Trichomonas

According to scientific data, Trichomonas is found in 10% of healthy women and more than 30% of people who visit dermatovenereology clinics.

Trichomoniasis is an inflammatory pathology of the genitourinary organs caused by protozoa.

Structure of Trichomonas

Trichomonads are classified as protozoa. They have a relatively high degree of organization, which includes all the main vital functions (basic metabolism, mobility, reproduction, etc.).

Under a microscope, Trichomonas most often have an oval-pear-shaped form, but some conditions can give them elongated, octagonal and other shapes.

The trichomonad body consists of fine-grained protoplasm with multiple vacuoles. The outer thin cover is the periplast, which is provided with a barely noticeable slit on the front side of the body. This is the cystosome, which acts as a mouth. Nearby is the nucleus, which contains 5 or 6 nucleoli. Near the nucleus are several granular bodies - this is the blepharoplast, from which the axoneme thread extends, serving as a kind of skeleton of the parasite.

Trichomonas moves with the help of flagella and a wave-like membrane, and feeds in the human body through phagocytic and endosomatic pathways.

Trichomonas reproduction occurs mainly through longitudinal or multiple division. It is interesting that under uncomfortable conditions for life (temperature change, action of medications, etc.), trichomonads get rid of their motor organs (flagella), become round and freeze motionless, as if falling asleep for a while. Sunlight is fatal for trichomonads: it slows down the movement and slows down the processes of life of parasites. They also die from drying out or from direct exposure to antiseptic solutions. Thus, 1% carbolic acid, 1% chloramine or mercury dichloride destroy trichomonads within a few seconds.

Trichomonas can develop resistance to medications.

How long does trichomonas live? According to scientific data, it dies at a temperature of +55 C within 30 seconds, at a temperature of +43 C – after 24 hours. The parasite is resistant to low temperatures: at a temperature of – 10 C it lives up to 45 minutes, at a temperature of +1 to +4 C it remains viable for up to 114 hours.

The life cycle of trichomonads in artificial nutrient media occurs only at a temperature of 36.5-37 C. It can maintain the ability to live in acidic, neutral and slightly alkaline conditions. The optimal environment for trichomonads is 5.2-6.2 pH.

Types of Trichomonas

There are several types of trichomonads. One of the most potentially dangerous is considered to be intestinal trichomonad, and the most common is oral trichomonad.

The reproduction of intestinal trichomonads occurs in the intestines. This can provoke the development of such unpleasant diseases as inflammation of the gallbladder, erosion, anemia, enterocolitis, polyposis. The main signs of damage by the intestinal parasite are muscle weakness and pale skin.

Oral trichomonas, as the name suggests, lives in the human oral cavity. Sometimes it is found in the respiratory tract, nasopharynx, and circulatory system. The presence of such a parasite in the body can lead to the development of paralysis, arthritis and arthrosis of the extremities, liver disease, and reproductive pathologies. Some of the main signs of oral trichomonas infection are pyoderma, progressive caries, and pulmonary diseases.

Urogenital trichomonas (Trichomonas vaginalis) lives in the reproductive system, where it is introduced during sexual contact. It feeds on epithelial cells and various types of bacteria. The method of infection through bedding and personal hygiene items is so rare that it is practically not considered. Urogenital trichomonas infection can manifest itself in the form of urethritis, endocervicitis, epidermitis, and can cause infertility and impotence.

There are no trichomonads that are safe for the body. All types of the disease require mandatory examination and treatment.

How is trichomonas transmitted?

Infection usually occurs through sexual intercourse, mainly after casual sexual contact. Transmission of the infection is also possible through contact with the patient's personal items.

The development of Trichomonas can be facilitated by:

• high virulence of the pathogen;
• chronic pathologies in the body (diabetes, tuberculosis);
• a decrease in the body's immune forces under the influence of external factors (toxic infections, hypothermia, poor nutrition);
• urethritis and vaginitis of various origins.

Often, infection with Trichomonas can be combined with gonorrhea or chlamydia.

Symptoms of Trichomonas

Immunity to trichomoniasis, as well as to gonorrhea, does not develop.

The incubation period for Trichomonas is on average 10 days, but in some cases it can be reduced to 2-3 days, or extended to 30-40 days.

Trichomonas in men usually occurs as an acute or chronic form of urethritis, often representing a sluggish process. Cases of latent course of the disease, as well as carriage of trichomonas without any signs of pathology, have been described.

