Trichomoniasis Health Article

Diagnosis

Diagnosis is easily made by taking a sample of the discharge from the woman's vagina or from the opening of the man's penis. The sample is put on a slide and viewed under a microscope. The protozoa, which are able to move about, are easily viewed.

Trichomoniasis tends to be underdiagnosed in men because of the relative mildness of symptoms in men and insufficiently sensitive diagnostic tests. The recent introduction of DNA amplification, however, indicates that the incidence of trichomoniasis in men is much higher than was previously thought.

Treatment

Cure of trichomoniasis may be difficult to achieve with alternative treatments. Some practitioners suggest eliminating sweets and carbohydrates from the diet and supplement with antioxidants, including vitamins A, C, and E, and zinc. Naturopaths may recommend treatment with two douches (a wash used inside the vagina), alternating one in the morning and one at bedtime. One douche contains the herbs calendula (Calendula officinalis), goldenseal (Hydrastis canadensis), and echinacea (Echinacea spp.); the other douche contains plain yogurt with live acidophilus cultures. The herbal douche helps to kill the protozoa while the yogurt reestablishes healthy flora in the vagina. Tea tree oil is another alternative remedy for trichomoniasis. Acidifying the vagina by douching with boric acid or vinegar may also be useful. Although not a cure, The Gynecological Sourcebook suggests inserting a garlic (Allium sativum) suppository (a peeled whole clove wrapped in gauze) every 12 hours for symptomatic relief.

Other remedies include vaginal suppositories that include the ingredient acidophilus once a day for three days. An alternative medicine practitioner can recommend the correct mixture. A vaginal douche consisting of grapefruit seed extract may also help relieve symptoms.

Allopathic treatment

The usual treatment is a single large dose of metronidazole (Flagyl) or split doses over the course of a week. Some sources suggest clotrimazole (Gyne-lotrimin, Mycelex) as an alternative treatment showing a lower cure rate. Application of Betadine, a concentrated antiseptic solution, is another recommendation, although Betadine is messy, stains, and should not be used by pregnant women. However, the Centers for Disease Control (CDC) states that there are no effective alternatives to therapy with metronidazole available. Topical treatment with metronidazole is not advised. Individual evaluations are recommended for those who are allergic to metronidazole or who experience treatment-resistant trichomoniasis. Sexual partners of an infected individual must all be treated, to prevent the infection from being passed back and forth. Sexual intercourse should be avoided until all partners are cured.

As of late 2003, the number of cases of metronidazole-resistant trichomoniasis appears to be increasing rapidly. Some success has been reported with the broad-spectrum anti-parasitic drug nitazoxanide, but further research needs to be done. A group of researchers in Thailand is currently investigating the effectiveness of a group of drugs known as bisquaternary quinolinium salt compounds in treating trichomoniasis.

Women who are taking antibiotics for other illnesses should speak to their health care provider about the possibile effects of the medication(s) on the balance of organisms in their vagina.