Trichomoniasis: Trichomonas destroy mucous membranes and sperm

Trichomoniasis is one of the most common infections affecting the human genitourinary system. The source of the disease is Trichomonas, which live in the urethra, seminal vesicles and prostate gland (in men) and in the vagina (in women). After trichomonas enter the body, symptoms do not appear immediately - the incubation period lasts up to 4 weeks.

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The disease is dangerous due to complications: if the infection is not treated, sick men will face prostatitis, and women will suffer from inflammation of the genitourinary organs, problems with pregnancy, etc.

Causes of trichomoniasis: features of trichomonas

The content of the article

Trichomoniasis is caused by the bacterium Trichomonas vaginalis. Once in the body, Trichomonas provokes inflammation of the mucous membranes of the genitourinary system. This is one of the most common groups of bacteria that cause sexually transmitted diseases (STIs).

There are no exact statistics, but scientists believe that at the moment there are from 600 million to 1 billion people in the world infected or carrying the bacteria. Every year, more than 50 million cases of Trichomonas infection are registered worldwide.

This is an unusual bacterium. Trichomonas vaginalis is the simplest single-celled organism that forms colonies. By uniting, Trichomonas act as a whole organism. They attack mucous membranes and destroy lactic acid bacteria, which create the normal flora of mucous tissues. In total, three varieties of Trichomonas can be found in the human body, but only Trichomonas vaginalis is a dangerous variety capable of aggressive actions. Therefore, in tests for trichomoniasis, this particular subspecies is isolated.

Colonies of bacteria are localized in the lower genitourinary tract:

• Urethra;
• Vagina;
• Simple.

In the absence of proper treatment, bacteria spread throughout all organs of the genitourinary system, requiring comprehensive and targeted treatment.

Where does Trichomonas come from?

At the end of the fifties of the last century, several international conferences were held to discuss where Trichomonas comes from in the reproductive tract. They decided that this single-celled organism can be obtained not only through sexual contact, but also from a bath bench or basin, and even from swimming pool water and just tap water, not to mention wells. Bath accessories were blamed because trichomoniasis was practically not detected in men due to the absence of clinical symptoms. If a woman complains of inflammation, and a man is fine, then apparently the woman “caught the infection” somewhere else.

Where can a decent and faithful woman become infected with a sexually transmitted infection? Of course, in a public bath, where she is completely defenseless. And at that time, personal bathrooms were very rare; citizens went to the baths to wash themselves. Another five-year-old mankind was convinced that Trichomonas brought into a family was not at all a consequence of the infidelity of one of the spouses, but evidence of a woman’s failure to observe personal hygiene. One good thing is that this misconception helped save the family, because the infection happened through “non-sexual” means.

But in the mid-60s, scientific proof of the extremely poor survival of Trichomonas outside the human body came from Soviet Estonia, therefore infection by any other method other than sexual intercourse is simply unrealistic. Trichomonas does not like sunlight and hot water, and is immediately killed by any antiseptic. Indeed, Trichomonas is so delicate, so demanding of the external environment that even in the secretion of the genital tract collected for the purpose of research, it often dies before it is brought to the microscope. Since that time, the disease caused by Trichomonas vaginalis has been recognized as a venereal disease.

The main route of transmission of Trichomonas in adults, of course, is sexual, but oral sex does not contribute to infection, in any case, they could not prove this possibility of transmission. A woman in labor with trichomoniasis can infect her child, more often this happens to girls. This route of transmission of infection is called vertical. And today, 2–17% of newborns have trichomonas vaginitis or, in the old way, colpitis inherited from their mother. It is quite possible, because tests are taken from pregnant women several weeks before giving birth.

At risk for trichomoniasis are citizens who have multiple sexual partners, workers in the illegal sex industry, drug addicts and HIV-infected people, socially disadvantaged people, in general, comrades. True, citizens are still actively using the idea of ​​contracting trichomoniasis in the pool, the main thing is to get treatment, and let them decide for themselves how to explain the appearance of Trichomonas vaginalis to their partner.

How can you become infected with trichomoniasis: routes of transmission

The main cause of trichomoniasis is classical sexual contact; the disease is not transmitted by kissing. As for the domestic route of infection, such cases in the practice of doctors are very rare and are usually questioned.

The risk of infection through unprotected contact is up to 70%. When using a condom, the risks are minimal, but still remain - 10%. A condom is not an absolute protection, so if Trichomonas is detected, it is imperative to check your sexual partner, even if he does not have any symptoms of the disease.

