Trichomoniasis In Women: Causes, Symptoms And Treatment Methods

2023 Author: Riley Dean | [email protected]. Last modified: 2023-05-24 12:07

Trichomoniasis in women. Among sexually transmitted diseases, trichomoniasis takes the leading position. As soon as Trichomonas, the causative agent of trichomoniasis, enters a woman's body, health problems begin. Trichomoniasis in women is manifested by redness of the genitals, itching, burning, vaginal discharge, frequent urination. In no case should this disease be left without treatment, otherwise serious complications may occur.

The content of the article:

• 1 What is trichomoniasis
• 2 Biological characteristics of the causative agent of trichomoniasis
• 3 Prerequisites for the development of trichomoniasis in women

• 4 Symptoms of trichomoniasis in women

  • 4.1 Indications for prescribing an analysis for trichomoniasis in women
  • 4.2 Methods of laboratory diagnosis of trichomoniasis in women
  • 4.3 Microscopy
  • 4.4 Molecular genetic methods
  • 4.5 Serological testing
  • 4.6 How long is the analysis done for trichomoniasis and how to interpret the results
  • 4.7 Treatment of trichomoniasis in women
  • 4.8 Prevention of trichomoniasis

What is Trichomoniasis

Trichomoniasis (or trichomoniasis) urogenital is a disease exclusively of the human urogenital system. The causative agent of trichomoniasis is vaginal (vaginal) Trichomonas, a sexually transmitted infection.

The target organs of trichomoniasis in men are the urethra, prostate, testes and their appendages, seminal vesicles, and in women - the vagina, the vaginal part of the cervical canal, and the urethra. Vaginal Trichomonas in women is found more often due to more pronounced manifestations of trichomoniasis and more frequent visits to the doctor for preventive purposes.

Trichomoniasis in women. Basically, women of reproductive age from 16 to 35 years old get sick with trichomoniasis. During childbirth, infection with trichomoniasis of a newborn from a sick mother occurs in about 5% of cases. In newborns, trichomoniasis is mild due to the structural features of the epithelium and is capable of self-healing.

In men, usually, the presence of Trichomonas does not cause obvious symptoms of trichomoniasis, they are often carriers of Trichomonas and, without experiencing obvious discomfort, transmit the infection to their sexual partners. Trichomoniasis can be one of the causes of non-gonococcal urethritis, chronic prostatitis and epididymitis (inflammation of the epididymis), contribute to the development of male infertility due to a decrease in the mobility and vitality of sperm.

Trichomoniasis infection mainly occurs through sexual intercourse. In everyday life - through contaminated linen, towels, swimwear, trichomoniasis is extremely rare.

The number of diseases associated with trichomoniasis is large. Trichomoniasis is often detected with other STI pathogens (gonococcus, chlamydia, ureplasma, candida fungi, herpes viruses). Currently, it is believed that Trichomonas contribute to the development of diabetes, mastopathy, allergies and even cancer.

Trichomonas is an extremely unstable organism. It does not tolerate drying, on damp laundry it can last only 2-3 hours, and even tap water kills it in just a few minutes. That is, it is almost impossible to become infected with trichomoniasis in the household way. This requires sexual contact.

Biological features of the causative agent of trichomoniasis

Trichomoniasis in women. The causative agents of trichomoniasis are Trichomonas (Type Protozoa, Family Flagella) - unicellular anaerobic organisms - parasites, widespread in nature. In the human body, 3 types of Trichomonas parasitize: vaginal (the largest, active, pathogenic), oral and intestinal. Thanks to the flagella, Trichomonas are very active and mobile. Trichomonas are asexual and omnivorous, multiply rapidly under optimal conditions - in the absence of oxygen and at t = 35-37 ° C.

Trichomonas are fixed in the cells of the mucous membrane of the genitourinary tract and cause an inflammatory process there. The waste products of Trichomonas poison the human body, reduce its immunity.

Trichomonas can live in the genitals and even in the bloodstream, where they penetrate through the lymphatic pathways, the intercellular spaces with the help of an enzyme - hyaluronidase. Trichomonas are extremely adapted to exist in the human body: they can change shape, disguise themselves as blood plasma cells (platelets, lymphocytes) - which makes it difficult to diagnose trichomoniasis; To "hook" on other microbes and in this way to evade the body's immune attack.

