Trichomonas infection

Trichomoniasis (trichomoniasis) is one of the most common sexually transmitted diseases worldwide. Learn more about the topic now!

Trichomonas infection

The Trichomonas infection (Trichomoniasis) is one of the most common sexually transmitted diseases of the genitourinary tract worldwide. It mainly affects women. In most cases, the infection is asymptomatic. Treatment is by a short dose of antibiotics. However, caution should be exercised during pregnancy. Find out everything important about symptoms, diagnostics and treatment of trichomoniasis here.

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in doctor's letters or on incapacity certificates. A59

Product Overview

Trichomonas infection

  • description

  • symptoms

  • Causes and risk factors

  • Examinations and diagnosis

  • treatment

  • Disease course and prognosis

Trichomoniasis infection: description

The trichomoniasis or trichomoniasis infection is an infection with Trichomonas vaginalis, This is a parasite that belongs to the protozoa. Protozoa are unicellular organisms. Other protozoans are the malaria parasites and the causative agents of toxoplasmosis. Trichomonas vaginalis has a pear-like shape and carries thread-like structures on the surface, which are used for locomotion.

In women, the protozoan is most commonly detected in the vagina, urethra and paraurethral glands. Trichomonas can cause a vaginal and also a urethral and cervical infection. In man, Trichomonas vaginalis feels especially well in the urethra. Except for humans, Trichomonas vaginalis has no other reservoir where it survives for a long time. Outside the human body, the parasite usually dies quickly - except for wet objects and water. However, contaminated water does not have much importance from an epidemiological point of view.

The Durchseuchung with Trichomonas vaginalis can be estimated in part only because the disease is not notifiable. It is estimated that between five and ten percent of women in the industrialized countries and around one percent of men are affected. Around 52 new infections per 1000 inhabitants occur each year in Western Europe. Due to the frequent freedom from symptoms of the infected Trichomonas vaginalis can spread quickly.

In addition to bacterial vaginosis and the fungal infection (candidiasis) of the female genital tract, trichomoniasis infection is one of the most common causes of vaginal complaints (vagina). A trichomoniasis infection should be detected early and treated. Otherwise, it can lead to complications in pregnancy. In addition, other sexually transmitted diseases are relieved, often resulting in multiple infections simultaneously.

Trichomonads infection: symptoms

In up to 85 percent of cases, the infection does not cause clear trichomonads symptoms. In all other cases, symptoms occur 2 to 24 days after the trichomoniasis infection. The most common symptoms of trichomoniasis are vaginal discharge, agonizing itching, painful urination or even unpleasant odor. The vaginal discharge occurs in more than three out of four cases as a trichomonas symptom. The discharge is often foul-smelling, green and foamy. In addition, sexual intercourse is often painful. Non-specific abdominal complaints may also be accompanied by a trichomoniasis infection.

Trichomonads in men rarely trigger symptoms. The signs are nonspecific and manifest as urinary symptoms and urethral pain. Even low discharge from the urethra may occur. In rare cases, the glans is inflamed. The intensity and severity, however, is usually much lower than that of women. In case of repeated and resistant complaints, however, the man should always be thought of a trichomoniasis infection.

Trichomoniasis Infection: Causes and Risk Factors

The trichomoniasis infection is one of the so-called sexually transmitted diseases. This means that the infection with trichomonads happens in almost all cases during sexual intercourse. As a result, the infection is usually limited to the vagina and the lower urinary tract. But trichomonads can also be transmitted by contact with infectious bodily fluids, for example during petting or through shared towels. Since the majority of infected people show no symptoms, the transmission is often unconscious. The colonization of the urogenital tract with Trichomonas vaginalis and attachment to the body cells leads to an inflammatory reaction. These cells are mainly damaged by soluble substances excreted by Trichomonas vaginalis, and also destroyed.

During childbirth, a mother's trichomoniasis infection can be transmitted to the child. However, this happens only in 2 to 17 percent of cases.