Household transmission through shared towels, sheets or toilet seats is 98% excluded. Trichomonas are poorly adapted to existence in the open air and can live no more than 15 minutes outside the human body. According to statistics, the percentage of people infected through household contact does not exceed 2% of all infections.

How carrier status turns into disease

After entering the body, Trichomonas can remain in an incubation state for a long period of time, existing in small quantities on mucous tissues and without causing harm to the host. The development and active reproduction of bacteria occurs only in the event of a violation of the flora of mucous tissues.

In the normal state, the flora of the mucous membranes of the genital organs includes a large number of lactobacilli. Lactobacilli maintain the acid-base level of the environment of mucous tissues, which does not allow pathogenic (hazardous to health) microorganisms to multiply. When the acidity or composition of the flora changes (dysbacteriosis), Trichomonas receive an excellent opportunity for development and reproduction.

Changes in the level of acidity and composition of the flora occur for the following reasons:

• Violation of the rules of personal intimate hygiene;
• Using caustic cleaning agents - only special neutral products can be used;
• Promiscuous sexual intercourse with various partners;
• Lack of hygiene during menstruation - rarely changing tampons and pads;
• Frequent wearing of panty liners;
• Using synthetic, tight-fitting underwear;
• Hormonal imbalances during pregnancy.

Diagnostic procedures

Diagnosis of trichomoniasis is aimed at detecting the causative agent of infection in the patient’s body. The primary diagnosis is formed based on the results of a patient’s examination by a doctor and on the basis of existing complaints. Laboratory tests can determine the presence of Trichomonas in the body of men and women:

• microscopy of urethral smears;
• PCR testing;
• culture for microflora.

Diagnosis of trichomoniasis in men is difficult due to the asymptomatic form of the pathology. Often the presence of a pathogen in the patient’s body is revealed during in-depth examinations when planning a pregnancy by married couples.

Symptoms of trichomoniasis

When trichomonas enter the mucous membrane in an environment that is acceptable for their life, the bacteria secrete mucous substances to attach to the membrane. Also, during the life of bacteria, a specific enzyme is released, which leads to the breakdown of cells of the mucous membrane.

Violation of the mucous membrane provokes inflammation, which gives the following symptoms:

• Swelling of the mucous membranes;
• Redness of the mucous membrane;
• Detachment of the surface layer of cells;
• Subfebrile (from 37.1 to 38 degrees) temperature;
• Unpleasant sensations, itching, burning.

Inflammation is caused by the body's natural defense reaction. The bacterium is attacked by biologically active substances of immune cells, which contribute to irritation of nerve endings. Trichomoniasis manifests itself differently in women and men.

Symptoms of Trichomonas infection in women

After Trichomonas enters the female body, the development of the disease begins with damage to the vaginal flora, then the bacteria spread to the urinary ducts, bladder and other mucous tissues of the genitourinary system.

Symptoms of the disease with varying intensity appear 5-7 days after infection; the incubation period of bacteria ends 30 days after entering the body. After this period, pronounced symptoms can be observed.

Trichomoniasis manifests itself in the form of trichomonas colpitis or vaginitis - vaginal dysbiosis, leading to inflammation of the surface layers of the vaginal mucosa.

An infected woman will experience:

• unpleasant-smelling vaginal discharge, discharge has a yellowish tint;
• burning sensation or severe itching on the outer surface of the genitals;
• characteristic pain during urination or sexual intercourse;
• increased sensitivity of the outer walls of the vagina to injury and other factors,
• which is manifested by bleeding and purulent discharge.

With vaginitis caused by Trichomonas, the following symptoms of the disease appear:

• Unpleasant-smelling discharge with a foamy structure. May be yellow or gray, depending on the stage of the disease. Foam occurs due to bacteria that produce gas during their life processes.
• A feeling of severe itching and burning localized in the vaginal area is a sign of inflammation of the mucous membrane.
• Redness of the skin of the labia and around.

Women who are sexually active are susceptible to the disease. Age from 18 to 45 years. Vivid symptoms and vaginitis appear in cases of weakened immunity, leading to rapid dysbiosis of the vaginal flora. With good immunity, the disease can manifest itself with minimal symptoms, or occur in a latent, chronic form. In this case, moments of exacerbation may occur in the period before menstruation.

If symptoms of trichomoniasis are detected, regardless of their intensity, you should immediately contact a gynecologist.