Microorganisms (gonococci, ureaplasma, chlamydia, fungi of the genus Candida, herpes viruses, cytomegalovirus), getting inside Trichomonas, find there protection from the action of drugs and the human immune system.

Mobile Trichomonas can carry other microbes through the genitourinary system and blood vessels. By damaging the epithelium, Trichomonas reduce its protective function, and facilitate the penetration of microbes and sexually transmitted viruses (including HIV).

Although modern venereology possesses effective drug methods for treating most genital infections, it is extremely difficult to get rid of trichomoniasis completely, even today. The fact is that the non-protein shell of Trichomonas does not respond to the action of antibiotics and can only be destroyed by special antiprotozoal drugs.

Prerequisites for the development of trichomoniasis in women

However, for the development of trichomoniasis, there are a number of other prerequisites in a woman's body:

• the postpartum period, when the expansion of the muscles of the cervix leads to a natural violation of mechanical protection;
• menstrual and postmenstrual periods, accompanied by fluctuations in the acidity of the vaginal contents (for Trichomonas, the optimal acidity of the vaginal contents is the range of 5.5-6.6 pH);
• abortion, which provokes changes in the body that contribute to the occurrence of trichomoniasis;
• orgasm, during which the uterine cavity is prone to "absorption" of the causative agent of the disease.

Symptoms of trichomoniasis in women

The clinical picture of the disease in different women is different. Trichomonas colpitis can be divided into: subacute (in 57% of all cases of the disease), acute (in 23%), chronic or recurrent (in 5%).

In other cases, a woman is a carrier of the infection, but does not have any pronounced signs of the disease.

The main symptoms of trichomoniasis include:

• redness of the perineum and genitals, their swelling. The vaginal mucosa is very irritated and may bleed. Granularity appears on it, which can later develop into genital warts;
• increased vaginal discharge. Most often they become caustic and foamy, since Trichomonas are able to emit carbon dioxide, acquire a yellowish-green color;
• the presence of small impurities of blood in the discharge;
• frequent urination, accompanied by cuts (characteristic of trichomoniasis of the urethra);
• spread of itching and burning in the genital area and inner thighs;
• increased irritation and pain during sexual intercourse;
• the occurrence of pulling pains in the lower abdomen and back;
• in severe advanced cases, there may be swelling of the labia.

If the acute form of trichomoniasis becomes chronic, women, as a rule, experience discomfort only in the period before and after menstruation. The specific symptoms of the disease most often depend on which organ of the genitourinary system is affected by trichomoniasis.

On the internal genital organs, such as the uterus, ovaries and fallopian tubes, Trichomonas are very rarely localized, since the cervix is a kind of border for the spread of any infection due to the circular compression of its muscles and the presence of an alkaline reaction of the secretion of the uterine cavity.

Trichomonas can penetrate into the uterine cavity only in case of abortion, childbirth, or during menstruation. The penetration of the disease into the fallopian tubes can cause the development of salpingitis and severe inflammation of the ovaries with the subsequent formation of adhesions and cystic formations.

The main symptoms of the disease are greatly influenced by the general condition of the woman's body: the presence of third-party infections and chronic diseases, weakening of the immune system, etc. It has been established that only 10% of women who become sick have trichomoniasis as a single infection. In all other cases, the disease is accompanied by the presence of gonococci, mycoplasmas, chlamydia, and various types of fungi.

Trichomoniasis in women. If these symptoms are found, it is advisable to consult a doctor who will carry out the necessary diagnostics and make an accurate diagnosis. Diagnosis of trichomoniasis consists in taking a smear of sludge from the vagina or urethra. This is the most reliable and inexpensive way to detect the presence of Trichomonas in the patient's body.

Also, such additional studies can be carried out as: microscopy of stained smears, which consists in staining vaginal smears with a special tool that allows you to see the causative agent of the disease under a microscope, a culture method in which Trichomonas is grown in a special liquid medium. The latter is the most expensive way to diagnose the disease and takes a long period of time (usually 4 to 7 days).

Indications for prescribing an analysis for trichomoniasis in women

Trichomoniasis does not always cause clinically significant disease. In women, up to half of infections may be asymptomatic. And this disease is revealed already during examination for complications - infertility, miscarriage, salpingo-oophoritis, endometritis.

Trichomonas increases the risk of HIV infection and the risk of cervical cancer. Due to trichomoniasis, an inflammatory reaction develops in the genital tract and in the urethra, microscopic hemorrhages appear. This disrupts the natural protective barrier and makes the body more susceptible to any other infection.