Infection of prepubertal girls is rare, as infection with Trichomonas occurs if any sexual contact that may have occurred is checked.

risk factors

Trichomoniasis infection is facilitated by estrogen deficiency in the vagina, damage to the vaginal flora and also foreign bodies such as forgotten tampons. Bacterial vaginosis also doubles the risk of trichomoniasis. In addition, certain diseases such as diabetes mellitus, immunosuppression, pregnancy, HIV infection or tumors increase the susceptibility to trichomoniasis. Statistically, trichomoniasis infections are more common with low socioeconomic status, changing sexual partners and poor hygiene. Patients with other sexually transmitted diseases often also have an existing trichomoniasis infection. Conversely, trichomoniasis makes it more sensitive to HIV infection.


To protect against trichomoniasis, a condom should be used during intercourse. Good intimate hygiene is the basis of effective infection prevention. Even when bathing you should exercise caution. After swimming, you should quickly put on dry clothes.

Trichomonads infection: examinations and diagnosis

The specialist in trichomoniasis infection is the woman's gynecologist and the man's urologist. The initial examination will ask questions such as:

  • Are you familiar with infections of the urogenital area?
  • Have you observed unusual discharge from the vagina / penis?
  • Do you have pain when urinating or having sexual intercourse?
  • Have you had frequent changing sexual partners lately?

At the beginning, the genitals and, if possible, the urinary tract are examined. Swelling, redness and other signs of inflammation are first indications of an existing infection. A close examination of the female genitalia by a colposcopy with a special examination microscope shows further signs of inflammation and irritation. In up to 15 percent of infected women, the examination is inconspicuous.

To determine if a Trichomonas infection has actually occurred, one will smear examined from the vagina or vaginal secretions under the microscope. The protozoan Trichomonas can also be detected from urethral secretions or urine. Trichomonads can also be stained for microscopic viewing, but this requires experience. However, infection detection is best achieved by the experiment of cultivation the trichomonads from secretions or urine. There is also a molecular biological method (PCR), with the help of which the DNA can be detected.

Trichomoniasis diagnosis should simultaneously look for other existing sexually transmitted diseases, especially HIV. It is also important to ask for further sexual contacts in order to possibly treat partners.

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    Attention, contagious!

    The light is dim, the kisses are greedy - but wait! Before you go all out, do not forget to bring the condom into the (love) game. Because not only HIV is transmitted during sexual intercourse: Learn more about the diseases that you prefer not to get during sex.

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    Bacterial vaginosis

    Cause of a bacterial vaginosis are rod-shaped bacteria usually Gardnerellen). They are transmitted during sexual intercourse. If the vaginal milieu is out of balance, the bacteria have easy game and multiply. Typical symptoms include increased discharge with fishy odor, itching and pain when urinating. Gardnerella infection usually causes no symptoms in men.

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    Chlamydia infections

    Chlamydia is one of the most common sexually transmitted diseases. Causer is a bacterial species. 80 percent of women and 50 percent of men have no complaints and therefore unknowingly engage their partners. In women chlamydia is otherwise expressed in the form of discharge, itching and burning on urination. In men, the urethra often becomes inflamed. In extreme cases, those affected become infertile.

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    Genital warts (Condylomata acuminata)

    Genital warts are caused by human papilloma viruses (HPV). Mostly, the variants HPV-6 and HPV-11 can be detected. Genital warts usually occur in large numbers on the genitals, the anus and the rectum. They tend to form beds, and can grow into large Brussels sprouts - not a pretty sight! Above all, young people are at risk.

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    Gonorrhea (gonorrhea)

    Gonorrhea is triggered by the bacteria Neisseria gonorrhoeae (gonococci). Younger adults are at particular risk - women and men are equally affected. It comes to inflammation of the genitals and purulent discharge. In women, the symptoms are much weaker. Since the mid-1990s, there have been more illnesses in Germany, after the numbers had previously been on the decline.

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    Hepatitis B

    Hepatitis B causes the liver to become inflamed. The causative agent is the hepatitis B virus (HBV), which is transmitted among other things by semen or vaginal secretions. The infection often causes initially little complaints, which is why it is not noticed in many cases.In 90 percent of patients, hepatitis B heals within six months. The remainder is chronic, meaning it lasts at least half a year.

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    Genital herpes

    Genital herpes affects the skin and mucous membranes of the genitals. The causative agents are herpes simplex virus type 2, while behind cold sores usually TYPE 1 is. If the liquid-filled bubbles form, the viruses are easily transmitted. The pathogens nest on the nerve roots - they "sleep". After the symptoms have resolved, the disease can break out again and again - for example, when the immune system weakens.