Consequences and complications

Consequences of the chronic form:

• sexual disorders
• obstruction of the fallopian tubes, resulting in the inability to conceive
• chronic inflammation of the uterine appendages, which leads to infertility
• malignant process in the cervix, that is, cancer
• pregnancy complications

During pregnancy, women with trichomoniasis may have the following complications:

• intrapartum and antenatal embryo death
• chorioamnionitis
• antenatal rupture of water
• premature birth
• miscarriage

Trichomoniades are a risk factor for the following diseases:

• genital cancer
• mastopathy
• allergy
• diabetes

Symptoms of trichomoniasis in men

During unprotected sexual intercourse, Trichomonas enter the urethra. If the bacteria take root, they may spread deep into the canal to the prostate. When it comes into contact with the prostate, inflammation begins, leading to acute or chronic prostatitis.

In the male body, in most cases the disease is practically asymptomatic. In rare cases, there may be discharge from the urethra and pain when urinating. In cases where the disease affects the prostate gland, the symptoms of Trichomonas can be completely similar to prostatitis.

At the stage of chronic trichomoniasis, urethritis appears, accompanied by the following symptoms:

• Burning in the urethra after urination;
• Mucus or foamy discharge;
• Difficulty passing urine accompanied by pain or tension in the abdomen;
• Feeling of bladder fullness after urination.

Trichomonas is transmitted to men in 65-70% of unprotected sexual contacts with a carrier of the infection. Microorganisms often leave the body naturally. A week after infection, Trichomonas disease is detected in only 30% of men. This is due to the fact that the flora inside the urethra does not meet the conditions necessary for the reproduction of Trichomonas.

In men infected with Trichomonas, trichomoniasis can occur in a latent, chronic form, asymptomatic or with minimal symptoms until exacerbation caused by decreased immunity. In this case, the man will act as a carrier of infection.

General information about the infection

The causative agent of the pathology is Trichomonas vaginalis. Infection occurs during unprotected sexual intercourse. Household items - linen, towels, clothes - rarely become transmission routes for trichomoniasis. Infection by this method remains possible if the patient’s immunity is weakened.

The targets of infection in men are the prostate, testicles and their appendages, seminal vesicles, and urethra. In women, trichomoniasis affects the vagina, urethra, and vaginal part of the cervical canal. In most cases, the causative agent of the pathology is detected in patients aged 16-35 years. A newborn can become infected while passing through the mother's natural birth canal. Infants easily tolerate the disease due to the structural features of epithelial cells.

Consequences of trichomoniasis during pregnancy

Trichomoniasis during pregnancy has a number of serious consequences. Exposure to bacteria on the organs of the genitourinary system during pregnancy, as well as at the stage of conception, can lead to the following problems:

• Sperm phagocytosis is a reaction of the immune system during an inflammatory process. The concentration of macrophages and neutrophils – cells that ensure the destruction of the source of inflammation – increases. Along with pathogenic bacteria, the immune system also destroys sperm, which leads to male infertility.
• Reduced sperm motility - Trichomonas actively secrete toxic metabolic products that inhibit sperm.
• Miscarriage - due to the effects of Trichomonas, prostaglandins are released into the blood - substances that provoke contractions of the muscular system of the uterus, which can result in spontaneous abortion;
• Premature birth - due to the reason described above, due to the increased tone of the uterus, it is possible to provoke premature birth.

Thus, at the stage of pregnancy planning, it is imperative to be tested for Trichomonas and undergo a course of treatment.

Features of the disease during pregnancy

Since during pregnancy the acidity of the vagina is reduced, and the immune system is significantly weakened, trichomonas manifest themselves with clear signs, or an exacerbation of a chronic illness occurs. In this case, there may be several lesions at once. Affected:

• rectal mucosa;
• urethra and bladder;
• vagina.

When a woman becomes pregnant, the body begins to create conditions that will help protect the fetus from any negative external influence. Therefore, the immune system begins to work much more actively when any microorganism penetrates. Additional protective mechanisms are present from the moment of conception until the baby is born.

The possibility of infection depends on how far along the expectant mother is. From the first trimester, the body changes, the mucus in the cervical area becomes thicker and more viscous to prevent the penetration of bacteria and viruses.

Important! It is better to identify the disease at an early stage and then carry out full treatment than to face unpleasant symptoms and consequences of trichomoniasis. In acute cases, microorganisms can cause pathologies in the fetus, miscarriage or early birth.

Diagnosis of trichomoniasis: how to identify trichomonas

You should not lead the disease to complications; to detect trichomoniasis in a timely manner, it is enough to visit a doctor for preventive purposes and take a smear for infections. Well, if you start to experience the first symptoms, you should contact the clinic immediately.

