What is trichomoniasis?
It's a sexually transmitted disease that causes vaginitis (vaginal inflammation) and infects a man's urethra. Each year, more than seven million Americans get it. The culprit is the tiny organism Trichomonas vaginalis, which produces symptoms such as vaginal itching and redness as well as a bad-smelling discharge in women. (The discharge is typically "frothy" and yellow, green, or brown, in contrast to the white or clear discharges associated with yeast or Gardnerella vaginitis.)
Women may also have symptoms of a urinary tract infection, particularly a burning sensation when urinating. In men trichomoniasis can cause painful urination and a puslike discharge from the penis. Many people who are infected, though, have no symptoms at all.
What harm can it do?
The disease, whose name is often shortened to trich (pronounced "trick"), usually causes more itching and discomfort than anything else. In the case of men and of women who aren't pregnant, trich itself hasn't been linked to any serious complications. But it needs to be treated right away; if left alone, it can increase your susceptibility to HIV, the virus that causes AIDS. And if you're pregnant, trich can cause your baby to be born prematurely or underweight.
How can I protect myself from it?
Since trich is generally spread through sexual contact, practicing safe sex (in particular, using a latex condom and limiting the number of sexual partners you have) will help you stay clear of it. Remember that men often show no symptoms and may seem completely healthy even though they're infected. If you're thinking about having sex with someone new, says the Centers for Disease Control and Prevention, both of you should arrange to be tested for sexually transmitted diseases first.
If you're a woman, keeping your vaginal area clean and dry will also help safeguard you against this and other forms of vaginitis caused by organisms that flourish in a moist environment. Wash between your legs daily with mild soap, and use cotton-lined underwear that allows the area to breathe. Change out of damp underpants after exercising, if you can, and avoid tight pants that might irritate the vagina. And don't douche; it upsets the bacterial balance in your vagina and makes you more vulnerable to vaginal infections and sexually transmitted diseases.
When should I call my doctor?
If you suspect you have trich, get in touch with your doctor immediately. He or she will examine some of the discharge under a microscope -- a test known as a "wet mount." The protozoa that cause the disease are mobile little creatures and can often be seen moving about. In addition, the organisms are sometimes discovered in an infected woman's Pap smear; this is particularly true for a woman without symptoms who doesn't realize she's infected.
What are my treatment options?
Your doctor will probably prescribe the drug metronidazole or tinidazole which are commonly used to treat trichomoniasis. Side effects like nausea and vomiting may occur, so be sure to have a full stomach in order to minimize any discomfort. Also avoid alcohol, which intensifies the side effects of the drug; in fact, you shouldn't drink alcohol until at least 48 hours after you've completed the treatment. (Tell your doctor if you're pregnant or think that you may be. Pregnant women should stay away from metronidazole during their first trimester.) Be sure to take all the medicine your doctor prescribed, even if your symptoms disappear; if you don't, the disease may not get cured.
To avoid being reinfected, make sure your sexual partner or partners get treatment at the same time you do. Even if your partner doesn't show any symptoms, he or she could still reinfect you or pass the disease on to other people. Postpone sex until you've finished all your medication. Finally, remember that having been infected with trich won't make you immune to it. Once you've completed the treatment, practice safe sex to keep from getting the disease again.
National Institute of Allergy and Infectious Diseases Fact Sheet. Vaginitis Due to Vaginal Infections.
JAMA Women's Health. Fact Sheet. Vaginal Infections and Vaginitis. June 1998.
Centers for Disease Control and Prevention. Trichomoniasis: Fact Sheet. 2004.
Centers for Disease Control and Prevention. Trichomoniasis. December 2007.