David Allan Baker, M.D. is a Professor of Obstetrics, Gynecology & Reproductive Medicine and the Director of the Division of Infectious Diseases at SUNY Stony Brook. He completed his internship and residency at the Hospital of the University of Pennsylvania and his fellowship in Maternal Fetal Medicine at the University of Vermont College of Medicine. Dr. Baker was included in New York Magazine's Best Doctors of 2006, and his areas of clinical interest include infectious diseases in Obstetrics/Gynecology, sexually transmitted diseases, vaginitis/vulvitis, and preterm labor.
TRICHOMONIASIS: THE NATION'S MOST COMMON CURABLE STD
Sexually transmitted diseases (STDs) too often go undiagnosed and untreated, even though they can have a long-term impact on sexual and reproductive health. Trichomoniasis - often referred to as "trich" - is an example of an STD that sexually active women and men need to know more about. An estimated 7.4 million cases of trichomoniasis occur annually in the United States, making it the most common curable STD in the country. Unlike other STDs, the incidence of trichomoniasis increases with age.
What causes trichomoniasis?
Trichomoniasis is caused by the single-celled parasite known as Trichomonas vaginalis, which is transmitted during sexual activity. A woman can acquire the disease from either an infected man or an infected woman. A man usually contracts it from an infected woman.
Why does trichomoniasis go undiagnosed so often?
Individuals often don't realize they have been infected because there may be no obvious signs of infection. When symptoms are experienced, they are often mild, which may lead to a delay in seeking treatment.
If a woman infected with trichomoniasis does have symptoms, what will she experience?
When symptoms of trichomoniasis do appear in women, they may include itching and redness in the genital area, and a yellow-green vaginal discharge that may have an odor. There also may be some discomfort associated with urination and intercourse. If symptoms occur, they appear within five to 28 days after exposure to an infected sexual partner.
How about men? What are their symptoms?
Although some males may experience some discharge from the penis or some genital irritation, most men with trichomoniasis do not experience symptoms. However, an infected man, even one who exhibits no symptoms, can continue to infect or re-infect a female partner until he has been successfully treated.
How is trichomoniasis diagnosed in women?
A health care provider must conduct a laboratory test to assess whether a woman has trichomoniasis. Trichomoniasis may also be detected during a woman's annual pelvic exam, which may reveal small red ulcerations on the vaginal wall.
How is trichomoniasis diagnosed in men?
Trichomoniasis is more difficult to diagnose in men. A swab can be taken from the urethra (urine canal) and sent for laboratory evaluation.
How should trichomoniasis be treated?
Trichomoniasis can be cured in both women and men with single-dose prescription therapy that is taken orally.
What drugs can be used to treat trichomoniasis?
Metronidazole, which is taken orally in a single dose, has long been the standard treatment of trichomoniasis. Another drug, Tindamax (tinidazole), was approved in 2004 and has recently been recognized by the Centers for Disease Control and Prevention (CDC) as a first-line treatment option for trichomoniasis. Both drugs have high cure rates when used to treat trichomoniasis.
If left untreated, does trichomoniasis increase susceptibility to other diseases and health complications?
Yes. If let untreated, the genital inflammation caused by trichomoniasis can increase a woman's susceptibility to HIV infection. Trichomoniasis also has been shown to increase the risk of infertility and pelvic inflammatory disease in women. Trichomoniasis may also play a role in increasing the risk of cervical cancer; it was associated with a six-fold increased risk of cervical cancer in a Finnish study. In men, an increased risk of prostatis and cystitis are associated with trichomoniasis.
Can trichomoniasis affect the health of a woman and her baby during pregnancy?
Yes. Trichomoniasis has been linked to premature birth, low birth weight (babies born at less than five pounds), and infection or rupture of the membranes as well as postoperative infection in women.
If I need to be treated for trichomoniasis, should my sexual partner also be treated?
Sexual partners should be treated at the same time to protect against re-infection.
How should a diagnosis of trichomoniasis affect sexual activity?
Sexual activity should be put on hold until both partners have been treated.
If I have trichomoniasis, should I be evaluated for other STDs?
Yes. Trichomoniasis can often co-occur with other STDs. CDC guidelines recommend that patients seeking treatment or screening for one STD should be evaluated for other common STDs.
Where can I find more information on treating sexually transmitted diseases?
The CDC's Sexually Transmitted Diseases Guidelines can be found at http://www.cdc.gov/std/treatment/2006/clinical.htm.
Created: 6/11/2007  - Donnica Moore, M.D.