If symptoms similar to trichomoniasis are detected, a specialist (gynecologist or urologist) prescribes tests to identify pathogenic organisms in the flora

Trichomoniasis can be diagnosed at any stage, for this purpose the following are carried out:

• Study of the drug (discharge from the urethra, vagina) at the microscopic level, using the Gram and Romanovsky-Giemsa method;
• Biological and molecular studies NASBA and PCR, etc.

The most accurate way to detect Trichomonas is to go through several stages of testing.

Popular tests for Trichomonas

• Microscopic examination method
  - for diagnosis, biomaterials are taken for analysis. For women - a smear from the posterior vaginal vault, cervical canal, urethra. In men, a scraping is taken from the urethra, prostate secretions and seminal fluid. The study is performed under a microscope. A 0.9% sodium chloride solution is added to the taken materials, after which the microorganisms change color and can be seen during examination. The advantage of the method is its efficiency: research must be carried out within no more than 30 minutes from the moment the material is taken.

Photo by isis325

• The method of cultivating Trichomonas
  is a smear containing biological material from the patient’s body and is placed in a special nutrient medium to accelerate the development of microorganisms. After some time, the flora is examined and if initially there were Trichomonas in the sample, their number increases significantly, allowing us to speak with confidence about the presence of bacteria in the body. The method allows you to diagnose the degree of infection, the stage of the disease, and also identify the most effective drug for killing bacteria.
• PCR method - for research, any biological fluids are taken, from a vaginal smear to a blood test. The study searches for DNA and RNA of pathogenic microorganisms. The advantage of the technique is the ability to detect Trichomonas, even if the disease is asymptomatic or in a chronic stage. The method is the most expensive, but very accurate.

Each method has its own advantages and differs in effectiveness and time to obtain results. Diagnosis is prescribed by the attending physician, gynecologist or urologist after a visual examination.

Diagnostics

Source: Leif Hellmann/Pixy.org
Diagnostic measures consist of determining the clinical signs of the disease and identifying pathogenic microorganisms. Laboratory methods help in this.

Smear microscopy

If Trichomonas vaginalis is immediately detected using microscopy, no additional studies are required to prove infection; treatment is prescribed.

Bacterial culture of samples

Usually used for the chronic form. Using this method, you can not only detect Trichomonas, but also find out its sensitivity to various drugs.

Serological method

Identifies specific proteins that the immune system produces in response to an infection in the body.

PCR (polymerase chain reaction)

Detects Trichomonas DNA or RNA in patient biological material. One of the most accurate modern methods makes it possible to detect the infectious agent even in small quantities.

Important! If trichomoniasis is suspected, it is advisable to prescribe additional tests for HIV, syphilis, hepatitis B and C, as well as for the presence of TORCH infections (a group of infections dangerous to pregnancy and the fetus).

Treatment of trichomoniasis: comprehensive treatment

The simplicity of the structure of Trichomonas is deceptive - these are the oldest bacteria, coexisting with humans for millions of years. This is due to their resistance to drugs. Treatment of trichomoniasis is prescribed by the doctor individually for each patient, based on the results of his examination. The wellness course must be carried out comprehensively, in three stages, and until complete recovery, otherwise the disease, after some time, will be able to manifest itself again. Monitoring of cure is mandatory.

• Antimicrobial drugs taken orally or intravenously are used to treat the infection. In some cases, combined use of drugs in various forms is required to provide local and general effects.
• When using strong antibiotics, women may develop thrush; the gynecologist should take this into account and, if necessary, prescribe vaginal suppositories to combat the fungus and special preparations containing lactic acid bacteria. Drugs can be prescribed in the form of suppositories or douching solutions.
• Treatment must be supplemented with local treatment: tampons, baths, urethral and bladder installations, suppositories.
• In cases of acute form, the course of treatment requires additional procedures, such as prostate massage, physical and immunotherapy, and instillation of the urinary canal. In any case, you should not self-medicate.

The general course of treatment lasts from 2 weeks to 1 month, depending on the effectiveness of the selected drugs and the patient’s immune system. Under no circumstances should you self-medicate. An error in choosing a drug and insufficient dosage will lead to stimulation of the bacteria’s immunity to the drugs used, which in the future will only complicate treatment.

If the patient has a regular sexual partner, he should also be examined by a specialist and, if necessary, undergo a course of treatment.

