременной женщины может привести к ряду осложнений, которые зависят от срока беременности, на котором произошла манифестация инфекции. These include:
- Spontaneous miscarriages during the development of infection in the early stages of pregnancy.
- Malformations of the fetus - the result of overcoming the placental barrier with trichomonads and their parasitism in the cells of the developing fetus.
- Intrauterine development of the fetus is a lag in the growth and development of the fetus before its birth with a discrepancy in gestational age. This occurs when parasitizing the causative agent of urogenital trichomoniasis in the cells of the placenta with the development of inflammation in it and deterioration of blood circulation.
- Congenital urogenital infection of the child, caused by his infection in the later stages of pregnancy.
In connection with the possible development of fetal developmental disorders during the manifestation of urogenital trichomoniasis during pregnancy, it is very important for a woman to undergo laboratory testing at the planning stage of pregnancy. This will provide an opportunity to undergo etiotropic treatment with the destruction of infection in the urogenital system of a woman.
Therapy of urogenital trichomoniasis is carried out on an outpatient basis. Treatment is complex with an individual approach to each patient, correction of therapeutic agents is carried out depending on the subspecies of the pathogen and functional disorders of the genitourinary system. Etiotropic therapy of urogenital trichomoniasis is aimed at the complete destruction of the pathogen and the release of the body from it. Used for this chemotherapy with activity against Trichomonas, these include:
- Metronidazole for systemic administration in the form of tablets.
- Metronidazole for local treatment of urogenital trichomoniasis in women in the form of vaginal suppositories.
- Immunotherapy - activities aimed at activating the cellular and humoral immunity in relation to the release of the organs of the urogenital system from Trichomonas. For this purpose, medicinal products with immunomodulatory effects are used. They begin to take only after a doctor's appointment and an additional study of the functional state of the immune system and the absence of side effects or individual intolerance to drugs.
The duration of etiotropic therapy of urogenital trichomoniasis is determined individually. It is very important to completely free the body from the pathogen, since stopping treatment at its earlier stages can lead to a chronic course of the pathology. In the future, this will complicate etiotropic therapy, since the remaining Trichomonas become insensitive to metronidazole. On average, the course of etiotropic treatment is 7-10 days for the acute course of infection and about 2-3 weeks for the chronic course of the process. Pathogenetic treatment of urogenital trichomoniasis is aimed at reducing the severity of the inflammatory process in the organs of the urogenital system and improving their functions. To do this, the doctor prescribes anti-inflammatory drugs, men apply prostate massage. Also useful in this infectious pathology are plant diuretics, which "mechanically" wash out Trichomonas from the urinary tract and bladder. Local antiseptics in the form of vaginal douches are also shown to women.
Specific prevention of urogenital trichomoniasis in the form of vaccination does not exist. Also, the immunity is not formed after the infection. Therefore, a very important role in the prevention of infection and the development of the disease belongs to general preventive measures, which include the culture of sexual life, the elimination of frequent changes in sexual partners and the use of personal protective equipment. Protected sexual intercourse helps in 99% of cases to prevent infection with Trichomonas and other pathogens, which are sexually transmitted. First of all it concerns incurable diseases - HIV AIDS and viral hepatitis. Also against the background of urogenital trichomoniasis, the risk of infection with other infections that are sexually transmitted is much higher.
The relevance of trichomoniasis today does not lose its value. Infection of the human population in almost all countries of the world reaches 60% and above.
Biological features of the causative agent of trichomoniasis
The causative agents of trichomoniasis - trichomonas (the simplest type, family flagellates) - unicellular anaerobic organisms - parasites, widely distributed in nature. In the human body 3 types of trichomonads parasitize: vaginal (the largest, active, pathogenic), oral and intestinal. Thanks flagella Trichomonas very active and mobile. Trichomonas are asexual and omnivorous, multiply rapidly under optimal conditions - in the absence of oxygen and at t = 35-37 ° C.
Trichomonas are fixed in the cells of the mucous membrane of the urogenital tract and cause an inflammatory process there. The waste products of Trichomonas poison the human body, reduce its immunity.
Trichomonas can live in the genitals and even in the bloodstream, which penetrate through the lymphatic pathways, the intercellular spaces with the help of the enzyme hyaluronidase. Trichomonas are extremely adapted to the existence in the human body: they can change shape, mask themselves as blood plasma cells (platelets, lymphocytes) - which makes it difficult to diagnose trichomoniasis, “cling” to other microbes and avoid the body’s immune attack.
