What Is Trichomoniasis?
Trichomoniasis, sometimes referred to as "trich," is a common STD that affects 2 to 3 million Americans yearly. It is caused by a single-celled protozoan parasite called Trichomonas vaginalis. Trichomoniasis is primarily an infection of the urogenital tract; the urethra is the most common site of infection in man, and the vagina is the most common site of infection in women.

Causes, incidence, and risk factors?
Trichomoniasis is found worldwide. In the United States, the highest number of cases are seen in women between age 16 and 35. Trichomonas vaginalis is spread through sexual contact with an infected partner. This include penis-to-vagina intercourse or vulva-to-vulva contact. The parasite cannot survive in the mouth or rectum.
The disease can affect both men and women, but the symptoms differ between the two groups. The infection usually does not cause symptoms in men and goes away on its own in a few weeks.
Occasionally, some men with trichomoniasis may develop prostatitis or epididymitis from the infection.

Signs and tests?
In women:
A pelvic examination shows red blotches on the vaginal wall or cervix. A wet prep (microscopic examination of discharge) shows the infection-causing organisms in vaginal fluids. A pap smear may also diagnose the condition.
In men:
The disease can be hard to diagnose in men. Men are treated if the infection is diagnosed in any of their sexual partners. Men may also be treated if they have ongoing symptoms of urethral burning or itching despite treatment for gonorrhea and Chlamydia.

Symptoms. Trichomoniasis, like many other STDs, often occurs without any symptoms. Men almost never have symptoms. When women have symptoms, they usually appear within four to 20 days of exposure. The symptoms in women include a heavy, yellow-green or gray vaginal discharge, discomfort during intercourse, vaginal odor, and painful urination. Irritation and itching of the female genital area, and on rare occasions, lower abdominal pain also can be present. The symptoms in men, if present, include a thin, whitish discharge from the penis and painful or difficult urination.

Treatment. Because men can transmit the disease to their sex partners even when symptoms are not present, it is preferable to treat both partners to eliminate the parasite. Metronidazole is the drug used to treat people with trichomoniasis. It usually is administered in a single dose. People taking this drug should not drink alcohol because mixing the two substances occasionally can cause severe nausea and vomiting.

Exams and Tests
The diagnosis is made by directly observing the trichomonads through a microscope (they are too small to be seen by the naked eye).

Trichomonads are pear-shaped and have several flagella (whiplike tails) at one end.

This lab test is usually ordered only if the doctor suspects trichomoniasis as a possible diagnosis.

In some cases, the doctor may have to send the sample to the laboratory, and the result may not come back right away.

The doctor will collect the specimen during a pelvic examination.

The doctor inserts a speculum into the vagina and then uses a cotton-tipped applicator to collect a sample.

The sample is then placed onto a microscope slide and sent to the laboratory to be analyzed.

Trichomonads are seen rarely during urine testing.

A diagnosis of trichomoniasis usually prompts a search for other sexually transmitted diseases, such as syphilis, HIV, gonorrhea, or chlamydia.
 

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