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    fungal infections

    Itchy fungal infections of the vagina are very common. Often the yeast fungus Candida albicans, a yeast, is the trigger. Typical symptoms include itching, burning pain, swelling, redness and increased friable discharge, reminiscent of cottage cheese.

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    Trichomonads are flagellates (unicellular organisms) that can move independently and are transmitted during sexual intercourse. Most affected are women. Symptoms include itching and burning of the vagina, sharp-smelling, green-yellowish discharge or burning sensation when urinating. In most cases men show no symptoms.

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    Hepatitis C

    Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Contagion through sexual intercourse is rare, but possible - especially if it comes to injury in the genital area. In the acute phase, patients feel slightly uncomfortable, but actually healthy. It can go into a chronic state - then increases the risk of cirrhosis and liver cancer.

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    Syphilis (lues venerea)

    Syphilis is caused by the bacterium Treponema pallidum. It is also known as lues, hard chancre, French disease or love search. Syphilis particularly affects men. It runs in four stages with different symptoms. Among other things, ulcers form and the nervous system is destroyed. In recent years, syphilis in Germany is on the rise again. Untreated, it is deadly.

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    HI-virus / AIDS

    The causes of AIDS are HI viruses, which are transmitted among other things during unprotected sex. The virus can be detected in the semen and in the vaginal fluid. It can penetrate the body through the slightest injuries that occur during sexual contact. The HI virus damages cells of the immune system. So the body can no longer effectively fight bacteria, viruses or fungi. HIV patients are therefore more susceptible to disease.

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    Ulcus molle (soft chancre)

    Ulcer molle is caused by the bacterium Haemophilus ducreyi. After infection, several painful, roundish-oval, euro-sized ulcers may occur. In addition, the inguinal lymph nodes swell painfully, they can fester and break through the skin. The Ulcus molle occurs predominantly in the countries of South America, Southeast Asia and Africa - tourists bring them but always as unwanted souvenir to Germany.

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    Join in!

    So there are many good reasons to practice safe sex with condoms. Especially with frequently changing sexual partners, this is very important. Anyone who enjoys it should always have a condom in their pocket - even as a woman. Otherwise, the love game can become a dance with death.

Trichomoniasis Infection: Treatment

With proven Trichomonads infection one should always also treat the partner, In most cases, a single dose of two grams of the antibiotic is sufficient metronidazole, Another treatment option is the administration of two times four lower doses of tablets six hours apart on the first day and one tablet the next morning. Alternatively, especially with repeated trichomonas infections, 500 gram metronidazole may be prescribed twice daily for five to seven days.

Local administration of metronidazole in the form of a gel is not recommended as it often affects glands or other areas that are inaccessible to local therapy. Until the completion of trichomonas therapy, those affected should remain sexually abstinent.

When applying these therapeutic suggestions, there is one high probability of a successful recovery, In up to 20 percent spontaneous healing without trichomonas therapy is possible. During treatment, alcohol should not be consumed - this is up to 48 hours after taking the last tablet.

In the case of an existing pregnancy metronidazole can not be used carelessly. Especially in the first trimester of pregnancy, the application should be carefully weighed. There are a number of studies on metronidazole use, most of which give no indication of adverse consequences of pregnancy therapy. In pregnant women, however, rather no high single-dose therapy should be performed.

If trichomoniasis symptoms persist or recur despite therapy, trichomoniasis diagnostics should be repeated and therapy may be intensified if necessary.

Trichomonads infection: disease course and prognosis

Trichomoniasis is well treated and therefore belongs to the group of curable sexually transmitted diseases. However, since trichomonads often cause no symptoms, the disease goes unnoticed for a long time - but can also heal in this time. An untreated trichomoniasis infection may affect the course of pregnancy. Important complications include premature birth and low birth weight. In rare cases, a trichomoniasis infection can lead to an ascending infection of the fallopian tubes. In men, this can cause a prostate inflammation. Added to this is the increased susceptibility to other sexually transmitted diseases. Among other things, for these reasons, rapid trichomoniasis therapy is required, especially for risk groups of sexual infections. After a through Trichomonas infection There is no protection against a new illness.

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