Trichomoniasis: Symptoms and Treatment
Trichomoniasis (trichomoniasis) is an inflammatory disease in which the urogenital system of men and women is affected. It provokes the appearance of a vaginal trichomonas, acting as the simplest — that is, not a microbe, but a unicellular creature. Trichomoniasis, the symptoms of which are provoked by this creature, unlike microbes, are more adapted to the conditions of the organism’s environment, as well as to attempts to exert antimicrobial agents on it.
Often the disease treated by us is determined by mistake as a gonorrhea, which is completely wrong. The fact is that the gonorrhea is another inflammatory disease, although it affects, along with trichomoniasis, the genitourinary system. Tripper is nothing more than a gonorrhea provoked by the gonococcus. The transmission of trichomoniasis in question is sexually transmitted, not only contacts in their traditional form, but also anal and oral contacts. It should be noted that infection with trichomoniasis in 2/3 of the total number of cases noted occurs as a result of extramarital affairs.
Trichomonas are of three kinds, being intestinal, oral and vaginal. The first two species refer to saprophytes, which, in turn, defines them as microorganisms, whose effects on the organism do not lead to the development of certain types of diseases.
Thus, leading to trichomoniasis, that is, a pathogenic trichomonas, is the trichomonas vaginal, which, in turn, can also exist in three varieties of forms. In particular, it is rounded, amoeboid and rounded in shape, besides them there is also a form of atypical (or, as it is still defined, cystic), which, despite overwhelming opposition among scientists, it is not necessary to exclude. The most difficult to treat are such forms of Trichomonas as rounded and cystic, the most aggressive form is the form of amoebae.
Trichomoniasis: Transmission Pathways
Certainly, the sexual way of transmission of the disease is the main, however, other ways should not be excluded, in spite of the generally insignificant percentage of those. Of the options that will be listed below, the contact-household transmission route, unlike the sexual one, has not been clinically proven to date.
- Sexual way. In this case, infection occurs as a result of direct genital contact. Other variants of sexual intercourse are also not excluded (petting, genital-anal, genital-oral).
- Contact with a biological type of fluid. Here the transmission of infection occurs through contact with liquids such as blood, saliva, sperm belonging to the patient. Given this, even kissing can become a way of transmitting infection to a healthy person.
- Contact-household variant of infection. Given the ability of the infection to maintain its own vitality in the environment for several hours, infection is not ruled out in cases such as the use of a toilet lid (common with a sick person, naturally ), Use of personal hygiene items, underwear of a sick person (the same applies to a bathing suit, bathrobe, etc.).
- Vertical transmission. This method is relevant for the birth of a child, with a special risk here for newborn girls. With regard to the possibility of intrauterine infection, it, as well as the peculiarities of pregnancy with trichomoniasis, will be considered below.
Trichomoniasis: flow features
The duration of the incubation period of this disease is about two to four weeks after infection of the patient, after the end of this period, respectively, the first symptoms of trichomoniasis appear. The course of the inflammatory process of this disease is acute, it is characterized also by the appearance of abundant secretions in a complex with quite pronounced pain sensations.
It should be noted that the exclusion of treatment, incorrectness in the definition of measures for him or insufficient implementation of them on the part of the patient can lead to trichomoniasis in a chronic form, which often happens. In this case, inflammation is the basis for the subsequent colpitis, urethritis, cervicitis, vulvovaginitis, etc. It is not superfluous to note the fact that trichomoniasis significantly affects the quality of life, thus violating the menstrual and sexual functions of sick patients.
Quite often, trichomoniasis also contributes to mixed infections, which is especially pronounced in manifestations with the urgency of the combination with gonococci. Microorganisms, highlighting the corresponding products of vital activity, provoke the activation of the process of toxic effect, carried out to the tissues of the patient’s body. In addition, they have a facilitating effect on the penetration of the underlying tissues of other pathogens.
The actual interaction that arises between trichomonads and bacteria is, in practice, extremely important, because as with the absorption of pathogenic microorganisms, trichomonads can act as conductors of infection not only to the upper parts of the reproductive system, but even to the abdominal cavity.
Based on modern research, there are all prerequisites for the assumption of the existence of an indirect and direct link between trichomonas infection and infertility. Most often, the infection leads to a stable male infertility, which is explained by a violation of viability and general mobility of spermatozoa.
In some cases, the onset of trichomoniasis appears sluggish (or torpid), which is accompanied by little or no symptomatology. Moreover, in such a course, patients may not even suspect that they have this disease, although even in this case the appearance of an inflammatory process does not exclude, as it does not exclude the infection of the disease by sexual partners.
It is noteworthy that the nature of the course of this disease is determined by specific factors, they, in turn, determine the actual state of the clinical picture. These factors include, in particular, the intensity of the infection, the characteristic properties of Trichomonas, the level of acidity of the vagina, and the mucosal state in combination with the composition of the microflora that accompanies them.
