Table of contents:
- Trichomoniasis: a description of the disease
- The causative agent of trichomoniasis
- Who is at high risk of contracting trichomoniasis
- How Trichomoniasis gets infected
- Diagnosing trichomoniasis
- The first signs of trichomoniasis in women
- Symptoms of trichomoniasis in women
- How does chronic trichomoniasis manifest in women?
- Features of the course of the disease in women
- Trichomoniasis during pregnancy
- Complications of trichomoniasis in women
- Treatment of trichomoniasis in women
- Traditional treatments for trichomoniasis
- Unconventional treatments
- What to do if trichomoniasis is found
- Prevention of trichomoniasis in women
Video: Trichomoniasis In Women - Causes, Symptoms And Treatment
Trichomoniasis in women - causes, symptoms and treatments Trichomoniasis in women is a common sexually transmitted disease that poses a threat to both women and men. Among sexually transmitted diseases, trichomoniasis takes the leading position. Representatives of the stronger sex may not notice the symptoms of the disease for a long time, women, as a rule, after the incubation period feel itching and burning in the genitals, and also notice yellowish foamy discharge. Trichomoniasis, the process of treatment of which in women should be carried out under the supervision of a specialist, is dangerous because it can become chronic. Trichomoniasis: Description of the disease Trichomoniasis is a fairly common disease that is inflammatory in nature. It is found in both women and men,affects the genitourinary system. Trichomoniasis is provoked by vaginal …
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Trichomoniasis in women is a common sexually transmitted disease that poses a threat to both women and men. Among sexually transmitted diseases, trichomoniasis takes the leading position. Representatives of the stronger sex may not notice the symptoms of the disease for a long time, women, as a rule, after the incubation period feel itching and burning in the genitals, and also notice yellowish foamy discharge. Trichomoniasis, the process of treatment of which in women should be carried out under the supervision of a specialist, is dangerous because it can become chronic.
The content of the article:
- 1 Trichomoniasis: a description of the disease
- 2 Causative agent of trichomoniasis
- 3 Who are at high risk of contracting trichomoniasis
- 4 How is Trichomoniasis infection
- 5 Diagnosis of trichomoniasis
- 6 The first signs of trichomoniasis in women
- 7 Symptoms of trichomoniasis in women
- 8 How does chronic trichomoniasis manifest in women
- 9 Features of the course of the disease in women
- 10 Trichomoniasis during pregnancy
- 11 Complications of trichomoniasis in women
- 12 Treatment of trichomoniasis in women
13 Traditional treatments for trichomoniasis
- 13.1 Tablets
- 13.2 Candles
- 13.3 Vaccination
14 Alternative methods of treatment
- 14.1 Infusions
- 14.2 Douching and baths
- 14.3 Tinctures
- 14.4 Juices
- 14.5 Tampons
- 15 What to do if trichomoniasis is found
- 16 Prevention of trichomoniasis in women
Trichomoniasis: a description of the disease
Trichomoniasis is a fairly common disease that is inflammatory in nature. It occurs in both women and men, affects the genitourinary system.
Trichomoniasis is provoked by vaginal Trichomonas, which is the simplest microorganism, unicellular. Due to such a simple structure, a single-celled microorganism adapts to life in the body and antimicrobial drugs do not always cope with the task and cannot relieve the patient of the disease.
In some cases, trichomoniasis is confused with another common disease - gonorrhea, the same inflammatory process.
Trichomoniasis in women. Infection occurs with various types of contacts and if the infection enters the vaginal route, then it is the vagina that will be most susceptible to the inflammatory process. The genitourinary system also suffers, any other organ can be affected (in the chronic course of the disease, when complications are already developing). Trichomoniasis can be of three types: vaginal, oral, intestinal and is most often transmitted sexually, during anal and oral contact.
We can say that Trichomonas is a pathogenic organism that can exist in three different forms and at the same time have some varieties. It is a round variety, amoeba-shaped and atypical, which leads to the development of cystitis. The most difficult to treat forms of a microorganism are atypical and round, and the most dangerous in its consequences is the amoeba form.
The causative agent of trichomoniasis
Trichomoniasis in women. Vaginal Trichomonas is not a bacterium at all, it is the simplest single-celled animal. That is why most antibacterial drugs cannot cope with this "villain". Trichomonas are mobile, that is, they can move independently with the help of their flagella; they do not need oxygen at all for life.