Microorganisms (gonococci, ureaplasmas, chlamydia, Candida, mushrooms, herpes viruses, cytomegalovirus), getting inside Trichomonas, there are protected from the effects of drugs and the human immune system. Motile Trichomonas can spread other microbes through the genitourinary system and blood vessels. Damaging the epithelium, Trichomonas reduce its protective function, and facilitate the penetration of germs and sexually transmitted viruses (including HIV).
Although modern venereology has effective drug treatment methods for most genital infections, it is completely extremely difficult to get rid of trichomoniasis even today. The fact is that the non-protein shell of Trichomonas does not respond to the action of antibiotics and can be destroyed only by special anti-protozoal drugs.
The clinical picture of trichomoniasis
Usually the incubation period of trichomoniasis lasts from 2 days to 2 months. If trichomoniasis occurs in an erased form, the first symptoms may appear several months after infection with a decrease in immunity or exacerbation of other chronic infections.
Trichomoniasis (depending on the severity of symptoms and duration) can occur in acute, corrective, chronic forms and as trichomonasal carrier.
The clinical manifestations of trichomoniasis in men and women are different. Trichomoniasis in women occurs with more pronounced symptoms, and male trichomoniasis usually exists in the form of trichomoniasis.
Trichomoniasis in women is manifested in the form of urethritis, vulvovaginitis, bartholinitis, cervicitis. The acute stage of trichomoniasis has the following manifestations:
- significant frothy discharge yellow, green, with an unpleasant odor,
- redness and irritation of the mucous membranes of the genitals (itching, burning), dermatitis of the inner surface of the thighs,
- genital mucosa damage (erosion, ulcers),
- discomfort during urination, dysuria,
- discomfort during sexual intercourse,
- sometimes lower abdominal pain.
The symptoms of trichomoniasis in women are aggravated before the onset of menses.
In childhood trichomoniasis occurs infrequently, as a rule, in girls. Infection occurs non-sexually from sick mothers through household items, underwear. Trichomoniasis in girls is manifested in the form of vulvovaginitis, in the acute course of which the symptoms are similar to the adult form of the disease.
Trichomoniasis in men occurs in the form of trichomonas urethritis (the urethra is affected) and is accompanied by mucopurulent discharge, slight itching, burning immediately after intercourse or urination. During the examination there are solid infiltrates, stricture of the urethra. Trichomoniasis can affect the prostate gland and epididymis, cause prostatitis (in 40% of cases) and epididymitis. Very rarely in men with trichomoniasis, erosions and ulcers of the mucous membrane, inflammation of the midline suture are observed.
The nature and amount of discharge depends on the stage of the inflammatory process: in chronic trichomoniasis, a small amount of mucous secretions is noted. Over time, they may subside, but recovery does not occur.
Fresh trichomoniasis, in the absence of treatment, becomes chronic (if more than 2 months have passed from the moment of infection) or into trichomonadal carrier. Chronic trichomoniasis can occur for years with little symptoms (
4% is accompanied by dysuria and slight pain,
Trichomoniasis is isolated as a form of trichomoniasis, in which the pathogen is detected laboratory, but the manifestations of the disease are absent. This division is conditional, since different forms of trichomoniasis can transform into each other. Worn forms of trichomoniasis play a large role in the spread of the disease. The pathogen that lives in the urogenital system is the source of infection of the partner during sexual intercourse and its own re-infection.
Trichomoniasis is dangerous because of its complications, because it increases the risk of transmission of other infections (including HIV), pregnancy pathologies (premature birth, stillbirth), the development of infertility (male and female), cervical cancer, chronic diseases of the genitourinary system. If there are similar symptoms and even in the absence of them, it is necessary to be examined for trichomoniasis, and possibly other STIs. This is important for women planning a pregnancy, for sexual partners - trichomonadal carriers and patients with trichomoniasis, for all, leading an active sex life.
Self-treatment of trichomoniasis can lead to the opposite result: Trichomonas pass into a more aggressive form, begin to multiply more actively, the disease becomes latent or atypical forms. To diagnose and treat trichomoniasis in this case is much more difficult.