Trichomoniasis - symptoms, diagnosis, treatment and prevention. Possible causes of trichomoniasis in women Trichomoniasis causes

The causative agent of trichomoniasis is the simplest single-celled organism - Trichomonas. This microorganism has the ability to live and develop even in the absence of oxygen; the vital activity of protozoal bacteria occurs in the human body.

A urogenital pathogen can be identified using instrumental and laboratory diagnostic measures. It is impossible to make an accurate diagnosis based on symptoms and medical examination alone. Trichomoniasis can be confirmed using the following studies:

• Laboratory examination of a smear taken from the urethral opening;
• Conducting microbiological research;
• Immunological analysis;
• PCR method.

Since such a disease can develop without pronounced symptoms, it is necessary to make a reliable diagnosis only with the help of laboratory tests.

Clinical manifestations in men

Trichomoniasis in men affects the following organs of the reproductive system: urethra, spermatic cords, prostate and testicles. Sometimes the symptoms manifest themselves in a subtle way, in which case the man is a carrier of the pathogen, which is transmitted during intimacy. If Trichomonas remains in the body for a long time, complications may arise that manifest themselves as non-gonococcal urethritis, an inflammatory process in the prostate and testicles.

The duration of the incubation process can vary from 2 to 200 days. Symptoms do not appear immediately. Typically, clinical signs begin to appear when the immune system is weakened or due to chronic infectious processes in the body. Symptoms are determined by the form of the pathological process. The development of urogenital trichomoniasis can occur in acute or chronic form.

Symptoms in men include a burning sensation when emptying the bladder. Discomfort extends to all areas of the external genitalia - penis, perineum, lower back, rectal area. If complications develop, the following signs appear - hyperemia of the foreskin, redness, swelling, abrasions and wounds. Additional symptoms that accompany the development of the disease include: hyperthermia, pain in the testicles.

Another consequence of the advanced form of trichomoniasis is the inflammatory process in the tissues of the prostate gland. This disease is accompanied by heaviness, pain in the rectal area and in the perineal area.

Clinical manifestations in females

According to statistics, representatives of the fair sex suffer more often than men. In this case, Trichomonas vaginalis is located in the uterine cavity. But the symptoms are expressed on the external organs of the reproductive system. Their redness, itching and hyperemia are noted. As the invasion develops, symptoms appear such as: copious mucus, ulcers, the appearance of slight bloody, foamy and watery discharge that has a strong fishy odor, painful sensations during sexual intercourse, the uterus and lower abdomen may increase in size.

The discharge is white or yellowish in color, its appearance is accompanied by intense itching, which is localized not only in the vagina, but also on the inner thighs. There is often pain or pain when emptying the bladder. In advanced forms of the disease, there is severe swelling of the external genitalia and severe itching. Timely diagnosis and treatment of the disease is very important, since its development is fraught with complications, including difficulties in conception.

Transmission routes

Trichomonas can be transmitted not only during intimate contacts. Other routes of infection may include contact with personal hygiene items. This happens rarely, but cases of infection through domestic means are recorded.

It is impossible to become infected through normal contact, for example during hugs. Also, the disease is not transmitted by pets or birds.

Therapeutic measures

It is possible to get rid of urogenital trichomoniasis only with a correctly designed treatment algorithm. It is important to first undergo all the necessary diagnostic measures that will allow you to make an accurate diagnosis. It is impossible to get rid of pathology using dubious folk remedies. Treatment should be carried out under the strict supervision of a physician. The prescription of medications is determined by the severity of the disease, its stage, and the severity of clinical signs.

For therapy, anti-trichomonas drugs are used, the action of which is aimed at combating the causative agent of the pathology. For treatment, systemic and local medications are prescribed that fight the pathogen in the body and eliminate external symptoms. To achieve a lasting positive effect, a comprehensive approach is very important. Traditionally, doctors prescribe a course of antibacterial drugs that helps cure the infectious process. It is important not to stop the course of treatment, even if the symptoms completely disappear.

You can recover from trichomoniasis, which develops without complications, within a few weeks. If the pathology is complicated by other infectious processes, the duration of therapy is significantly delayed. It is important to adhere to all medical recommendations and undergo the prescribed course of treatment even in the absence of severe symptoms.

When you have completed taking the last drug, it is very important to undergo repeated laboratory diagnostics, thanks to which you can assess the patient’s condition and determine the presence of a pathogen or antibodies to it in his body. It is very important to adhere to the following recommendations of doctors: exclude sexual relations for the entire duration of therapy, remove too spicy, fried, spicy, smoked and pickled foods from the diet, and do not drink ethanol-containing drinks. A prerequisite is compliance with the rules of personal hygiene.

Trichomoniasis how the disease develops after infection with vaginal Trichomonas, Trichomonas vaginalis, and the inflammation they cause. Microorganisms belong to single-celled protozoa, are capable of independently actively moving with the help of flagella and fixating on the epithelium of the vagina or urethra. Next, Trichomonas begin to multiply and secrete metabolic products that destroy cells and cause the formation of erosions and then ulcers. Destruction of integumentary tissue leads to an increased risk of infection by viruses during unprotected sexual intercourse.

Trichomonas vaginalis at the onset of the disease give a picture inflammation of the vagina (in women)and urethritis in men.

The main route of transmission of trichomoniasis is sexual, the contact-household route is somehow not considered, although there is a point of view that infection is possible through just used bath accessories, on which fresh discharge of a patient with trichomoniasis could remain.