That is why they can easily penetrate into the upper urinary tract and, through the cervical canal, into the uterine cavity and appendages, causing a specific inflammation. Another significant feature of Trichomonas is their adherence to moisture. At the slightest heating, drying or exposure to direct sunlight, it dies.
Yes, and in favorable conditions, but outside the body, it lives only a few hours. Accordingly, in order to become infected with trichomoniasis not sexually, but through personal hygiene items - a towel, underwear, etc., you need to violate all the rules of personal hygiene. Although theoretically possible.
Trichomonas are the simplest microorganisms, in an active form are present only in human biological fluids. They are quickly inactivated at room temperature. Trichomonas die instantly under the influence of the following factors: during boiling; in saline and acidic solutions; when exposed to ultraviolet radiation.
The optimal habitat of Trichomonas is the mucous membranes of the genital organs and the genitourinary tract, therefore the term "urogenital trichomoniasis" is often encountered.
Who is at high risk of contracting trichomoniasis
Trichomoniasis in women. You are at increased risk of developing trichomoniasis if:
- you have had several sexual partners with whom you have had sex without a condom (the more partners you have, the higher the risk of trichomoniasis);
- you are sexually active early (girls who have lost their virginity before the age of 19 have an increased risk of trichomoniasis);
- you have previously had trichomoniasis or other sexually transmitted diseases (gonorrhea, chlamydia, etc.);
- you have had unprotected sex with a man with trichomoniasis.
How Trichomoniasis gets infected
Trichomonas infection occurs only during sexual intercourse. The incubation period can last up to two weeks. Moreover, saliva in the oral cavity and gastric juice act destructively on them, therefore oral contacts do not lead to infection, unlike syphilis, for example, when chancres (ulcers) are found anywhere, often on the tonsils and tongue.
Trichomoniasis in women. Often women are interested in whether there is another route of transmission. The contact-household route of infection is not excluded, however, in practice it is extremely rare. In order to get sick, you must simultaneously use, for example, one towel, linen and other intimate accessories. In this case, the clinical picture of inflammation will not be obvious, more often these are signs of vulvitis - redness, itching of the external genital area.
The household route of transmission is possible for little girls, whose parents do not adhere to distinctions when using personal hygiene products. Therefore, if an inflammation of the vulva is found in girls, first of all, it is necessary to examine the mother for genital infections.
Trichomoniasis in women. Modern medicine suggests four options for diagnosing this disease:
- culture study, which is recommended in the absence of pronounced symptoms of trichomoniasis;
- molecular biological research, which is designated as the most reliable diagnostic method that does not require additional confirmation;
- microscopic examination of a preparation stained with 1% methylene blue solution. This method is the simplest, but its sensitivity does not exceed 60 percent;
- microscopic examination of an unstained preparation, which demonstrates the highest sensitivity with a pronounced form of infection.
At the same time, progressive medicine in the diagnosis of genital infections, including trichomoniasis, is guided by the principles of the least time and cost, not to the detriment of the reliability of the research results.
According to this, the algorithm for diagnosing infection in modern clinics is as follows:
- gynecological examination with a sampling of a native smear, which, although it does not demonstrate high sensitivity, has the qualities of cheapness and speed of determining the result. The presence of a positive result for the presence of Trichomonas in this case is sufficient to determine the diagnosis;
- the presence of signs of trichomoniasis infection and a negative result of the native smear are the basis for more complex testing for antigen determination. As in the first case, with a positive test, treatment is prescribed, and with a negative test, additional research;
- The last study in this diagnostic protocol is culture. Modern medicine considers this complex of procedures to be absolutely sufficient for diagnosing the presence of Trichomonas and does not recommend further actions, guided by the above principle of rationality.
Examination for trichomoniasis in the presence of a single permanent sexual partner must be carried out in both men and women, even if the man does not have symptoms of trichomoniasis.
Remember that the partner's disease often goes unnoticed, and the risk of mutual infection during sexual intercourse is very high.
The same applies to the treatment procedure. Having cured trichomoniasis in a woman and not examining a man at the same time, the risk of relapse increases sharply, which can provoke acute or chronic trichomoniasis.
The first signs of trichomoniasis in women
Trichomoniasis in women. If we talk about a venereal group of diseases, often the symptoms are almost identical in all of them, all are not very similar.
