Trichomoniasis in men

Among all infections that are transmitted through sexual contact, gonorrhea and trichomoniasis are considered the most famous pathologies. Moreover, if the first disease is provoked by pathogenic microbes, then the second is caused by parasitic protozoa, small microorganisms that can only be seen under a microscope. The medical name of the pathogen is Trichomonas vaginalis, hence the name of the disease – trichomoniasis. The problem with this disease is that a man can get it without even knowing about the infection; in many, the pathology proceeds as an asymptomatic carriage or sluggish inflammation.

The infection is one of the most common sexually transmitted infections, it is well cured with timely diagnosis, and has relatively favorable prognosis in men. On average, according to urologists and venereologists, up to 4 million people suffer from it, half of them are men. Susceptibility to the disease is high, immunity to it is practically not formed, so a man can get sick with it several times in his life.

A man’s risk of contracting trichomoniasis is increased if he:

• does not use condoms during sex;
• has multiple sexual partners.

What is trichomoniasis

By definition, trichomoniasis refers to the “classic” sexually transmitted infections. Both traditional contacts and anal, oral sex are dangerous, although oral lesions are extremely rare.

In addition, trichomoniasis is contagious, a man who has both severe or individual symptoms, and an asymptomatic carrier can infect his sexual partners. The pathogens are transmitted with vaginal secretions or mucus from the urethra and semen.

Causes of trichomoniasis in men

Although both women and men can be asymptomatic carriers or symptomatic carriers of T. vaginalis, trichomoniasis in men is usually less clinical and shorter. In addition, numerous studies have shown that T. vaginalis infection is less common in men than in women.

The estimated frequency of trichomoniasis among men in various populations ranges from 0,8% to 17%. But the incidence may be underestimated depending on the method of detection and where the samples were collected. The use of multiple specimens in the urogenital tract (urine, urethral swab and semen) in male patients has been shown to increase diagnostic sensitivity. In one study, T. vaginalis was found in 72% of men whose partners had the infection, of whom 77% were asymptomatic carriers.

Transmission of T. vaginalis is predominantly sexual, so it usually occurs in sexually active men. Almost half of infected women and almost all infected men (up to 95%) are asymptomatic. One third of asymptomatic carriers develop symptoms within 6 months. Because of this, the absence of sexual history should not be used to rule out T. vaginalis infection as a possible diagnosis.

Symptoms of trichomoniasis in men

Men with trichomoniasis may be asymptomatic carriers of the infection, have mild symptoms, or may be suffering from acute trichomoniasis. Men with trichomoniasis are more likely than women to have a much faster natural resolution of the disease. In men, the microorganism is found in the anterior part of the urethra, vulva, prostate gland, epididymis and sperm. Symptoms of trichomoniasis in men vary depending on the affected area, ranging from urethritis to complicated prostatitis. Non-gonococcal, non-chlamydial urethritis is the most common symptom in men with trichomoniasis. Typical symptoms of urethritis include the following:

• discharge from the head of the penis (purulent or mucous in nature);
• urination disorders;
• urethral itching.

Less common symptoms may include the following:

• pain, burning in the urethra;
• pain in the testicles;
• discomfort in the lower abdomen.

Most uncomplicated T. vaginalis infections in men can be self-limiting.

Treatment of trichomoniasis in men

Often, men go to the doctor only after the sexual partner falls ill, and after laboratory diagnostics, trichomonas are detected in the urethra or semen. But treatment in any case is necessary to completely eliminate the infection.

Diagnostics

Most men with trichomoniasis have no physical features. It is not uncommon for infected men to have abnormal discharge from the penis. However, the discharge is usually only scanty and thin. Trichomoniasis in men may be associated with local inflammatory conditions, including balanitis (inflammation of the foreskin) and balanoposthitis. Epididymitis (lesion of the epididymis) and prostatitis (inflammatory process in the prostate) are also possible.

To detect trichomoniasis, laboratory tests must be performed. The attending physician examines a sample of genital discharge from the urethra under a microscope to check for signs of infection. The collected material from the urethra can be sent to the laboratory for further testing if Trichomonas is not visible under a microscope.

Modern treatments

Without treatment, trichomoniasis can last for months or even years. It doesn’t go away on its own. During the entire time of infection, a man can transmit STDs to his sexual partners.

Oral anti-infective drugs kill Trichomonas. Your doctor may prescribe Metronidazole or Tinidazole. During treatment, it is important to remember the following:

• one dose of the drug cures up to 95% of those infected, but men may need to take medication for 5 to 7 days – the patient himself and his sexual partners must undergo treatment for trichomoniasis, otherwise re-infection is possible;
• a man should not have sex for one week after stopping the medication to give the medicine time to kill the infection and eliminate symptoms – too early sex can lead to re-infection; you need to see a doctor after three months to make sure that the infection is completely eliminated;
• you should not drink alcohol while taking Metronidazole or Tinidazole – the combination can cause severe nausea and vomiting, as well as heart palpitations; drugs can also cause the following side effects – heartburn, metallic taste in the mouth, urethral candidiasis.

Prevention of trichomoniasis in men at home

If you are sexually active, you can take the following steps to protect yourself from trichomoniasis and other sexually transmitted infections:

• use condoms;
• get regular testing for trichomoniasis and other sexually transmitted infections;
• get treated if you have trichomoniasis or other illnesses – let your sexual partners know if you have trichomoniasis so they can get tested and treated;
• maintain a monogamous relationship with one sexual partner;
• limit the number of your sexual partners.

Popular questions and answers

Regarding the diagnosis and treatment of trichomoniasis in men, the characteristics of the transmission of infection, we talked with urologist, specialist in ultrasound diagnostics, doctor of the highest category of the Center for Disaster Medicine Yuri Bakharev.