Leukocytes and other immune cells migrate to the lesion focus, where their high concentration is created. Namely, these cells are primarily affected by HIV infection. And the probability of infection depends on how high their concentration is at the place of contact with the virus.

Symptoms of trichomoniasis in women are pain and discomfort in the lower abdomen, which are aggravated by sexual intercourse or urination. A yellowish discharge from the genital tract appears. This discharge is often frothy and odorless.

Methods of laboratory diagnosis of trichomoniasis in women

To identify Trichomonas, four types of methods are used: microscopic, cultural, molecular genetic and serological. In order to establish a diagnosis, it is enough to detect this microorganism by at least one of the first three methods.

Microscopy

Microscopy is the detection of Trichomonas in smears. The biological material is applied to a glass slide and examined under a microscope. In the first hour after taking the material, the native or "wet" smear is examined, that is, the material without staining. In it, you can identify the mobile cells of Trichomonas. This method is especially effective in acute illness. In this case, its sensitivity reaches 70%, and the specificity is 100%.

Trichomoniasis in women. If more time has passed since the moment of taking the biomaterial or the disease proceeds in a latent form, then the chance of finding mobile cells is much less, on average from 30 to 70%. In addition to the study of a wet smear, the material can be treated with various dyes.

In this case, the doctor looks for cells of a certain size with a specific color and shape under a microscope. There is a "gold standard" for the diagnosis of trichomoniasis infection. This is a microbiological study in which a biomaterial is placed on a nutrient medium (inoculation). This method is used when the disease is not accompanied by pronounced symptoms. It is also used as a second step in diagnostics if the microscopic method fails. The sensitivity of this method reaches 95%. Of the minuses, the duration of the study can be noted.

Molecular genetic methods

Molecular genetic methods are various types of PCR, NASBA and other reactions that identify regions of DNA or RNA in a biomaterial. PCR is less sensitive than the culture method, about 88–97%. And according to some sources - from 55 to 95%. It is desirable to use PCR in conjunction with culture assays. This greatly increases the likelihood of detecting a pathogen.

Serological examination

Trichomoniasis in women. Serological research, that is, the determination of antibodies to Trichomonas in the blood, is used as an addition to the first three methods. In short, it is possible to take a blood test for trichomoniasis, but its results should be assessed only in a comprehensive manner, taking into account other studies.

Its disadvantage is the possibility of false positive and false negative reactions. On the positive side, antibodies persist for a long time, about 1 year after infection. That is, even after a year, it can be determined that a person has suffered trichomoniasis.

To determine the level of antibodies, blood will be needed; for all other studies, a scraping from the urethra is most often taken. In women, material can also be taken from the vagina or from the cervical canal - here the concentration of Trichomonas will be the highest. Before being tested for trichomoniasis, men should not urinate for about two to three hours. For women, there are a few more rules.

The examination is not carried out during menstruation or the day before, after colposcopy or vaginal ultrasound. 1-2 days before the examination, it is advisable not to use suppositories, douching and refrain from intercourse.

All these procedures violate the composition of the microflora, and the study may turn out to be inaccurate. For PCR, in addition to scraping, you can use the first portion of morning urine or semen. Collect semen or urine in a special sterile container.

How long is the analysis for trichomoniasis done and how to decipher the results

Of all the tests for trichomoniasis, the fastest is microscopy of the native smear. Ideally, it should be done 10 minutes after sampling. During this time, Trichomonas do not have time to lose their mobility and retain their typical shape. That is, after about an hour, the doctor can give a preliminary result. In reality, this is possible in gynecological or urological clinics, which have their own laboratory with the ability to conduct microscopic examination. Stained smears do not require such urgency of analysis. Therefore, the result will be ready the next day or every other day.

Trichomoniasis in women. PCR test results are usually available in 1–2 business days. If Trichomonas is detected, the result may be delayed for the production of confirmation samples. A positive result is given when these microorganisms are detected, negative - in their absence. Diagnosis of trichomoniasis by the culture method is the longest.

It can take over a week. During this time, the test material is placed on a nutrient medium, the growth of microorganisms on it is monitored, and the pathogen is re-determined. The ideal option is no growth. This means that the collected material did not contain living Trichomonas. If, of course, all the requirements for the collection of biomaterial, its storage and transportation were exactly met.