They can shock and provoke natural bewilderment - in practice, the following symptoms are most common:
- discharge from the genitals, the color of which can vary from white to brownish-dirty, interspersed with pus;
- pain and discomfort during intercourse;
- burning sensation when visiting the toilet and urinating, when pus or blood splashes may be present in the urine;
- redness and swelling of the genitals.
Most often, such negative symptoms are clearly manifested in women - so vaginal discharge has an untidy smell of rotten fish, high viscosity. With regard to the symptoms of trichomoniasis in men, here most often doctors are faced with morning discharge from the urethra, supplemented by pain in the groin area, burning sensation and discomfort when visiting the toilet.
It is worth remembering that in trichomoniasis, the period of its incubation development can last up to a month, during which the disease will not manifest itself in any way. The patient during the incubation course of the disease does not know about the infection, but he himself is a carrier and distributor of pathogenic microflora. It can infect other people through sexual contact - the main route of transmission of the disease is sexual.
In the practice of doctors, the disease manifests itself quite clearly and sharply, although situations are not excluded in which the symptoms show themselves sluggishly or do not manifest themselves at all. As a rule, this can be an incubation period, but also a manifestation of a chronic, asymptomatic form of pathology, or the disease manifests itself as minor symptoms.
Symptoms of trichomoniasis in women
Trichomoniasis in women. The main symptom of trichomoniasis in women is vaginal discharge, usually liquid, frothy, yellowish or yellow, accompanied by itching and burning of the genitals.
In most cases, genitourinary trichomoniasis is a multifocal disease. The place of introduction of Trichomonas in women is the vaginal mucosa. Then, gradually, microbes enter the urethra, cervix, and spread through the mucous membranes.
There is also an ascending infection of the genitourinary organs. The inner part of the cervix is a kind of boundary for the spread of urogenital trichomoniasis due to the circular compression of the muscles of the cervix and a sharply alkaline reaction of the secretion of the uterine cavity. These protective barriers lose their strength during menstruation, abortion, and childbirth.
In addition, the rhythmic movements of the uterus during intercourse are a predisposing factor for the absorption of Trichomonas located in the cervix into the uterine cavity. In this case, there is an inflammation of the uterus - endometritis. With the penetration of Trichomonas into the tubes, salpingitis occurs, often accompanied by inflammation of the ovaries with the formation of adhesions and cystic formations.
When the urethra is damaged, urethritis occurs, with a prolonged course of which the formation of narrowing of the urethra is possible. With an ascending course, the development of symptoms of cystitis and pyelonephritis is possible.
The incubation period for trichomoniasis is 4 to 28 days. This means that the first symptoms of trichomoniasis may appear within a week after infection. In some women, the disease may be asymptomatic.
The main signs of trichomoniasis in women are:
- discharge from the vagina with an unpleasant rotten odor. Discharge in trichomoniasis can be yellow, green, white, or transparent. Sometimes the discharge may foam;
- bloody vaginal discharge, which can also foam;
- itching, discomfort, burning and dryness in the intimate area;
- pain during sex and spotting after sex;
- pain during urination;
- dull pains in the lower abdomen.
How does chronic trichomoniasis manifest in women?
Trichomoniasis in women. With a long course of the disease (more than 2 months), the symptoms of the disease become almost invisible. A woman may notice a scanty vaginal discharge with an unpleasant odor, recurrent itching in the genital area, dryness and pain during sex.
The following factors influence the nature of the development and symptoms of trichomoniasis in women: the intensity of the infection; properties of the pathogen; acidity (pH) of vaginal contents; condition of the mucous membranes; the composition of the accompanying microflora.
Features of the course of the disease in women
Where do Trichomonas come from in the intimate and other places of a woman? They penetrate the mucous membranes upon contact with a person or a carrier with trichomoniasis. They are fixed on the cells of the epithelium of the mucous membrane, penetrate into the glands and lacunae. Getting into the genitourinary organs, they cause the development of inflammatory processes.
The enzymes secreted by the pathogen lead to a significant loosening of tissues and more free penetration of toxic metabolic products of bacteria and accompanying microflora into the submucosa.
The severity of the inflammatory response depends on the number and properties of the parasite. This can be: redness, swelling, increased mucus secretion, minor hemorrhages and ulceration. The incubation period of the disease is 5-15 days. The severity of symptoms is determined by the properties of the pathogen and the state of the human body.