Oral and anal infection is extremely rare, but possible in principle. Trichomonas remain motile outside the human body for two hours if the ambient temperature is no more than 40 degrees. Incubation period, which is defined as the period of time between infection and the appearance of the first signs of the disease, with trichomoniasis lasts from 4 days to 4 weeks, on average from a week to one and a half, however, as with any infection, it can extend to 1 - 1.5 months or shorten to 2-3 days.

In men pathogens are found in the urethra, prostate gland and seminal vesicles, from secretions - in semen and prostate secretions. In infected women– in the vagina and Bartholin glands, cervical canal, urethra. Neisseria and chlamydia are often found inside Trichomonas, and in these cases they accompany trichomoniasis, complicating the diagnosis and treatment of the disease. Therefore, some microbiologists believe that the threat is not so much the Trichomonas themselves, but rather the pathogenic microbes that Trichomonas vaginalis transports.

Features of the causative agent of trichomoniasis

All these transformations make it difficult to diagnose trichomoniasis, patients do not receive the necessary treatment and very often the disease becomes chronic or a carrier of the infection. Mostly, men become carriers (and distributors) of Trichomonas, because the clinical manifestations of trichomoniasis are practically invisible in them.

Another unpleasant feature of Trichomonas is the ability to adapt to medicinal drugs, in particular antibiotics. Too often, patients with trichomoniasis do not attach importance to the micro-symptoms associated with the introduction and reproduction of pathogens and self-medicate. The result is either a chronic version of the disease with periodic exacerbations due to stress provocations, which include alcohol, smoking, hypothermia and any infectious diseases, including a common cold. In women, vaginal dysbiosis and hormonal changes contribute to exacerbation. During menstruation, Trichomonas reproduce especially actively, as with the onset of pregnancy, since the pH of the vaginal environment shifts slightly to the alkaline side and becomes very comfortable for the microorganism.

Trichomonas are sensitive to high temperatures (at a temperature of +43°C they live for a day, and at a temperature of +55°C they die in half a minute), drying and ultraviolet radiation, so after washing the patient’s clothes, it is enough to dry them in the sun and the trichomonas will die. But the microbe tolerates low temperatures (slightly above zero) remarkably well and can retain its properties for almost 5 days.

Periods and main symptoms of the disease

Considering the time periods of manifestations of the disease and their severity, trichomoniasis is divided into three clinical forms:

The acute phase is characterized by severe symptoms or (inflammation of the vagina), a rise in temperature and changes in the blood that are inherent in a violent inflammatory process (leukocytosis, increased ESR).

Chronic trichomoniasis develops if the disease lasts more than two months. Symptoms of inflammation of the organs of the urogenital system are erased, and concomitant sexually transmitted infections are often detected.

Without treatment, the chronic form can worsen or become hidden - carrier status Trichomonas. If you are a carrier, there are no signs of infection, but Trichomonas are always found in scrapings and discharge from the urethra or vagina.

Clinical symptoms of trichomoniasis and their severity depend on a combination of several factors:

• Vaginal acidity (pH), which is associated with the activity of normal microflora, is in the range of 4.0-4.7 in a healthy woman. Deviations from the norm occur after taking antibiotics, hormonal changes (menstruation, menopause, pregnancy, oral contraceptives); when using spermicidal vaginal preparations, as well as after nervous strain or during rapid changes in climate zones.
  Acidity changes, indicators shift to neutral or slightly alkaline, the protective abilities of the mucous membrane decrease. With trichomonas colpitis, the pH is in the range of 5.5-6.0. These indicators still correspond to an acidic environment, however, such a pH already promotes the proliferation of not only Trichomonas, but also other opportunistic and pathogenic microorganisms.
• Condition of the cells of the urethral or vaginal mucosa. Normally, the mucous membrane of the male urethra is covered predominantly by transitional epithelium, while the female urethra, like the vagina and cervix, is lined with non-keratinizing stratified squamous epithelium (MSE). When Trichomonas, carrying other pathogenic agents in its body, penetrates the cervix, dysplastic changes can occur in the MPE, during which cells lose the ability to differentiate, while the properties of the epithelium change and at the same time its protective function is disrupted.
• Associated microflora: chlamydia and gonorrhea pathogens can be found inside Trichomonas. Accordingly, the manifestations of the disease change; the symptoms of trichomoniasis are joined by manifestations of chlamydia and gonorrhea.

The main symptoms of trichomoniasis are discharge from the urethra or vagina, the entry point of infection. Among women, this symptom is observed in approximately 8 out of 10, and in men – in half of cases of trichomoniasis.

Trichomoniasis in women

In women during the initial period of the disease, vaginal trichomoniasis. For acute forms of the disease characteristically abundant, having an unpleasant “fishy” odor and a yellowish-greenish color, which can change to gray-green streaked with blood. A gynecological examination reveals swelling and redness of the labia minora and majora, hyperemia and ulceration of the vaginal walls.

Trichomoniasis discharge has a characteristic color scheme

A common symptom of trichomoniasis is pain in the vaginal area during sexual intercourse., with urethritis, a local sensation is felt. There may be slight bleeding from the vagina and spread to the skin of the inner thighs. The accompanying symptoms of intoxication can be mistaken for fatigue: weakness, minor headaches and muscle pain, loss of strength, temperature 37.0-37.2.

The uterus, tubes and ovaries are affected by trichomoniasis less frequently than the urethra, vagina and cervix. However, Trichomonas, actively moving, can become a “transport” for gonococci and chlamydia. When released, these pathogens cause symptoms and inflammation of the ovaries -. The area of ​​distribution of Trichomonas above the cervix expands after abortion, childbirth and during menstruation, which leads to ascending inflammation with the formation of adhesions in the fallopian tubes and ovaries. The outcome may be infertility.

