Trichomoniasis is an infection that affects the sexual organs and urinary tract. This sexually transmitted disease is caused by a protozoan, that is, by a unicellular parasite (therefore composed of a single cell). This microorganism, called Trichomonas vaginalis, is mainly transmitted through unprotected sexual intercourse. Its infection mostly causes sexual and urinary disorders, such as vaginitis, urethritis and prostatitis. Under the microscope, the Trichomonas vaginalis it appears as a large, oval-shaped cell. Furthermore, this protozoan is equipped with an undulating membrane and flagella. The flagella are a kind of tails, with which the parasite is able to move inside the genital apparatus. In particular, the preferred sites of infection are the urethra, the prostate, but above all the vagina. trichomonas has the ability to exploit the glycogen, naturally present in the vaginal mucosa, for its own development. In this way, the parasite removes glycogen from the lactobacilli preventing its natural transformation into lactic acid. Consequently, there is an increase in the vaginal pH which facilitates the perpetuation of this and other possible vaginal infections.The incubation period is quite long and extends from 4 to 28 days.
As anticipated, trichomoniasis is a typical infection transmitted through sexual contacts, especially if unprotected. Any sexually active person can, therefore, become infected with the Trichomonas. The risk is clearly related to the number of partners and sexual habits. It is not surprising, therefore, the wide spread of the prostitute disease, among people with different sexual partners or suffering from other venereal diseases. Another possible mode of contagion occurs through the mixed use, therefore shared, of wet towels, sex toys, swimming pools, toilets or underwear. However, this is a possible but unlikely eventuality, given that the Trichomonas vaginalis it survives for a very short time outside the human body.Indicatively, Trichomonas can live no longer than 40-50 minutes outside the body. To complete the picture, in rare cases, vertical transmission is also possible, that is, from mother to newborn at the time of delivery.
Very often infection with Trichomonas vaginalis it does not cause significant symptoms or complaints. In cases where the symptoms occur they are clearly different in men and women. Men, in particular, are more often asymptomatic carriers and only in the rare cases where the infection causes urethritis or prostatitis can there be irritation of the glans, scarce or moderate urethral secretions, burning when urinating and during ejaculation. Compared to men, women are more prone to developing symptoms, given that infection with Trichomonas vaginalis often causes vaginitis, cervicitis and urethritis. Therefore, the symptoms are characterized by intense itching or burning in the external genitals and vagina, with yellow-greenish, foamy and generally malodorous discharge, sometimes with small blood spots. As a result, intercourse can be somewhat painful. Also in women, there may also be urination disorders, such as burning and the need to urinate frequently. Another rather common finding, identifiable during a gynecological examination, is that of the so-called "strawberry cervix". This similarity derives from the typical presence of small reddish spots on the surface of the cervical mucosa and on the wall of the vagina.
Trichomoniasis is not just an annoying, unpleasant and irritating disease. Even when it goes unnoticed for years, if not treated properly, trichomoniasis can in fact give rise to severe complications. In particular, it can cause sterility, both in women and men. In addition, it can cause irritation of the penis and inflammation of the prostate in men, while in women it can cause infection of the uterus and tubes. In addition, it seems to increase the risk of cervical cancer, favor the transmission of HIV. As regards pregnancy, infection with Trichomonas Ectopic pregnancies, premature births and low birth weight of the baby are associated. The newborn, in turn, may, albeit rarely, acquire the infection during the passage through the birth canal and suffer damage of varying severity, ranging from asymptomaticity to conjunctivitis and pneumonia.
Diagnosis is obtained by simply observing vaginal or urethral secretions under a microscope, accompanied by microbiological analysis. Given its peculiar characteristics, the Trichomonas vaginalisin fact, it is clearly visible in the fresh smear. Culture examination and amplification tests to search for protozoan DNA, both on the urethral secretion and on the urine, allow to confirm the diagnosis. These tests also make it possible to check for any co-infection with other sexually transmitted infectious diseases, such as chlamydia and gonorrhea, to which trichomoniasis is often associated.
If the treatment of trichomoniasis is timely, recovery is rapid. Treatment of trichomoniasis is based in particular on the intake of specific antibiotics, such as metronidazole. Alternatively, for infections resistant to metromidazole, tinidazole is prescribed. After the conclusion of therapy it is important to avoid alcoholic beverages for at least 24 hours for metronidazole or 72 hours for tinidazole. Drinking alcohol, in fact, can give rise to manifestations such as nausea, vomiting, abdominal cramps, hot flashes and headaches. It is advisable to combine a probiotic supplement with antibiotic therapy. to promote the regrowth of the normal vaginal bacterial flora. Furthermore, it is necessary to abstain from sexual intercourse until the end of the treatment. Another very important consideration is that the therapy must also involve the sexual partner or partners. This precaution, to be taken even when the partner does not show symptoms, is important to limit the spread of the disease to other people and avoid the ping-pong effect, ie the continuous passage of the infection from one partner to another. In women and in sexually active men infected with Trichomonas a check-up is often recommended within 3 months of the end of therapy, given the high incidence of relapses in this type of infection.
The prevention of trichomoniasis is essentially carried out by adopting the rules of the so-called "safe sex". Among these, the regular and correct use of condoms in every sexual relationship is useful, especially when we are dealing with occasional partners.