The initial inflammatory reaction develops in the anterior lobe of the urethra, subsequently spreading to the posterior lobe. The disease is not characterized by a specific picture of symptoms. The severity of subjective sensations is extremely insignificant and is not constant. Sometimes itching and burning in the urethra may be observed, and pain may occur during urination. Inflammatory reaction in the external opening of the urethra is rare. Discharge from the urethra may be present (purulent, mucous, transparent or mucopurulent, sometimes foamy).

The prostate, epididymis, glandular system of the foreskin, urinary bladder, and kidneys are often affected. The pathology is often complicated by prostatitis, balanoposthitis, and epididymitis.

There is no evidence of trichomonas metastasis. One can only assume that sometimes other bacterial infections are to blame for the development of trichomonas complications.

In women, Trichomonas is most often localized in the urethra, vaginal cavity, and cervical canal. Relatively rarely, Trichomonas are found in the uterine cavity and fallopian tubes.

In the acute stage of the process, patients may complain of discharge, itching and burning of the external reproductive organs. During the examination, pronounced swelling, redness, and the presence of purulent-serous discharge are visible. Erosions are possible in some areas of the mucous membrane. During a mirror examination, patients note painful sensations. Accordingly, pain is also observed during sexual intercourse. One of the most characteristic signs of trichomonas is the appearance of foamy discharge.

When the urethra is affected, cutting pains occur during urination. If you press on the urethra, a drop of discharge may appear from it.

Chronic trichomonas is usually asymptomatic.

Trichomonas during pregnancy

Trichomonas can initially prevent pregnancy, so you should visit a doctor during the period of preparation for conception. Before planning a pregnancy, it is important to take a test for possible infection with trichomonas, as this is a fairly common pathology. Moreover, in half of the cases, the disease occurs without pronounced symptoms, so a woman may not even suspect a possible infection.

It is necessary to pay attention to some symptoms: urinary disorders, inflammatory diseases of the genital area. At the slightest suspicion, you should consult a doctor, since trichomonas can provoke a spontaneous abortion, premature labor, interfere with the normal physical growth of the baby (the child may be born premature or poorly developed - weighing less than two kg).

If a pregnant woman has obvious clinical signs (burning of the genitals, itching, foamy discharge), a test for trichomonas and a doctor’s consultation should be immediate.

Don't hesitate to get tested for trichomonas in advance. This will make your pregnancy safe and protect your health.

Trichomonas in children

Most often, children become infected with trichomonas during childbirth, from an infected mother. Boys are usually not affected by this disease. Girls are susceptible to infection due to their anatomical features: first of all, the pathogen causes an inflammatory process that affects the external genitalia of the newborn. The disease in girls manifests itself with the same symptoms as in adult women (excluding, of course, subjective sensations): these are signs of swelling, redness of the vaginal mucosa, the formation of erosions, pain during urination.

The first month of life may not show symptoms of the disease. This is due to the fact that along with the pathogen, the girl also receives antibodies to trichomonads from her mother, which fight the infection for some time. However, by the end of the first month of life, the symptoms increase.

Household transmission of trichomonas is considered extremely rare, but it does exist. A child can become infected by using someone else's hygiene products: a towel, underwear, a washcloth. Children need to be explained what personal hygiene is and why it is needed. By developing good habits in a child, we take care of his healthy future in advance.

Diagnosis of Trichomonas

It is important to know that microscopic examinations are not always guaranteed to detect trichomonas. There are cases when, even with clearly defined symptoms of trichomonas infection, parasites can only be detected by repeated examination. In this regard, to achieve plausible results, several repeated analyses should be carried out, if possible using different laboratory methods. Trichomonas can be detected both in a native preparation and in stained smears.

The method for studying live trichomonads in a smear is very simple: a drop of warmed physiological solution is applied to a glass slide, a fresh drop of secretions is added to it; the resulting preparation is covered with a special glass and examined under a microscope.

Trichomonas are examined under a microscope using dry systems at magnifications of 100 to 400 times. Most often, parasites become visible at magnifications of 100 times. However, trichomonads may also be represented by very small specimens that can only be recognized at higher magnifications. The preparation is usually examined in a darkened space, because sufficient illumination may hide the presence of transparent representatives of trichomonads in the smear.

Microscopic examination must be carried out immediately after taking the material, in order to prevent the effects of temperature changes and drying of the preparation. Interestingly, under the microscope, trichomonads are recognized by their pendulum-like, pushing, swinging mobility.