During pregnancy Trichomoniasis is detected more often than in non-pregnant women, which is associated with loosening of the vaginal epithelium for hormonal reasons. Infection of a child is possible during childbirth, when passing through the birth canal. During pregnancy, trichomoniasis can lead to spontaneous abortion, inflammation of the membranes, premature rupture of amniotic fluid and “dry labor”. This option is undesirable for mother and child, because an intact amniotic sac helps dilate the cervix and facilitates the final stage of labor. Also, pregnant women with trichomoniasis often experience inflammation of the glands of the vaginal vestibule - and proliferation of genital warts-condylomas, if trichomoniasis is accompanied by papillomavirus infection and they aggravate the negative impact of each other on the epithelium.

Only in 10% of all identified cases the cause of the disease was mono-infection Trichomonas vaginalis. The normal distribution of vaginal microflora is also disrupted: during illness, the proportion of yeast fungi (), strepto- and staphylococci increases, and the number of lactic acid bacteria decreases.

The reasons for increased symptoms of trichomoniasis in women can be a vulnerable immune system, concomitant inflammation, poor diet and hypovitaminosis. With trichomoniasis, all problems with the genitourinary organs become aggravated, the disease affects the condition of the skin: a pustular rash is possible on the face in the area around the lips.

Trichomoniasis in men

The differences between trichomoniasis in men are scant symptoms and a latent course; carriage is often observed. The first signs are associated with urethritis: burning and pain when urinating, possibly streaks of blood in the semen. Next, the infection from the urethra spreads to the prostate gland and its inflammation begins (), then to the seminal vesicles (). Trichomonas secrete substances that deprive sperm of motility, and with vesiculitis, the production of male germ cells is disrupted. Subsequently, everything can end in infertility.

An infected person may not suspect that he is the source of the infection and transmit Trichomonas to sexual partners or family members. Therefore, if a man has even the slightest signs of a urogenital infection, he needs to contact a urologist and get tested not only for trichomoniasis, but also for other STIs.

Signs of Trichomonas (and anyone else) prostatitis:

1. Pain in the perineum, pubic area, groin and anus;
2. Dull pain in the lower back, radiating to the inner thigh;
3. Unpleasant sensations during defecation and urination;
4. Discharge of mucus or pus from the urethra when the abdominal muscles are tense;
5. Erection problems (occurring after inflammation of the nerves that pass through the prostate);
6. Constant low-grade fever (37-37.2°);
7. Persistent bad mood.

A note about mood: a characteristic symptom of chronic prostatitis is changes in the psyche like depressive neurosis. The man is always dissatisfied with everything, is very irritable, is concerned only with his own well-being and is absolutely devoid of the ability to think critically. In addition, due to illness, he eats less; Blood glucose drops, which is expressed by aggressive behavior. It is believed that for successful treatment of prostatitis, the doctor must be not only a good urologist, but also an excellent psychologist.

The risk of developing prostatitis with “dormant” trichomoniasis increases if factors that provoke inflammation of the prostate. These may include hypothermia, regular constipation, sedentary work and a lifestyle with limited exercise. Prolonged sexual abstinence or excessive sexual activity, stress at work and at home, poor nutrition and fitful sleep, previous sexually transmitted diseases - all this can contribute to the occurrence of prostatitis. Mechanism associated with ascending infection with Trichomonas from the urethra, impaired blood supply to the pelvic organs (venous stagnation) and the proliferation of pathogens.

Complications of trichomoniasis

Trichomonas vaginalis can carry bacteria without rendering them pathogenic. In these cases, when another person is infected, not only trichomoniasis is transmitted to him, but also other sexually transmitted diseases, more often gonorrhea (more than 30% of cases of co-infection).

Diagnosis of trichomoniasis based on a traditional algorithm - survey, examination, analysis data. During survey listen to the patient’s main complaints, find out the connection between the onset of symptoms and sexual activity, and try to determine the source of infection. In women, they find out the presence of chronic inflammation of the external and internal genital organs, whether there have been cases of miscarriage, abortion, complications during pregnancy and childbirth. They also ask if she has noticed signs of urethritis in her sexual partner. Men are asked about signs of urethritis and prostatitis, and erection problems.

Then proceed to inspection, assess the condition of the genital organs - whether there is hyperemia and swelling, erosion or areas of ulceration, hemorrhage and abscesses. The location and nature of the discharge is determined and taken, in women - from the cervical canal, vagina and urethra, in men - from the urethral opening. If necessary, a bacteriological analysis (tank culture) is prescribed.

Analyzes if trichomoniasis is suspected, the same as those done for any urogenital infection. A general clinical blood test may show signs of inflammation (leukocytosis, increased ESR) and anemia (with this disease in later stages, a decrease in hemoglobin is sometimes observed due to the loss of iron in red blood cells, which Trichomonas “love” so much).

In a urine test, the number of leukocytes and red blood cells may be present above the permissible level. The presence of casts in the urine indicates involvement of the bladder and kidneys in the pathological process, which is quite rare. Prostate secretion and sperm - leukocytes, traces of blood, sedentary sperm.

In a fresh smear from the urethra or cervix, motile Trichomonas are visible; in a stained fixed preparation, unicellular pear-shaped (less often round) organisms with or without flagella, but with a characteristic almond-shaped pink nucleus with pointed edges are visible. In a fixed specimen at high magnification it is difficult to confuse them with anything, although at low magnification the artifacts (flakes of squamous epithelium with collapsing nuclei) are very, very reminiscent of Trichomonas. The main difference between artifacts and Trichomonas is the rounded nuclei.