Trichomoniasis during pregnancy
Trichomoniasis in women. This disease is especially dangerous for pregnant women.
If a woman does not treat the disease, then she exposes herself and her baby to such dangers:
- frozen pregnancy;
- the likelihood of miscarriage;
- there is a possibility of amniotic fluid drainage before the term of labor, which stimulates premature contractions and labor.
Treatment for pregnant women is based on the following manipulations:
- treatment earlier than 12 weeks is based on the use of local vaginal agents (betadine or clotrimzole);
- women whose pregnancy has exceeded 12 weeks are prescribed short-term courses of drug therapy. Basically, various imidazole preparations are used.
Doctors categorically prohibit self-medication during pregnancy, since choosing the wrong medication can pose a serious threat to the life of not only the mother, but also the future baby.
Complications of trichomoniasis in women
Trichomoniasis in women. As a rule, trichomoniasis is successfully treated and almost never causes long-term consequences after recovery. Cases of inflammation of the uterus and fallopian tubes against the background of trichomoniasis with subsequent infertility are rare.
Trichomoniasis has been noted to increase the risk of viral infections such as HIV and HPV. Women who have had trichomoniasis have an increased risk of developing cervical cancer.
Trichomoniasis during pregnancy can lead to miscarriage, miscarriage, premature birth, fetal growth retardation, and intrauterine infection.
Gynecologists recommend getting tested for trichomoniasis and other sexually transmitted infections if you have at least one of the risk factors for trichomoniasis listed above.
Treatment of trichomoniasis in women
Trichomoniasis in women. When diagnosing such a diagnosis as trichomoniasis, you should not practice self-treatment, relying on the opinion of friends, the Internet and traditional medicine. This will only aggravate the course of the disease, launch it, allowing it to go into a chronic form of the course. Today, this disease responds well to treatment - a timely visit to a doctor, undergoing a full course of treatment will allow in the future not to have an opening with health and continue to lead an active, full life.
When treating trichomoniasis, the following rules should be observed: together with a woman, her sexual partner must be treated; sexual activity during the treatment period is prohibited; treatment of trichomoniasis is necessary for all forms of the disease (including trichomoniasis).
The control of the treatment result is carried out 7-10 days after treatment, and then again within 3 menstrual cycles. In the absence of Trichomonas in vaginal discharge after the end of menstruation, treatment should be considered successful. The need for compulsory treatment of Trichomonas is due to the fact that Trichomonas in many cases is the cause of infertility in men and women. The waste products of Trichomonas reduce the viability of sperm and immobilize them. The same effect is exerted by Trichomonas located in the genital tract of a woman. During pregnancy, Trichomonas cause infection of the membranes, which leads to premature birth and infection of the fetus.
In chronic trichomoniasis, treatment is supplemented with methods of correcting immunity. For mixed infections, anti-trichomonas drugs are combined with appropriate agents.
Traditional treatments for trichomoniasis
Trichomoniasis in women. The disease is treated in a comprehensive manner, while tablets for internal use, candles, ointments and creams are prescribed. Also, agents are additionally used to improve the functioning of the immune system. Both sexual partners should be treated.
Most often, drugs from the nitroimidazole group are used to treat the disease. Their mechanism of action is to disrupt the DNA structure of sensitive microorganisms. They are quite effective and allow you to get rid of trichomoniasis within 7-14 days.
These drugs include:
- Metronidazole (Trichopolum). There are different treatment regimens for trichomoniasis. You can take the agent 500 mg twice a day for 7 to 10 days. You can also get rid of the disease by consuming 2 g of the drug (4 tablets of 500 mg) per day for 5 days.
- Tinidazole. In order to get rid of the disease, take 2 g of the drug (4 tablets of 500 mg) once a day. If necessary, tinidazole is prescribed again.
- Ornidazole (Tiberal). After meals, take 1 tablet twice a day for 5 days.
When taking drugs, side effects from the digestive system are possible, in the form of nausea, stool disorder. Headache and dizziness may also occur.
