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| |    Trichomonas Vaginitis by Marjorie Greenfield, M.D. reviewed by Laura Jana, M.D., F.A.A.P. Trichomonas is a one-celled parasite that can live in the vagina, the cervix, or in the male lower genital tract. Under the microscope, this protozoan looks like a teardrop-shaped cell with a tail. Women with trichomonas usually have accompanying discharge or irritation. Occasionally the cervix can become inflamed, leading to bleeding after intercourse or at the time a Pap smear is taken. In rare cases, a woman will notice discomfort with urination. Often bacterial vaginosis coexists with this infection, since the Trichomonas organism creates an alkaline pH in the vagina that encourages the growth of the "bad" bacteria. In this case, a woman may also notice a fishy odor, especially after intercourse. How do you get Trichomonas? Trichomonas, commonly called "trich" (pronounced "trick"), is a sexually transmitted infection. If you believe your relationship is monogamous and have come down with Trichomonas, you may be wondering what the implications are. While it's true that trich lives in the male genital tract, it survives for only a few days or weeks at most. But it can be present in the vagina for years, and has even been discovered in elderly women who have not had sex for decades. So you may have in fact contracted the infection from a previous partner and not known it. Nevertheless, it's important that you have an open, honest discussion with your current partner, as it still remains possible that he passed on the infection to you if he was sexually involved with someone else. Almost half of all women with Trichomonas present no symptoms and may go undiagnosed for years, even if they have had regular annual examinations. Condoms can help protect against transmission of this organism. Risks Trich has no significant medical risks. It doesn't travel up into the uterus or fallopian tubes and does not affect other parts of the body. It is purely an uncomfortable annoyance. Treatment Trichomonas is treated with an anti-protozoan antibiotic. The most effective treatment is metronidazole (Flagyl), which can be taken by mouth. A one-time dose is often all that is needed. Sexual partners of women with trich should be treated simultaneously so that the couple doesn't pass it back and forth. Rarely, Trichomonas is resistant to the usual doses of metronidazole and higher doses are needed.
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