– culture on a nutrient medium, isolation of trichomonas and re-culture to determine sensitivity to antibiotics. It takes time from 7 to 10 – 14 days, but in the future it facilitates treatment and increases its effectiveness. Sowing is indicated for chronic forms of trichomoniasis and suspected carrier status.

: about 100% accuracy (96.5%), if the answer is positive, no other confirmation of the diagnosis of trichomoniasis is required. To exclude concomitant sexually transmitted infections, a PCR test is performed for gonorrhea, chlamydia, as well as separate tests for HIV, HPV, hepatitis B and C.

Video: doctor about trichomoniasis and its diagnosis

Treatment

Treatment of trichomoniasis is carried out based on the detection of the pathogen, even if there are no symptoms of the disease. Needs treatment all at the same time sexual partners, sex life and alcohol are strictly prohibited until complete recovery.

For treatment acute uncomplicated forms of the disease, antibiotics with antiprotozoal (against protozoa) action are used. The main drug is metronidazole (Trichopol), either a single dose of 2 g orally, or a course of 5-8 days of 400 mg x 2 per day. Take during or after meals, do not chew the tablets. Women are additionally prescribed suppositories or vaginal tablets with Trichopolum. The course of treatment is repeated after 3-4 weeks if the control PCR test was positive for Trichomonas.

Treatment regimen for children: course of metronidazole for 10 days, the daily dose is divided into two doses. For children from 2 to 5 years 250 mg per day, up to 10 years 375 mg/day, over 10 – 500 mg/day. During pregnancy metronidazole is prescribed once 2 g, but only starting from the second trimester.

At chronic relapsing trichomoniasis use metronidazole 500 mg x 2 for 7 days, combined with the administration of the drug "Solkotrikhovak"(vaccine against trichomoniasis) 0.5 ml IM. There are only 3 injections, the interval between them is 3 weeks; a year later, another 0.5 ml is administered intramuscularly once. Swelling and hyperemia are possible at the injection site; they go away on their own within a few days. The vaccine normalizes the pH of the vagina and urethra, helps restore normal microflora and displace Trichomonas vaginalis along with concomitant infections. The protective effect of the vaccine is the prevention of re-infection, the therapeutic effect is the reduction of inflammatory manifestations in the vagina and urethra.

Topical medications help treat local infection and inflammation. Advantages – reduction of the toxic effects of pharmaceuticals. drugs on the body as a whole, reducing the risk of allergies and almost zero load on the liver and kidneys. Women are prescribed vaginal balls or metronidazole tablets, 0.5 g x 1 per day, for a course of 6 days. Before insertion into the vagina, vaginal tablets should be immersed in a glass of water for 15-20 seconds so that the protective coating begins to dissolve. After administering the tablet, you need to lie down for at least half an hour. Vaginal medications are best used at night, before bed.

For instillations Protargol, 1-3% solution, is used in the urethra. It is also effective if trichomoniasis accompanies gonorrhea. The drug is good as an antiseptic, as an astringent and anti-inflammatory medicine. Sterile catheters are required for instillation and procedures are performed on an outpatient basis.

A week after the end of the full course of treatment, and then twice more with a pause a month, they are prescribed control tests(PCR). Women are examined 3 cycles in a row, after menstruation. If PCR was negative for 1-2 months in men and 3-4 months. in women, the patients are considered cured.

Folk recipes

Folk remedies cannot cure trichomoniasis, but herbal infusions for douching, herbal teas as mild antidepressants and immunomodulators, and nutritional mixtures to replenish vitamin and mineral deficiencies are quite acceptable.

St. John's wort tea

A tablespoon of dried flowers and herbs is poured into 1 liter of boiling water and left for 1 hour. Take a glass three times a day. An excellent remedy for depression, which develops during a long-term illness, such as chronic prostatitis.

Aloe juice (not to be confused with agave)

Take before meals, three times a day. As an immunomodulator, it mobilizes the body's defense systems, has an anti-inflammatory effect, and accelerates the healing of ulcers and erosions.

Infusion for vaginal douching, for baths (for men)

1 tablespoon each of oak bark, chamomile flowers, 2 each of nettle and calendula flowers. The mixture is poured into 1 liter of boiling water and left for 2 hours. Apply once a day, for a course of 5-7 procedures. The action of the components is antiseptic, tanning, anti-inflammatory and analgesic.

Nutrient mixture

Dried fruits – prunes, dried apricots, figs; walnuts and whole lemons are taken in equal proportions and passed through a meat grinder. The mass is mixed with honey to obtain the consistency of a thick puree. Take 1 tablespoon in the morning. The mixture tones and gives energy.

Video: trichomoniasis in the program “Live Healthy!”

Trichomoniasis in women is a sexually transmitted infection of the genitourinary system. The most common cause of the disease is considered to be unprotected contact with a patient or carrier of the infection, however, this is not the only route of infection. In this article we will look at the possible causes of infection and the symptoms accompanying the disease.

What is trichomoniasis in women

The development is caused by a pathogenic microorganism - Trichomonas, in total there are about fifty species, but not all can provoke negative changes in the human body (3 species).

The danger of infection with this pathogen is quite high; according to WHO, 10% of the population are carriers of the infection, most of whom are not even aware of its presence. Monitoring your health status and periodically taking tests for Trichomonas cannot guarantee the absence of the disease.