In the complex treatment of trichomoniasis in women, suppositories or vaginal tablets are used:
- Terzhinan. The preparation contains ternidazole, neomycin sulfate, nystatin, prednisolone sodium metasulfobenzoate. Before use, the tablet must be held in water for 30 seconds, then inserted deep into the vagina. Use the drug once a day for 10 days. It helps to eliminate not only trichomoniasis, but also vulvovaginitis and colpitis of bacterial or fungal origin.
- Mikozhinaks. Combined drug, which includes metronidazole, chloramphenicol, dexamethasone and nystatin. Before inserting a vaginal tablet, it must be held in water. Apply the agent once a day for 10 to 12 days. If during this period the disease does not get rid of, the treatment is continued.
- Neo-Penotran. Suppositories contain miconazole and metronidazole. They are inserted deep into the vagina once a day before going to bed for 2 weeks, or twice a day for a week.
Traditional medicine in the treatment of trichomoniasis, both in men and women, uses creams and gels and ointments with metronidazole (Metrogyl, Macmiror). For males, the drug is injected into the urethra, and for women, into the posterior fornix of the vagina.
Trichomoniasis in women. Nitroimidazole-based drugs are very effective in the treatment of the acute stage of trichomoniasis, but they cannot cope with the normalization of the vaginal environment. In order to create unfavorable conditions for the reproduction of Trichomonas, the SolcoTrichovac vaccine is used.
It is prepared from abnormal strains of lactobacilli. It restores normal microflora in the vagina, thereby creating unsuitable conditions for the reproduction of Trichomonas.
In order to provide one-year protection against the disease, 0.5 ml of SolcoTrichovac is administered 3 times intramuscularly with an interval of 14 days. A year later, revaccination of 0.5 ml of the drug is required once. When using the remedy, immunity increases, the normal flora of the vagina stabilizes, and pathogens disappear.
During the period of treatment, it is necessary to give up sexual activity. You should also refrain from drinking alcohol and eliminate all factors that lower the body's resistance.
Trichomoniasis in women. Treatment of trichomoniasis with folk remedies is a rather long procedure. In order to get rid of the disease, you must follow all the recommendations. Complex treatment uses many methods. This is the use of infusions and decoctions for oral administration, as well as douching and baths.
For the preparation of decoctions and infusions, the following medicinal fees are used:
- White birch leaves, rowan berries, yarrow grass, nettle leaves, corn silk, cold mint, knotweed grass, immortelle flowers.
- Oak bark, linden flowers, raspberry leaves, goose finger grass.
- Linden and black elderberry flowers, raspberry leaves, rose hips.
- Yarrow, oak bark, chamomile flowers, rosemary, sage.
- Calamus root, nettle leaves, buckthorn bark, thyme, St. John's wort.
All components are mixed in the same amount and stored in a linen bag in a dry, dark place. To prepare a medicinal infusion, 2 tablespoons of the collection are poured with half a liter of boiling water and placed in a thermos. In the morning, filter the infusion and consume 250 ml each morning and evening. The collection is changed every week. Alternative treatment should last for a month.
Douching and baths
To prepare solutions for douching, the following fees are used:
- Chamomile flowers, calendula, sage leaves, white birch and oak bark.
- Linden flowers, oak bark, bird highlander, chamomile flowers, rosemary.
- Helichrysum flowers, calendula, chamomile, yarrow herb, oak bark.
- Mallow and elderberry flowers, sage leaves and oak bark.
- Melilotus officinalis, sage leaves, marshmallow root.
The plants are mixed in equal proportions. To prepare the product, an hour before the procedure, 20 g of one of the fees is poured into 700 ml of boiling water and insisted under the lid. Thoroughly filter before use. You need to douche once a day. The procedure is carried out for 10 days. For the period of menstruation, it is stopped.
Douching with medicinal infusions can be combined with the use of suppositories and vaginal tablets. Also, the products can be used for sitz baths or washing the external genitalia, both in men and women.
Trichomoniasis in women. In order to get rid of trichomoniasis, folk remedies are used in the form of tinctures, which help to fight this pathogenic microorganism and strengthen the immune system.
They are prepared as follows:
- A glass of walnut partitions must be crushed with a coffee grinder. Pour 200 ml of vodka into the powder and leave in a dark place for a week. Strain and take 15 drops on an empty stomach. Continue treatment until the signs of the disease disappear.
- Grind a glass of ripe viburnum berries and mix with the same amount of liquid honey. After the product has stood for a week in a dark place, it must be rubbed through a sieve and mixed with 100 ml of brandy. Take 5 ml in the morning and in the evening for three days, then 10 ml for 2 weeks.