Cultural research also plays a role – sowing for trichomonads. This method is used when there is a suspicion of hidden and asymptomatic variants of urogenital trichomoniasis, as well as to confirm the effectiveness of patient treatment.

In situations where for some reason it is not possible to take a smear, the first morning stream of urine can be centrifuged for analysis. The flakes that appear are extracted from it with a special pipette, which are then applied to a glass slide for examination.

Trichomonas provocation is carried out by injection of Proginal. This is done in order to weaken the body's immune defense for some time, so that the pathogen (if any) is again visible in the smear. Provocation can also be the intake of alcoholic beverages or spicy and salty food.

Blood tests for trichomonads are not performed. There is another informative blood test that determines the presence of antibodies to trichomonads. It is called an enzyme immunoassay. The positive aspects of this method include the fact that the localization of the process does not matter for obtaining results. Blood is given on an empty stomach, from a vein. The only condition for preparing for the test is to exclude alcohol and spicy salty food for 24 hours.

The polymerase chain reaction method is another accurate diagnostic method that is based on the study of trichomonas DNA. For such a study, blood, discharge from the urethra, vagina, etc. can be used. Thanks to this type of diagnostics, pathogens can be detected at the initial stage of their development, which accelerates recovery and prevents further progression of the disease.

When preparing for in vitro fertilization, a method of parasitological examination for trichomonad atrophozoites (vegetative forms of the pathogen) is often used: vaginal discharge is examined (culture).

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Treatment of Trichomonas

Treatment procedures for trichomonas are carried out for patients with or without an inflammatory process. Treatment of trichomonas carriers is mandatory because they can become a source of infection for other people. In addition, the presence of parasites in the body poses a risk of repeated manifestations of the disease. The source of infection and persons who have sexual contact with it are subject to therapy.

Sulfanilamide drugs and antibiotics do not have a therapeutic effect on trichomonas: they are prescribed only in cases of mixed infectious flora. In such situations, antibiotics relieve the inflammatory reaction and promote a speedy recovery.

Metronidazole (Flagyl, Trichopol), which is taken orally, has a significant effect in the treatment of Trichomonas.

The treatment regimen for trichomonas with the drug Trichopolum is presented in three of the most popular variants:

• in a daily dose of 0.5 g, divided into two doses, for 10 days;
• the first four days - 0.25 g three times a day, the next four days - 0.25 g twice a day;
• the first day - 0.5 g twice, the second day - 0.25 g three times, on the third and fourth days - 0.25 g twice a day.

Some patients avoid using metronidazole because of the drug's side effects: dyspeptic disorders, stomach discomfort, vomiting. In such cases, the drug is replaced with ornidazole, which is much easier for patients to tolerate.

According to statistics, recovery after the first course of therapy is observed in approximately 90% of cases. Some patients may subsequently have post-trichomonal inflammation, which must be treated additionally.

After the signs of acute inflammation have been relieved, women who have been diagnosed with vulvitis and vaginitis may be prescribed douching with a decoction of chamomile and sage.

Treatment of chronic trichomonas, as well as complicated course of the disease, can be reduced to the use, in addition to the above treatment, of methods used in the corresponding clinic of gonorrhea. Also prescribed are agents that stimulate the body's defenses (complex vitamins, immunostimulants - thymogen, kipferon, imunorix, isoprinosine, glutoxim, apilak, myelopid, prodigiosan).

Patients with trichomonas are prescribed tinidazole in the amount of 2 g as a single dose. For internal use, Nitasol tablets are produced for trichomonas, which contain nitazole, lactose, starch, talc and stearic acid. The drug is taken three times a day for 5-10 days.

As a local treatment, a combination of levomycetin (0.2 g), boric acid (0.1 g) and hexamethylenetetramine (0.5 g) is effective. In this composition, the drug is administered once a day into the vagina or urethra, the course of treatment is 10-15 days.

Trichomonas suppositories are used to treat the urogenital form of the disease. Usually, Klion D is used, which consists of metronidazole and miconazole nitrate. The drug is prescribed to women in the amount of one suppository at night, before going to bed. The course of therapy with such a drug is 10 days.

Male patients may be prescribed treatment with the drug Klion D in the form of tablets taken orally. A special effect of such treatment is observed in mixed infection (simultaneous trichomoniasis with candidiasis).