The onset of an acute inflammatory process is predominantly characterized by the appearance of vaginal discharge, as well as discharge from the urethra. It is the secretions arising from the genital tracts that are the main and most common symptom of the disease under consideration, with such discharges in about 75% of cases noted. This indicator is significantly increased among women, respectively, slightly lowered in men. Given that trichomoniasis in women is characterized by a greater severity of manifestations, it is with the symptoms of this disease that we begin.
Trichomoniasis: symptoms in women
Among the most pronounced and pronounced symptoms of the disease we are considering, women can include the following manifestations:
- redness in the genital area, their general puffiness
- formation of small ulceration and hemorrhage
- the appearance of significant mucous discharge;
- the appearance of watery or foamy in the consistence of secretions with a characteristic smell of fish
For selections, their acerbity may be characteristic, as for color, it can vary from white to greenish-yellow. Often, vaginal discharge is accompanied by a burning sensation in a complex with acute soreness in the vulva, and itching often occurs in the genital area, the latter, in turn, can spread even to the inner femoral surface. With particularly severe itching and irritation, minor vaginal bleeding may appear.
In some cases, complaints from patients on the pain and burning that occur during urination are possible, and these manifestations may also accompany sexual intercourse.
It is noteworthy that the pain that accompanies inflammation can be felt by patients not only within the sexual organs, but also in the lower abdomen or back. As for the visible changes in the mucous uterus and the walls of the vagina, they are usually absent, unless, of course, we are talking about severe cases in which the inflammatory process in the perineum and vulva can be accompanied by swelling of the labia.
If we talk about the specific symptoms of this disease, then they are mostly determined by which of the zones of the genitourinary system was affected by Trichomonas. So, for example, if the vagina has suffered a lesion, then discharge, burning and itching appear, as well as pains in the lower abdomen of the pulling character and pain during sexual intercourse. If the bladder and urethra have been affected, the symptomatology, respectively, affects the main functions inherent in these areas, manifested as a violation of urination and its frequency, and also in the form of pain that accompanies, again, urination.
The defeat of the internal organs (ovaries, uterus and fallopian tubes) with trichomonads is extremely rare. This is explained by the fact that nature appropriately took care of providing a kind of barrier from the inside of the cervix, which prevents the spread of the urogenital form of trichomoniasis. Such an obstruction is provided by the circular compression of the muscles produced by the cervix, as well as by the sharpness of the alkaline reaction from the secretion of the uterine cavity.
Meanwhile, certain factors of impact (childbirth, abortion, menstruation) lead to the fact that the natural impassability inherent in this barrier with respect to infection is lost, as a result of which it is no longer possible to exclude the possibility of penetration into the uterus of trichomonads. Ultimately, because of this process, endometritis can develop — a serious disease that causes inflammation of the uterus with the subsequent development of a number of serious complications.
If trichomonads enter the fallopian tubes, then a disease such as salpingitis, which often occurs in combination with ovarian inflammation, which produces adhesions and cystic formations, may develop.
In addition, according to some experts, the absorption of various types of bacteria by the Trichomonad (but not their killing by it) is the reason for transferring them to the internal genital organs, as a result of which, upon their subsequent release, an inflammatory process of the corresponding nature of the flow is formed.
In addition to the specific area of Trichomonas localization, the symptoms of trichomoniasis are also determined by the state in which the patient’s body is in general. In particular, the most acute manifestations of this infection are noted with a weakened immunity of the patient, as well as with the urgency of another type of inflammation, etc. It is noteworthy that the ingestion of trichomonads into the body leads to a negative effect on the immune system, which consequently leads to an aggravation of all diseases that are already present in the patient, which is especially important if there are such within the genitourinary system.
Finally, consideration of such a disease as trichomoniasis in women, the symptoms of which we have identified above, determines not to overemphasize the characteristics that are characteristic of this infection in a single or complex course with other types of infections.
So, on the basis of WHO data for a certain period of time, it was found that only 10.5% of the total number of patients face the infection in its single variant, that is, without joining other types of infections. On the other cases of the disease, there are variants of mixing up to a certain variant of combining. Among the most common satellites of this disease (in order from the greater prevalence of the variant to the lesser) are microplasmas, gonococci, gardnerelles, ureaplasmas, chlamydia, and various species of fungi.
Almost always, trichomoniasis occurs with disturbances in the normal state of the microflora in the vaginal area, as a result of which the content of the bifidobacteria required here is susceptible to decrease, lactic acid bacteria are liable to disappear, and the growth, accordingly, is due to pathogenic microorganisms. Simultaneously with this increase is noted and the number of staphylococci, yeast-like fungi, spirochaetes, enterococci, etc. As a result of the complex of these processes, the overall picture of the disease is noticeably more complicated, this in turn affects the possibility of diagnosis, and the subsequent treatment of trichomoniasis.
Trichomoniasis in men: symptoms
Of course, the consideration of trichomoniasis in men is also superfluous, but it should be noted immediately that they have very little or no symptoms of this disease. Whatever it was, even the absence of symptoms of this disease is not at all an indicator of the harmless existence of an infection in the body.
