Trichomoniasis, The Silent Endemic

Most men with trichomoniasis do not have signs or symptoms.

Trichomoniasis is a common sexually transmitted disease (STD). An estimated 7.4 million new cases occur each year in women and men, in the States. Unfortunately, it is not a well-known STD, due to its somewhat lengthy spelling and difficult pronunciation (Pronunciation similar to try-ko-mon-nieh-ses).

Trichomonas vaginalis, a single-celled parasite, is the causative organism. The vagina is the most common site of infection in women, and the urethra is the site of infection in men. The parasite is transmitted through penis-to-vagina intercourse or vagina-to-vagina contact with an infected partner. Women can acquire the disease from infected men or women, or possibly, even from contaminated objects. Men usually contract it from infected women. Most men with trichomoniasis do not have signs or symptoms. Occasionally, the infected men may have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation. These often go away untreated but can last up to many weeks. Some women have signs or symptoms of vaginitis which include a yellow-green vaginal discharge. The discharge often carries a strong smell and looks frothy. They may also have a slight pain during intercourse and urination, as well as irritation and itching of the genital area. Lower abdominal pain can occur but is rare. After exposure, the symptoms usually take 1 to 4 weeks to appear. The parasite is harder to detect in men than in women. In women, a pelvic examination can reveal small red sores on the vaginal wall or cervix. In men, examination of the genital is often completely normal. At times, there is a light pink discoloration or a mild soreness to pressure at the tip of the penis. In men, the diagnosis relies more heavily on the history than on physical examination. Trichomoniasis is usually cured with prescription drugs, either metronidazole or tinidazole, given by mouth in a single dose. In an infected man, the symptoms of trichomoniasis may disappear after a few days without treatment. This is a dangerous situation as he then can infect or re-infect one or more female partners until he gets treated. Therefore, both partners should be treated at the same time to eliminate the parasite. Persons being treated for trichomoniasis should avoid sex until they and their sex partners complete treatment and have no symptoms. There is no immunity to Trichomoniasis after infection and recovery (the person can be infected repeatedly). Condoms, when used consistently and correctly, offer some protection (but not guaranteed) against trichomoniasis. The only certain way of prevention is to have both partners stay in a “single partner only” sexual relationship.

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