Drug therapy

Once the cause of the symptoms is determined, the doctor may prescribe treatment for the patient, which includes drugs that destroy these microorganisms. Metronidazole is one of the most popular and powerful drugs; it is prescribed to patients. To treat the infection, the doctor prescribes taking 1 tablet twice a day, it is important to take the medicine with plenty of water. The course of treatment is 10 days, after which tests are taken again.

Metronidazole penetrates the body and then begins to actively affect Trichomonas, destroying the DNA of single-celled organisms. Since all biological processes are stopped, the microbe quickly dies. But it is worth noting that the medicine has a number of side effects and contraindications. For example, it is not recommended to use the drug when carrying a child or if the body is hypersensitive to the components.

There are also other pharmaceutical medications that can be prescribed to treat trichomoniasis.

1. Klion D. This is a combination drug, it contains Metronidazole and Miconazole. Klion D is often prescribed to patients who are faced with diseases of the genitourinary system. The product can be prescribed to a woman in the form of vaginal suppositories. The medication is used for 10 days, suppositories are inserted into the vagina in the evening before bedtime.
2. Tinidazole. This drug belongs to the same group as Metronidazole; the effect of the main components of the drugs is very similar. This remedy can be used not only to eliminate Trichomonas, but also to get rid of gonococci. The medication should not be used in case of hypersensitivity to the components, as well as in diseases associated with the hematopoietic organs. Tinidazole is prohibited during breastfeeding and pregnancy.

During the treatment process, the doctor must constantly monitor the patient's condition in order to see the result of the therapy. The treatment process is tracked in the following ways:

• women should take a vaginal smear after the end of menstruation, 1-3 days later, based on the result of the smear examination, the effectiveness of treatment will be obvious;
• after therapy is completed, within three months the patient is prescribed a vaginal and urethral smear to detect the presence of Trichomonas.

Diet and restrictions

Also, while taking medications, the specialist will recommend a diet and introduce some restrictions. In particular, recommendations may be of the following nature:

• Eliminate fried, fatty, spicy foods from the diet;
• Add fermented milk products that help restore lactobacilli;
• Strictly refrain from intimacy, since during treatment the flora is most vulnerable and there is a risk of getting an additional infection or fungus.

Following these recommendations will speed up treatment and achieve the best result with minimal discomfort to the body.

Control smear

To ensure the success of treatment, a control test for trichomoniasis is carried out 2 weeks after antibiotic therapy. If the result is negative, the patient is completely cured; further observation by a doctor is not required.

If the result is positive, a second course of treatment is prescribed for a longer period. The doctor selects other drugs or increases the dosage of previously prescribed ones. If during treatment there were deviations from the recommendations (the patient did not take antibiotics, did not follow the dosage regimen or dosage), the doctor should be notified about this.

Trichomoniasis can be prevented: preventive measures

To prevent the disease, you must adhere to simple rules in intimacy and lead a healthy lifestyle:

• Be careful during sexual intercourse, do not be promiscuous, it is better to choose a single partner - mutual trust and honesty are the best cure for sexually transmitted diseases;
• Use a condom during sexual intercourse, use contraception correctly;
• Follow the rules of intimate hygiene - taking a shower and changing linen every day, using soap made from natural ingredients;
• Timely treatment of any urological diseases that provoke vaginal dysbiosis.
• Be examined annually by a gynecologist or urologist, and consult a specialist when the first alarming symptoms appear.

By adhering to these simple rules, you can avoid most sexually transmitted diseases and reduce the risk of dysbacteriosis and related infections.

Prevention measures

The main cause of infection is considered to be sexual intercourse that took place without using a condom, for this reason it is so important not to abandon traditional methods of protection. Gynecologists and venereologists give useful advice on how to avoid infection, and it’s worth listening to them:

• you should refrain from promiscuity;
• it is better to refuse contact with an unfamiliar partner in whom there is no confidence;
• It is recommended to use a condom during sexual intercourse;
• after the act, bactericidal solutions are used to disinfect the genitals in case of accidental contact;
• Conduct rapid diagnostics at least once every six months.

If you follow these simple rules, you can significantly reduce the risk of contracting this infection. Venereologists strongly recommend not to refuse examinations twice a year. Pregnant women are required to undergo tests to detect hidden infections in order to cure the disease in time.

It is easier to prevent an infection than to treat it. As experts say, at the first signs of illness, you should consult a doctor and undergo an examination. This will help to detect infection in time and begin treatment. If therapy is not started on time, trichomoniasis will become chronic, and as a result, the disease will constantly worsen. To prevent infection, barrier methods of contraception should be used, as well as strict hygiene rules.