The asymptomatic course of trichomoniasis in men can provoke, for example, a «sudden» prostatitis (manifestations of which, as you may know, are in the lesion of the prostate gland), during which, in turn, provokes infertility. It is noteworthy that the case in this case is not even so much in the possible appearance of prostatitis. Thus, active reproduction of Trichomonads in the seminal fluid leads to the isolation of specific products of vital activity, as a result of which the growth of spermatozoa slows down when they are immobilized in parallel. In addition, of course, even asymptomatic carriage of infection by men in this situation determines the possibility of its transmission to sexual partners.
As for the few manifestations that are still possible with trichomoniasis in men, for example, they may include soreness of urination, which is accompanied by a characteristic incision and burning sensation. Also there are sudden or frequent desires to it, especially this manifestation is actual in time for the early morning. In some cases, the emergence from the urethra of frothy white discharge or purulent discharge, possibly the appearance of blood — its impurity is found in the urine, in the sperm can also be found blood veins.
As a result of the development of the inflammatory process against the background of trichomoniasis in the perineum or in the deeper region of the pelvis, pain and burning, discomfort and a feeling of heaviness can be noted. In the event of injury to the trichomonads of the urethra, inflammation may occur, which is defined as urethritis. If the course of urethritis is long-lasting, then it subsequently leads to narrowing of the urethra. The ascending nature of the inflammatory process can provoke cystitis or pyelonephritis.
As a rule, the symptoms of an acute form of trichomoniasis appear on the order of about 1-2 weeks, after which the manifestation clinic is either subject to reduction or disappearance, or transition to a chronic form of the disease.
Trichomoniasis and pregnancy, trichomoniasis in children: symptoms
Most specialists hold the position that trichomoniasis is not a disease that can fatal effect on the fetus, but in any case trichomoniasis during pregnancy is certainly an extremely undesirable condition. As an explanation, there are several reasons.
So, trichomoniasis in pregnant women can provoke premature birth, respectively, acting as a factor increasing the risk of such a development of pregnancy. In addition, it is trichomoniasis that can lead to a premature outflow of water surrounding the fetus.
It should be noted that trichomonads do not enter the fetus through the placenta, but the passage of it later along the birth canal, by them, affects the possibility of infection with trichomoniasis. Trichomoniasis in a child can be treated within the first week of birth, but this, in turn, can lead to the defeat of the immune system, the formation of which as such, in principle, to speak early. And in general, if at the beginning of a child’s life it is necessary to use medications, then this is not the best option for him.
However it may be, it is much worse if the child’s organism is exposed to trichomonads on him, respectively, treatment of this disease should be started earlier — in the vast majority of cases, a positive result is achieved. In this case, as, incidentally, for adults, an important role is played by subsequent treatment, focused on strengthening immunity and normalizing the microflora of the body.
The danger of the disease we are considering for a child is not particularly great, but the consequences of its course are much more serious for the health of the pregnant woman and the fetus. Running cases of trichomoniasis can lead to the fact that the infection spreads to the uterus, after which it is possible and its switching to the membranes of the fetus. As a result of inflammation of the latter, an extremely dangerous situation arises, the outcome of which can be even miscarriage or stillbirth. Meanwhile, this situation is extremely rare, with a neglected disease. The exclusion of such a result is possible when conducting appropriate surveys recommended in planning pregnancy for the presence of sexually transmitted infections, trichomoniasis to them, as you might guess, also applies.
It also happens that before the onset of pregnancy signs of trichomoniasis in a woman did not manifest, and the identification of the corresponding symptomatology occurred already during her. A similar result is possible with passive carriage of infection, which, due to the weakening of immunity (which is typical of pregnant women in general) has manifested itself in acute form. This situation requires a re-examination of the diagnosis followed by the appointment of a treatment that includes taking into account the factor of pregnancy.
Diagnosis of the disease is based on bacteriological detection of infection after the coloration of the Gram stain, or on their detection in fresh (or native) preparations.
In the latter version, everything is extremely simple: a special isotonic solution is applied to the surface of the slide, then a drop of the patient’s vaginal discharge is added, after which the drug is examined using a microscope. Meanwhile, the detection of Trichomonas by this method does not always occur immediately, therefore, the necessity of repeated conduct of this study is not ruled out.
As a modern technique for detecting trichomonads in the body, the method of searching for genetic markers is used, in which the polymerase chain reaction (known to most in the form of a reduction — PCR) is applicable.
Treatment of the disease under consideration provides for the need to observe several basic principles, including:
- treatment of the disease in a simultaneous order, that is, it implies the treatment of both sexual partners
- prohibition of sexual activity during the treatment of the disease
- elimination of the factors provoking a decrease in the body’s resistance, which implies the need for curing of concomitant diseases, hypovitaminosis and other similar species
- use of anti-trichomonias drugs in combination with local and general hygiene procedures
In the case of the appearance of symptoms characteristic of trichomoniasis, a consultation of several specialists is needed: a gynecologist / urologist, as well as a venereologist.