Where does trichomoniasis come from, and who is at risk for developing the disease:

• an adult of reproductive age can “acquire” flagellates through unprotected sexual contact with a carrier;
• a child can become infected at birth from his mother. It is important to plan your pregnancy in advance and undergo an examination before its onset; if a pathogen is detected, treatment of both partners at the same time will save the unborn child from undesirable consequences. During pregnancy, casual sexual intercourse without protection is not allowed.

Important. The possibility of becoming infected through a household method is negligible, which is associated with the low life expectancy of the pathogen outside the body, however, it is not completely excluded. The use of individual personal hygiene products eliminates the risk of household infection.

Trichomoniasis in women - causes

Infection with Trichomonas can be asymptomatic throughout life and never manifest itself; even taking a test if you are a carrier of the infection does not matter; the pathogen will not be detected in the blood. However, under favorable conditions for flagellates, carriage develops into a disease with a pronounced clinical picture, sometimes even with a long absence of sexual contact. What are the provoking factors, we will consider below.

The causes of trichomoniasis in women, under what conditions carriage can manifest symptoms of the disease:

• change in microflora. The acid-base balance of the vagina, provided by “beneficial bacteria,” protects a woman from the development of pathogenic flora; if there is an imbalance in this area, there is an uncontrolled growth of pathogenic colonies that cause sexually transmitted diseases. The main causes of microflora disturbances: frequent changes of sexual partner, violation of personal hygiene rules; in women, disruption in the vaginal environment is caused by hormonal changes caused by menstruation and pregnancy. Frequent douching and love for antiseptics leads to the destruction of normal flora, which can also cause pH changes. When penetrating the weakened vaginal microflora, Trichomonas attaches to its mucosa, causing symptoms of inflammation;
• violation of the integrity of the vaginal epithelium. The most common cause of this condition is medical abortion, given that after termination of pregnancy it is necessary to take antibiotics and the microflora changes. The combination of these factors contributes to the activation of a “dormant” infection;
• decreased immune response of the body. Any chronic or systemic disease leads to a disruption in internal regulation. Against the background of reduced immunity, Trichomonas can be activated during carriage or easily take root during infection.

In order not to be tormented by the question of where I got a sexually transmitted infection, it is important to follow basic preventive measures. Monitor your health not only in the sexual sphere, but also in your general well-being. Undergo preventive examinations, which will allow timely detection of pathology and correct the functioning of the body. If possible, lead a healthy lifestyle (eat right, combine work and rest, avoid harmful production factors). Plan your pregnancy in advance: approach pregnancy and childbirth with full responsibility. If you follow these rules, there will be no question of what causes trichomoniasis.

Forms

Trichomoniasis in women, regardless of the causes, has three forms of manifestation:

• “fresh” trichomoniasis develops after infection, the duration of the disease does not exceed 2 months. It can occur in the form of an acute, subacute or asymptomatic course;
• Chronic infection when infected more than 2 months ago, is characterized by periods of exacerbation (the manifestation of clinical symptoms) and remission (when it does not bother you);
• Carriage. This form is difficult to diagnose due to the absence of clinical manifestations; it is often detected during routine examinations.

Trichomonas is particularly dangerous due to its ability to transmit other sexually transmitted infections. Trichomoniasis in women or men in its pure form is observed in only 10% of infected people; in other cases, along with this pathology, a whole “bouquet” of STDs is detected. This combination is explained by the fact that Trichomonas absorbs pathogens of various diseases and, when introduced into the body, “releases” them, thus flagellates are carriers of pathological microflora.

Trichomoniasis in women - symptoms

Symptoms of trichomoniasis appear 4-10 days after infection. The first signs of an acute infection are quite pronounced; the disease can be identified by the following manifestations:

• The first sign of trichomonas infection is profuse leucorrhoea (discharge) from the vagina of a greenish or yellowish hue of a foaming nature;
• a pronounced unpleasant odor (varies depending on concomitant genital infections transmitted in conjunction with Trichomonas);
• pain during sexual intercourse;
• if the urinary system is affected (penetrates through the urethra), signs of a bladder infection appear (pain when urinating, frequent urge, increased body temperature);
• itching and burning of the vagina;
• hyperemia and swelling of the vagina and vulva;
• aching pain in the lower abdomen.

Advice. The appearance of one or more signs of trichomoniasis should not be ignored. Lack of proper treatment leads to chronicity of the process and the occurrence of various complications of the genital area.

Symptoms of chronic trichomoniasis

Chronic trichomoniasis is observed in men and women who have ignored proper treatment. This form of the disease is characterized by periodic changes in exacerbation and remission of the pathology. During the period of exacerbation, patients experience all the beauty of the disease, as in the acute form. There are no obvious signs of remission; it may manifest itself in the form of leucorrhoea and discomfort during intimacy with a sexual partner

The trigger mechanism for exacerbation of the chronic process is:

• lack or violation of genital hygiene;
• menstruation in women;
• sexual contact;
• drinking alcoholic beverages or consuming too spicy, salty or fatty foods;
• overheating or hypothermia;
• hormonal imbalance;
• decreased immune response of the body in various therapeutic and surgical diseases.

Possible complications

The consequences of trichomoniasis can have long-term manifestations. The scourge of females suffering from chronic infections of the reproductive system is infertility. The inability to get pregnant and bear a healthy child deprives you of the chance to experience the happiness of motherhood and leads to various psychological disorders. Difficulty in pregnancy is caused by obstruction of the fallopian tubes or chronic inflammation of the appendages.