A patient with trichomonas can be considered cured if, after a course of treatment, trichomonas are not detected in laboratory tests for two months. Those patients who have traces of the inflammatory process or tissue dystrophy after treatment for trichomonas can be prescribed physiotherapy procedures: the use of phonophoresis, instillation, diathermy, massage, silver cauterization, tamponade.

When treating trichomonas in children, the same metronidazole is usually prescribed, but in a lower dosage than in adults. At the same time, sitz baths or douching with weak antiseptic solutions are taken.

During treatment, you must follow a diet that excludes salty, spicy and fatty foods, as well as alcohol.

Treatment of Trichomonas during pregnancy

In pregnant women, therapy is carried out only from the beginning of the second trimester, using the drug metronidazole and clotrimazole. In this case, treatment is prescribed to both partners without fail.

• In the first trimester, the use of Terzhinan, Atsilakt and Bifidumbacterin is permitted, which support the normal microflora of the vaginal environment. The tablets are used daily for 10 days, 1 piece;
• in the second trimester, metronidazole is added (orally 0.5 g twice a day for a week), terzhinan suppositories, clion D, clotrimazole at night for 10 days, then acylact or bifidumbacterin for 10 days. To correct immunity, rectal suppositories Viferon can be prescribed, twice a day for 10 days;
• In the third trimester, metronidazole is also used orally at 0.5 g twice a day for a week. In general, treatment in the first and second trimesters is practically no different.

It is recommended to take a smear test for trichomonas every two weeks to monitor the positive dynamics of treatment.

Folk remedies for trichomonas

Treatment of trichomonas at home can be carried out only as an addition to traditional treatment. You should not treat trichomonas on your own without consulting a doctor: the treatment of the disease must be monitored by test results.

• Trichomonas in the intestines. Antiparasitic plants such as tincture of wormwood, cloves, natural phytoncides - garlic, onion, horseradish are often used. Sour and red berries have a detrimental effect on trichomonas in the intestines: cranberry, rowan, viburnum, etc.
• Trichomonas in the genitourinary tract. The vaginal parasite can die almost immediately from the action of horseradish juice, onion, lemon. However, these plants can provoke a burn of the mucous membrane, so their use on the genitals is dangerous. For douching and sitz baths, you can use infusions of coniferous trees, currant and birch leaves, burnet plants, cranberries, and tangerine peel.
• Trichomonas in the prostate. Men with trichomonas are recommended to use rinses or baths from herbal decoctions: buckthorn bark, oak, tansy, field horsetail. A man should take such a sitz bath with a warm decoction for 15 minutes. Kaolin clay also helps well: you need to take a tablespoon of clay and dissolve it in a liter of warm boiled water. This solution can be used to wash the genitals or baths.

Along with treatment, you should change your diet: you should not eat sweets, baked goods, hot spices, salty foods, or fatty foods.

During the treatment period, it is advisable to abstain from sexual intercourse, spend more time in the fresh air, and eat foods rich in vitamins to stimulate the body's immune system.

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Prevention of Trichomonas

Prevention of infections is the most important aspect of a healthy lifestyle. Moreover, if we take into account the peculiarities of the spread of the pathogen – sexually transmitted infection – preventive measures are natural and generally available:

• You should not have sexual contact with a partner whose health you are not sure of. If you decide to have such a relationship, be sure to use a condom;
• Observe the rules of personal and intimate hygiene. Use your own towel, toothbrush, washcloth, do not wear someone else's underwear. Do not forget to take a shower once or twice a day, paying special attention to the cleanliness of the genitals;
• See your doctor periodically, even when there are no signs of illness.

It should be noted that there is no need to be ashamed of treating a sexually transmitted infection. It is shameful to infect others with the infection when you are sick or a carrier.

Trichomonas is a very common infection that needs to be treated, and it is imperative that it be treated.

Sex with trichomonas

Sexual contact is one of the main ways of infection with parasitic microorganisms. The pathogen can be transmitted both from a sick person and from an infection carrier, who in most cases does not even suspect that he is a carrier.

Trichomonas treatment is usually carried out for two partners at the same time. Therefore, if a man and a woman who are undergoing simultaneous treatment for the disease want to have sex during this period, this is acceptable (provided that a condom is used). In such cases, when one partner begins treatment before the other, the risk of re-infection increases. In this situation, sex should be avoided.

By the way, many women experience extremely painful and unpleasant sexual intercourse with urogenital trichomonas inflammation. Therefore, some refuse sex during treatment for this reason.