With over 200 million people infected worldwide each year, trichomoniasis is one of the most common Sexually Transmitted Infections.

Most often benign and asymptomatic, trichomoniasis is a sexually transmitted infection that can cause complications and should not be overlooked. Appropriate prevention and treatment eradicate this parasite in 90% of cases.

In general, the incubation period of the parasite ranges from 5 to 30 days after contamination. Most often the infestation is asymptomatic in humans.

In women

In about 50% of cases, symptoms may appear in women. Vaginal infection with Trichomonas Vagonalis accounts for about 30% of vulvovaginitis and 50% of vaginitis with discharge in women.

Symptoms vary in intensity, ranging from asymptomatic forms to profuse, yellow-green, foamy vaginal discharge with a fishy odor. There is also pain in the vulva and perineum associated with pain during intercourse and pain when urinating (dysuria).

An asymptomatic infection can become symptomatic any time when inflammation of the vulva and perineum and edema of the labia (vagina) develop.

The intensity of pain is more marked at the beginning and end of the menstrual cycle due to the increase in vaginal pH, favorable to the development of the parasite. Menopause, which causes a variation in pH at the vaginal level, is also favorable for the development of the parasite. In pregnant women, Trichomonas Vaginalis may be responsible for premature labor in infested women.

In humans

Clinical signs are rare, the infestation being asymptomatic in 80% of cases. Sometimes urethritis is manifested by a urethral discharge which may be transient, foamy or purulent or cause pain when urinating (dysuria) or a frequent urge to urinate (pollakiuria), usually in the morning. Urethritis is often benign.

The only rare complications are epididymitis (inflammation of the duct connecting the testis to the prostate) and prostatitis (inflammation of the prostate).

In men, trichomoniasis is responsible for chronic pain of varying intensity during sexual intercourse.

The search for Trichomonas Vaginalis is based on direct examination of a urogenital sample or by molecular diagnostic technique (PCR).

This molecular technique (PCR), which is not reimbursed, must be the subject of a specific prescription and is not performed during the routine examination of a routine vaginal sample.

As trichomonas Vaginalis is a mobile parasite, it can be easily detected during a microscopic examination provided it is carried out immediately after the sample is taken. Otherwise, direct examination is carried out after staining of a slide read under a microscope. Examination of the Pap smear may reveal cytological (study of cells) abnormalities suggestive of Trichomonas Vaginalis infection. However, it does not allow to conclude to an infestation by the parasite.

Trichomonas Vaginalis is a sexually transmitted parasite. It is recommended to test for its presence in people with other STIs, as the latter can increase their transmission due to the inflammation it causes in the urogenital level.

Less frequent, transmission by damp towels, bath water or previously contaminated toilet glasses is also possible. The parasite can live up to 24 hours in outdoor environments if conditions are favorable.

In women, trichomoniasis may increase the risk of contracting HIV when having sex with a partner who carries the AIDS virus. On the other hand, trichomoniasis may increase the risk of transmitting HIV from a woman with AIDS to her or her partner.

The treatment is based on the oral administration of an antiparasitic antibiotic from the nitro-imidazole family (metronidazole, tinidazole, etc.). The treatment can be single dose (“minute” treatment) or to be taken over several days depending on the symptoms, without consuming alcohol during the treatment. During the first trimester of pregnancy, it is preferable to give local treatment (ova, cream) although there is no contraindication to taking oral nitro-imidazoles.

In the event of breast-feeding, it is recommended to stop it during the duration of the treatment and 24 hours after the end of the latter.

In all cases, even in the absence of symptoms, it is recommended to treat the partner (s) of the infected person. There is no vaccine to prevent infection with Trichomonas Vaginalis. Prevention is based on the protection of sexual intercourse.