- Chop 4 large heads of garlic and pour 150 ml of vodka. Insist in a dark place for a week. Strain and take 15 drops twice a day for 2 weeks.
In order to improve the functioning of the immune system and get rid of trichomoniasis, natural juices are used. To soften the taste and make them healthier before consuming, you can add a little honey.
Trichomoniasis in women. The following natural helpers will help the treatment:
- Cranberry juice. It quickly kills the protozoan parasites and is used not only to treat trichomoniasis, but also in diseases of the bladder. For its preparation, fresh berries are taken, which are squeezed out using a juicer. Dilute 100 ml of juice with the same amount of water and add honey. Drink in small sips using a cocktail straw. You need to take the remedy once a day, in the morning. You can not use cranberry juice for people with high acidity of the stomach. You can prepare the product from frozen berries. To do this, they are left at room temperature until they let the juice out.
- Radish juice. In order to prepare it, the fruits of black radish are grated and squeezed out with gauze. Drink it in a tablespoon no more than three times a day. You cannot store ready-made juice; it must be prepared immediately before use. The finished product contains the necessary enzymes that kill Trichomonas.
- Grate horseradish root and squeeze out the juice. First, it must be diluted in half with water. Take 20 ml in the morning and evening. Continue taking for at least 3 weeks.
In order to get rid of the disease, you can use tampons soaked in medicinal infusions or oils:
- A tablespoon of oak bark is poured into 200 ml of boiling water and simmered over low heat for half an hour. Filter, soak a tampon with the agent and place it in the vagina overnight. The finished broth can be stored in the refrigerator for no more than 3 days.
- 100 g of fresh sea buckthorn berries are turned into gruel and poured with the same amount of refined olive oil. Insist in the refrigerator for a week and grind through a sieve. A tampon with sea buckthorn oil is placed overnight. This continues for a week.
- Cranberry juice is diluted with boiled chilled water in a ratio of 1 to 4. The tampon is soaked in this solution and placed in the vagina for 2 hours. The procedure is carried out once a day for a week.
Treatment with folk remedies allows you to avoid the negative effects of drugs on the body, but it is not a fact that it will allow you to get rid of the disease and prevent it from becoming chronic. If within a week after the start of the use of folk remedies or drugs, no positive effect is observed, consultation with the attending physician is necessary.
What to do if trichomoniasis is found
Trichomoniasis in women. First of all, do not worry, as modern treatment methods help to cure trichomoniasis in almost 100% of cases. Contact your gynecologist who will draw up a treatment regimen for you. Do not try to treat trichomoniasis at home, as this can lead to the transition of the disease into a chronic asymptomatic form.
Since trichomoniasis is very often accompanied by other sexually transmitted diseases (gonorrhea, chlamydia, HIV infection, etc.), experts recommend testing for all these infections.
Be sure to tell your sexual partner that you have trichomoniasis. If you have had multiple sex partners in the past 3 months, contact everyone. Trichomoniasis is very often asymptomatic in men, so your partner may not even know that he is sick and infectious. Encourage your partner to visit a urologist and get tested for trichomoniasis and other sexually transmitted diseases.
Communicating with former partners and, moreover, reporting such news can be very unpleasant, but in this way you will protect many people from this disease and its dangerous consequences. You can even do this anonymously by sending an SMS from a new number or by writing an email from a new mailing address.
Prevention of trichomoniasis in women
Trichomoniasis in women. These factors indicate that in order to prevent this disease, it is necessary to strictly follow a number of recommendations, which, however, does not contain anything supernatural:
- culture of sexual relations;
- in the presence of inconsistent sexual partners, the use of exclusively barrier contraceptives;
- high culture of intimate hygiene, excluding the use of underwear and hygiene products of other people;
- regular medical examinations, which you need to undergo at least six months.
In addition, there is a fairly effective method of one-time prevention of trichomoniasis after accidental sexual intercourse without using a barrier contraceptive. It consists in the introduction of five milliliters of miramistin solution into the vagina and external treatment of the genitals with antiseptics.
Doing so will reduce the risk of Trichomonas transmission by 70 percent. But at the same time, doctors strongly recommend avoiding situations where such emergency therapy is needed.
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