When pregnancy occurs, pregnancy complications may occur, accompanied by premature birth, underdevelopment of the fetus, and in severe cases, miscarriages or antenatal death. If infected during pregnancy, self-medication is not acceptable; only a specialist will be able to select the necessary medications depending on the stage of pregnancy, so as not to harm the unborn baby. After birth, it is necessary to monitor for the presence of the pathogen.

Attention. Trichomonas infection is especially dangerous for pregnant women. An acute process can provoke a miscarriage or premature birth, and the infection also interferes with the normal development of the fetus, which can be reflected in underdevelopment or the birth of a child with pathology or weak immunity.

Chronic trichomoniasis in women is a risk factor for the development of cervical cancer.

According to statistics, more than 10% of the world's population is susceptible to this pathology. More than 160 million cases of infection are reported every year. Treatment of the disease should be determined by a specialist, based on the form of the pathology and the individual characteristics of the patient.

Pathogen

Diagnostics

The urogenital type of disease is diagnosed using instrumental and laboratory research methods, which make it possible to identify the pathogen. The symptoms described by the patient and his examination do not allow a complete clinical picture of the disease to be drawn up. A diagnosis made in this way requires confirmation by the following tests:

• microscopy of a smear from the urethra;
• microbiological analysis (when the causative agent of the disease is placed for research in a special artificial environment);
• immunological research;
• polymerase chain reaction method.

Isolating the causative agent of infection in men is difficult because Trichomonas can take on an amoeboid form. In order for the diagnosis to be as accurate as possible, certain rules must be followed before performing it:

1. Limit sexual activity for 2-3 days before the examination.
2. Avoid using intimate hygiene products (except soap).
3. Stop using medications.
4. A few hours before visiting a specialist, refrain from emptying your bladder.

Since urogenital trichomoniasis is a disease that can be asymptomatic, the only accurate way to determine its presence is laboratory diagnosis.

Symptoms in men

The organs most often affected by trichomoniasis are the urethra, seminal vesicles, prostate gland and testicles. In some cases, symptoms of the disease do not appear, then the man acts as a carrier through sexual contact. When Trichomonas remain in the body for too long, complications appear in the form of non-gonococcal urethritis, chronic inflammation of the prostate gland and epididymis.

The duration of the incubation period ranges from 2 to 200 days. Signs of trichomoniasis do not appear immediately. As a rule, the symptoms of the disease become pronounced when the immune system is weakened or another infection is present in the body.

Symptoms of the disease may vary depending on its form. Urogenital trichomoniasis can occur in the following forms:

• acute;
• chronic;
• Trichomonas carriage.

The disease in the stronger sex is manifested by a burning sensation when urinating. Unpleasant symptoms can spread to the head of the penis, perineal area, lower back, and rectum.

Symptoms that occur in men when complications occur: redness, swelling of the foreskin, the appearance of abrasions and wounds on the penis. On average, 10% of patients develop trichomonas epididymitis.

Symptoms accompanying this disease: fever, pain in the testicles. Another complication of trichomoniasis is prostatitis, in which there is heaviness, pain in the anus and perineum.

Symptoms in women

Statistics show that women have more severe symptoms than men. In this case, Trichomonas vaginalis (lat. Trichomonas vaginalis) concentrated in the uterus. However, symptoms affect the external genitalia. In particular, this is redness of the genitals, their itching and swelling.

The following manifestations are also noted:

• significant mucus discharge;
• constant minor bleeding, ulceration;
• foamy and watery discharge with an unpleasant, pungent odor of fish;
• pain during sexual intercourse;
• it is possible to increase the volume of the abdomen in the uterine area.

The color of the discharge may be white or yellow-green. As a rule, they are accompanied by itching in the genital area. It may spread to the inner thighs.

Burning and itching may occur along the entire length of the vagina. If the sensations are significant, they may be accompanied by pain and vaginal bleeding. This is often observed when urinating. In some severe cases, the sensation of itching in the perineal area is combined with swelling of the labia.

Transfer methods

Contrary to popular belief, trichomoniasis is not transmitted only through sexual contact. Among the methods of transmission of the disease are:

• sexual contact (oral-genital, traditional, anal);
• household route (the pathogen is rarely transmitted through personal hygiene items, in a bathhouse or sauna, but such cases do occur).

Bacteria are not transmitted by contact (through a handshake, for example). Livestock, birds and other animals also do not carry the disease.

Treatment

Urogenital trichomoniasis should be treated exclusively under the supervision of a specialist who monitors its course through periodic laboratory tests. It is impossible to cure the pathology on your own, since special medications are needed to eliminate the pathogen. Prescription of medications is carried out based on the form of the disease and the nature of its course.

The infection should be treated with anti-trichomonas drugs that destroy pathogenic bacteria. Therapy is carried out with general and local drugs.

General medications eliminate bacteria from the inside, while topical medications help treat symptoms such as redness, itching, and swelling. The separate use of external local agents is not effective, since it can treat the pathology only symptomatically, without eliminating the cause of the disease.

If antibiotics are prescribed during treatment, they must be used in a course that cannot be interrupted, even if the signs of infection have disappeared. As a rule, trichomoniasis, which occurs without complications, can be cured in two weeks.

If the disease is accompanied by other infections, this period may differ significantly. When the disease is in an advanced form, therapy should continue until the symptoms of the disease go away. After completing the course of medication, laboratory tests must be carried out to confirm that the disease has been cured. A prerequisite for successful therapy is compliance with the following rules:

1. During the period of drug therapy, sexual contacts should be limited.
2. You should refrain from eating spicy, too fatty, fried and salty foods.
3. Alcohol consumption should be avoided.
4. Observe the rules of personal intimate hygiene daily.