A positive test result for trichomoniasis indicates infection. A blood test for trichomoniasis is performed within 1–2 working days. A positive result indicates that there are antibodies in the blood, that is, the patient either suffers from trichomoniasis, or has had it in the past. A negative result is no disease or low antibody levels. Doubtful is a borderline result that is difficult to interpret. In this case, it is usually recommended to repeat the study after 1–1.5 weeks.

Treatment of trichomoniasis in women

Trichomoniasis is treated by venereologists, gynecologists and urologists. It must be carried out in any form of the disease, regardless of the presence or absence of manifestations. Treatment of trichomoniasis should be carried out simultaneously for sexual partners (even if one of them is negative). Treatment of trichomoniasis in only one of the sexual partners is ineffective, since re-infection may occur after treatment. The production of antibodies against the causative agent of trichomoniasis does not form persistent immunity; after treatment, you can get sick again with re-infection.

Trichomoniasis in women. Treatment for trichomoniasis must be combined with treatment for other STIs that often accompany the disease. The need to treat trichomoniasis in a pregnant woman is determined by the doctor, it can be prescribed only in the second trimester. Due to the insensitivity of trichomoniasis to antibiotics, antiparasitic therapy is prescribed for the treatment of trichomoniasis: drugs of the 5-nitroimidazole group are used. These include tinidazole, metronidazole, ornidazole, nimorazole, ternidazole.

When treating trichomoniasis, it is forbidden to consume alcohol even in small quantities, since all drugs with the exception of ornidazole cause an antabuse-like syndrome (affect the metabolism of alcohol in the body). If trichomoniasis occurs in an uncomplicated acute (subacute) form, treatment consists of taking antiprotozoal drugs orally.

In case of a complicated and chronic course of trichomoniasis, stimulating therapy is preliminarily prescribed. Symptomatic and local treatment is used according to indications. Only local treatment of trichomoniasis (ointments, suppositories) will be ineffective. In the presence of a mixed infection (chlamydia, ureaplasma, gonococcus, cytomegalovirus, candida), an antibiotic is prescribed together with an antiparasitic drug.

Trichomoniasis is considered cured when the pathogen is not detected during diagnosis, and clinical symptoms are not observed. Sexual life during treatment is excluded. It is necessary to inform your sexual partner about the presence of trichomoniasis and other STDs, about the need for examination and treatment.

The result of trichomoniasis treatment depends on the normalization of the microflora of the genitourinary system and the body as a whole. In women, for this purpose, a vaccine against inactivated acidophilic lactobacilli is used. Perhaps the appointment of immunomodulatory drugs.

Sometimes Trichomonas resistance to a certain drug of the 5-nitroimidazole group is found (usually partial), but changing the dose, duration of administration or replacing the drug of the same group give a positive result in the treatment of trichomoniasis. To avoid the development of resistance of Trichomonas to antiparasitic drugs, while undergoing a course of therapy, it is necessary to strictly follow all the doctor's recommendations.

Treatment of female trichomoniasis can be carried out using topical drugs. A good remedy for getting rid of the disease is Metrogyl vaginal gel. 5 g of gel is injected into the vagina twice a day for 5 days. Ornidazole is considered another effective drug for the treatment of trichomoniasis. This drug should be taken one tablet daily after meals.

One course of treatment lasts at least 5 days. The absence of Trichomonas in a woman's smear after treatment indicates a complete cure of the disease. However, it is recommended to have a second smear after the end of the next menstruation.

Trichomoniasis in women. Currently, there is a special vaccine Solkotrichovac, shown to increase the immunity of women who are carriers of the infection. This vaccine helps to restore normal vaginal microflora. The vaccine is given twice with an interval of two weeks, intramuscularly. It lasts for one year. Then another vaccination is carried out.

Trichomoniasis belongs to a group of diseases requiring compulsory treatment, since it is the main cause of the development of inflammatory processes in the genitourinary system. Persistent inflammation can ultimately lead to female infertility.

Prevention of trichomoniasis

The best prevention of sexually transmitted diseases in general and trichomoniasis in particular is the use of barrier contraceptives - condoms during intercourse.

Take the time and a small amount of money to buy and use them, and you will not have to test the symptoms, diagnosis and treatment of trichomoniasis in practice.

Find out more:

• Trichomoniasis - symptoms, causes, diagnosis and treatment
• Trichomoniasis in women - causes, symptoms and treatment