The clinical diagnosis and management of trichomoniasis is not difficult; however, control of the disease requires notification and treatment of partners as well as lifestyle changes. Women are more likely than men to have obvious symptoms of this disease, but in many cases, neither sexual partner will display any clinical signs or symptoms (Centers for Disease Control, 2010).
Clinical Signs and Symptoms
Specifically, women may experience a frothy, yellow-green, and malodorous vaginal discharge when they have trichomoniasis. There may be discomfort with intercourse or urination, and the genital area may itch or show irritation. Uncommonly, these women will have lower abdominal pain. Since these clinical signs and symptoms may take from 5 to 28 days to appear after acquisition of the infection, it can be a challenge to control the spread of this medical condition.
In other words, the incubation period, or the time from acquisition of disease to the development of signs and symptoms, may account for additional transmission of the infection because the patient does not know that he or she has it.
Women with this parasitic infection may develop red spots on the cervix or the wall of the vagina, and physicians refer to this well-known clinical finding as strawberry cervix. The diagnosis requires history, physical examination, and laboratory tests.
Men who develop symptoms from this disease may experience a sensation of burning when they urinate or ejaculate.
Medical Therapy
Antimicrobial therapy has been available for several decades to treat trichomoniasis. Metronidazole and tinidazole are effective oral agents to cure it. These drugs will relieve symptoms, achieve microbiologic cure, and reduce the occurrence of disease transmission. Since the occurrence of trichomoniasis does not confer any immunity for the patient, he or she can acquire it many times again if they continue to participate in unprotected sexual intercourse.
Both sexual partners, and previous sexual contacts, must take the medication and refrain from sexual activity until therapy is complete. Otherwise, they may transmit the disease again. The recommendation for metronidazole is two grams orally as a single dose; the dose for tinidazole is the same. An alternative regimen for metronidazole is 500 milligrams twice daily by mouth for seven days.
Pregnant women can take metronidazole. It is essential that they obtain prompt and adequate treatment for this medical condition because trichomoniasis may lead to premature or low birth weight babies.
Topical products such as gels which the patient can apply to the skin or genital region are available, but none of them is as effective as oral medication, and every patient with the disease must take a course of either metronidazole or tinidazole.
Sources
- Centers for Disease Control. (2010). Trichomoniasis. Retrieved September 23, 2011.
- U.S. National Library of Medicine. (2011). Trichomoniasis. Retrieved September 23, 2011.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.
Michael Koger - Dr. Koger obtained his medical education at Meharry Medical College and specialized in Internal Medicine.
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