Since the causative agent of the disease is sexually transmitted, the infection must be treated together with the sexual partner, even if he has no visible manifestations of the disease.

To destroy vaginal Trichomonas, the doctor prescribes antibiotics, which, while suppressing pathogenic microflora, also destroy beneficial microorganisms, so such drugs must be taken in combination with products containing bifidobacteria to prevent the occurrence of intestinal dysbiosis.

In addition, to prevent the occurrence of secondary infections, immunomodulators are prescribed, which increase the body's immunity and resistance to pathogenic organisms. Such remedies include Chinese lemongrass, echinacea or ginseng tincture. These drugs strengthen the body and tone up. Additional treatment measures include prostate massage, physiotherapeutic procedures and instillation of the urethra. The successful completion of therapy is considered to be the absence of signs of the pathogen in the man’s tests for two months.

Prevention

Preventive measures:

• the use of barrier type contraceptives for traditional, anal, oral-genital sexual contact;
• regular visits to a specialist for the purpose of preventive examination;

• in case of accidental rupture of the barrier contraceptive, the genital organ should be treated with local antiseptic drugs;
• avoiding treatment for this and other STDs without the consent of a doctor.

Compliance with these simple rules will significantly reduce the risk of infection, complications and concomitant infections.

Treatment with folk remedies

The use of traditional medicine is possible only as an additional therapy. Placing hopes on eliminating the infection at home without the use of medications and medical supervision can be dangerous and will only make the situation worse. Among the means that can be used to supplement drug treatment, there are several effective recipes.

Recipe No. 1

Chop 2-3 medium cloves of garlic and squeeze out the juice through cheesecloth. Drink the resulting product half a teaspoon in the morning, lunch and evening.

Recipe No. 2

Grate a quarter of a medium onion and a few cloves of garlic on a fine grater. Place the mixture on gauze and apply to the affected head of the penis for 4 hours. The duration of the course is at least 5 days. If irritation occurs from using the mixture, you should add calendula ointment to it.

Recipe No. 3

The aloe leaf needs to be crushed and the juice squeezed out using gauze. Take 1 teaspoon half an hour before meals. Aloe juice can also be used to treat affected areas of the genitals.

Trichomoniasis is a urogenital infectious disease, mainly sexually transmitted.

The pathogens - Trichomonas vaginalis and Trichomonas homonis belong to the genus Trichomonas, family Trichomonadidae, class Flagellata, phylum Protozoa.

Morphology. Trichomonas, as representatives of protozoa, have a fairly high organization. They are most often oval-pear-shaped. The body consists of fine-grained protoplasm with numerous vacuoles, surrounded on the outside by a periplast - a thin shell, in the front part equipped with a hook-shaped slit - a cystostomy, which performs the function of a mouth. The nucleus is oblong, round, pear-shaped or bottle-shaped, containing five to six nucleoli. Near the nucleus there are several bodies in the form of grains - blepharoplasts. From them begins a straight axial thread - an axoneme, which is an elastic cord. It is located inside the protoplasmic body and protrudes outward in the form of a spine. Trichomonas move with the help of flagella and an inducing membrane; They reproduce mainly by longitudinal division.

Cultural and enzymatic properties. Pathogenic three homonads grow on artificial nutrient media only at a temperature of 36.5-37 °C. Their cultures are not capable of hemolysis and plasma coagulation; They decompose glucose, maltose, starch well, weakly - lactose, galactose, do not decompose arabinose, dulcite, mannitol, sucrose, rhamnose; do not form hydrogen sulfide and indole.

Resistance. Trichomonas vaginalis is sensitive to sunlight and dies when it dries out and is exposed to disinfectants - mercury dichloride, carbolic acid, chloramine B.

Pathogenic trichomonas are sensitive to elevated temperatures, dying after 30 seconds at 55 ° C and after 24 hours at 43 ° C, but at the same time relatively resistant to low temperatures.

Epidemiology. Trichomoniasis is an anthroponotic disease. It has been established that Trichomonas are detected in 10% of healthy women and in more than 30% of patients seeking venereological help. In tropical countries they are found in 15-40% of healthy women of childbearing age. Exacerbation of trichomoniasis is often accompanied by gonorrhea, chlamydia and other sexually transmitted diseases. With urogenital trichomoniasis in men, other pathogenic microorganisms are found in the discharge from the urethra, along with Trichomonas.

Pathogenesis. The main habitat of urogenital trichomonas in men is the urethra, through the mucous membrane of which they penetrate into the prostate gland and epididymis, bulbourethral glands, and paraurethral ducts;

prepuce glands and foreskin. Inflammatory changes are nonspecific. Trichomoniasis in women develops primarily in the urethra, vagina and cervical canal. Much less often, Trichomonas penetrate the glands of the vestibule of the vagina and very rarely - into the uterine cavity and fallopian tubes.

Clinic. With the development of an acute process, patients complain of discharge, itching and burning in the area of ​​the external genitalia, which upon examination are swollen, hyperemic, and have individual areas of erosion. Characteristic is the presence of foamy serous-purulent discharge. Acute trichomonas urethritis is accompanied by a feeling of pain and pain when urinating. Chronic urethritis is asymptomatic. Asymptomatic Trichomonas carriage was established.

Immunity absent in trichomoniasis.

Laboratory diagnostics. The material for the study is urethral discharge and urine. In cases where patients have no discharge from the urethra, take the first stream of urine into a test tube, centrifuge it, and remove the sediment

(threads, flakes, crumbs) and applied to a glass slide, followed by staining with a 0.5-1% solution of methylene blue, according to Gram, Romanovsky - Giemsa or Leishman. The “crushed” drop method is also used. In some cases, a bacteriological research method is used.

