How Trichomoniasis is Diagnosed

Trichomonas vaginalis (TV) is diagnosed in three main ways. 

1. Fresh discharge may be swabbed and examined under a microscope in a clinic ('on-the-spot' microscopy), which will show the organisms busily moving around. 

2. Fresh discharge may also be cultured from a vaginal swab sent to the laboratory (by a GP, for example) 

3. Unsuspected TV may occasionally be seen on a routine cervical smear.

Reliability of the Diagnosis

No test for TV is more than about 70 per cent accurate. A number of factors complicate the diagnosis.

If it is seen on culture or 'on-the-spot' microscopy, the diagnosis is seldom wrong. However, there may be too few organisms to be seen or, if the specimen has been taken at some distance from the laboratory, the organisms may die in transit.

If TV has been found only on a cervical smear, it may have been confused with some types of immune cell (which it can resemble once stained with dyes as part of the cervical smear process). The diagnosis has to remain dubious until it can be confirmed in another way.

Often TV is present together with the bacteria that cause Bacterial Vaginosis (BV) and, because the latter are easier to find, BV may be the only diagnosis made. Fortunately, treatment for BV works for Trichomoniasis too.

If Trichomoniasis is not diagnosed, however, your male partner will not realize that he needs to be treated and you may catch it back from him. Failing to diagnose Trichomoniasis also means a missed opportunity to look for and treat any accompanying infections, such as Chlamydia infection and gonorrhea.

Factors that Predispose you to Trichomoniasis

As TV is sexually transmitted, the predisposing factors are all those that increase the risk of catching any sexually transmitted infection. Studies have shown that the following factors are more common in people with a sexually transmitted infection:

• A recent change in sexual partner

• Sex outside a relationship

• Being aged under 20 years

• Living in an inner city

• Not using barrier contraceptive methods (for example, condoms).


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