Treatment. Antibiotics and sulfonamides are not effective in treating trichomoniasis. He is treated with Trichopolum and Flagym according to certain regimens. After acute inflammatory phenomena subside, instillations of the urethra with a solution of silver nitrate, mercury oxycyanide, and ethacridine lactate are used.

Prevention. There is no specific prevention.

CAUSES OF TRYPANOSOMOSIS

Trypanosomiasis is a group of protozoal transmissible blood infections. African (sleeping sickness) and American (Chagas disease) trypanosomiasis are known.

African trypanosomiasis (sleeping sickness) is a vector-borne infection characterized by irregular fever, rash, swelling, lymphadenopathy, and severe damage to the central nervous system.

Mentions of sleeping sickness are found in Arabic manuscripts of the 16th century. The pathogen was first discovered by P. M. Ford in the blood of a patient in 1901. The epidemiological role of trypanosomes and tsetse flies in the transmission of African trypanosomiasis was proven by D. Brutse and D. Nabarro (1903), and the life cycle of trypanosomes with a change of vertebrate and invertebrate hosts was studied by H. Kinghorn and W. York (1912-1913).

The causative agents of African trypanosomiasis belong to the family Trypanosomatidae, the genus Trypanosoma, the species Trypanosoma brucei gambiese (the causative agent of Gambian trypanosomiasis) and Trypanosoma brucei rhodesiese (the causative agent of Rhodesian trypanosomiasis).

Morphology. Differing in some biological properties, these species are practically indistinguishable by morphological characteristics. The blood forms - trypomastigotes - are characterized by polymorphism associated with the immune reaction: some forms, found at the height of the disease, have the appearance of a long spindle-shaped cell with a well-defined undulating membrane and a long flagellum at the end, 25-40 µm long and 1.2-2 µm wide, others, during the decline of the infection, are represented by short, wide cells with or without a short flagellum. Trypanosomes reproduce by binary longitudinal fission. Stained according to Romanovsky - Giemsa: the cytoplasm is blue, the nucleus, blepharoplast and flagella are red.

Cultural properties. Cultivated on media containing blood and blood substitutes, NNN medium.

Epidemiology. The source of African trypanosomiasis of the Rhodesian type in nature is antelopes and other species of ungulates. Under natural conditions, the infection is zoonotic in nature, and the circulation of the pathogen occurs along the chain: antelope - tsetse fly - antelope. Infection of a person is possible accidentally when entering natural foci. The permanent population of endemic areas is included in the epidemiological transmission: antelope - tsetse fly - human - tsetse fly - human. In this case, the source of infection can be not only humans, but also farm animals, primarily cattle.

The vector-borne mechanism of infection is associated with the habitat of blood-sucking tsetse flies belonging to the species Glossina morsitans, Glossina pallidipes, Glossina swynnertoni. They lay larvae in the soil, where all stages develop: larvae, pupae, adults. An adult lives three to nine months. In the body of the tsetse fly, the development cycle of trypanosomes lasts about 20 days, and then the parasite penetrates the salivary glands of the insect. The fly remains infected for six months. Transovarial transmission of the pathogen was not detected.

Gambian trypanosomiasis is an anthroponosis. The circulation of the pathogen is carried out according to the following scheme: man - tsetse fly - man. It mainly affects the rural population.

Pathogenesis. At the site of a tsetse fly bite in the subcutaneous tissue, trypanosomes persist for several days, causing a local acute inflammatory process (trypanosomal chancre), and then penetrate the bloodstream, causing hyperplasia of the lymphoid tissue of the spleen, Kupffer cells of the liver, and then affect the central nervous system, localizing in the frontal lobes , pons and medulla oblongata, causing meningitis.

Clinic. At the site of penetration of the pathogen, a so-called trypanosomal chancre is formed - an infiltrate in the form of a hard, painful nodule. Two weeks later he disappears without a trace.

The incubation period ranges from two weeks to two years. Extreme clinical signs include: enlarged lymph nodes (especially cervical) and fever of the wrong type with a temperature from 36.6 to 41 "C. Subsequently, trypanosomes penetrate into the spinal canal; this period is characterized by damage to the central nervous system - headache, lethargy, drowsiness. The disease proceeds chronically over months and years, attacks of fever alternate with periods of apparent recovery, then depression sets in, progressive lethargy develops, drowsiness increases and the patient falls into a coma. Patients die from cachexia and associated infection.

tions three to six years from the onset of the disease. If treatment is started in a timely manner, they recover in two to three years.

Immunity is cellular in nature, low-tension and short-lived.

Laboratory diagnostics. Microscopic method - detection of trypanosomes in blood and punctate from lymph nodes. Serological method - complement fixation reaction, formol reaction, determination of globulin fractions in human blood serum.

Treatment. Drugs can be divided into two groups. At the early stage of the disease, the following are used: suramin, pentamidine; in the second period of the disease, two or three courses of therapy with arsenic preparations (tripareamide, arbosal) are prescribed.

Prevention. This is ensured by a set of measures aimed at identifying and treating patients, protecting the population from tsetse fly bites (mosquito nets, protective clothing, repellents), as well as destroying biotopes of fly vectors.

CAUSES OF LEISCHMANIASIS

Leishmaniasis is a group of protozoal vector-borne diseases of humans and animals caused by Leishmania. There are two main forms of leishmaniasis: cutaneous and visceral.

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