Trichomoniasis: modes of transmission, symptoms in women and treatment regimens. Symptoms and treatment regimen for trichomoniasis in men and women - diagnosis and list of drugs Rapid treatment of trichomoniasis in women

Trichomoniasis is one of the urogenital infections, which, if not properly treated, threatens to develop serious complications. In most cases, this disease is diagnosed in women, because women are more likely than men to undergo routine examinations, and also because the signs of infection are more pronounced in them.

Trichomoniasis can only be transmitted during direct sexual intercourse. The household route of infection with this infection through washcloths, wet swimwear, bed linen, and shared towels is almost impossible. For the optimal existence of the infectious agent, it is necessary that the pH level of the vaginal environment (in women) be 5.5-6.6.

Causes of trichomoniasis in women:

sexual intercourse (at the time of orgasm, Trichomonas enters the uterine cavity);

abortion (consequence) or childbirth (a natural violation of the mechanical protection of the uterine cavity due to the expansion of the muscles that close the cervix);

the period of menstruation and the period after its end (there is a change in the acidity of the vaginal environment).

Based on the duration and symptoms of the disease, there are three forms of infection:

Trichomonas carriage (the course of the disease is asymptomatic, and Trichomonas is found in the vaginal whites);

chronic trichomoniasis (minor clinical manifestations are present) - the time of the presence of the disease is 2 or more months;

fresh trichomoniasis (oligosymptomatic, subacute and acute form).

In general, in 10.5% of infected people, the infection proceeds independently, and all other cases of the disease are combined with gonorrhea, ureaplasmosis, chlamydia and other pathologies. This behavior of the infection is explained by the fact that Trichomonas is a kind of base for other microorganisms. The frequency of trichomonas carriers is 2-41%, which is associated with the degree of immunity.

Diagnosis of the disease:

immunological methods (RIFA and PCR diagnostics);

cultural method (sowing material on a special nutrient medium);

microscopic examination of the stained preparation (Romanovsky-Giemsa method, methylene blue, Gram);

microscopy of an unstained (native) smear.

With a combination of several diagnostic methods, the determinability of trichomoniasis is significantly increased.

The first symptoms of trichomoniasis after direct infection

The incubation period of the infection is 4-14 days, while the first signs of the disease begin to appear 4-5 days after the moment of infection. With trichomoniasis, the symptoms directly depend on the place of introduction and spread of the infectious agent. In most cases, the infection affects the cervix, urethra, and vagina.

The pathognomic sign of infection is the presence of copious amounts of leucorrhoea discharge from the vagina.

These secretions are yellowish or greenish in color, profuse, foamy.

In addition, vaginal leucorrhoea in the case of trichomoniasis has an unpleasant odor, which, when attached to gardnerelles, leads to a fishy odor.

Quite often, the disease is accompanied by dyspareunia (pain during intercourse).

When the infection spreads to the urethral mucosa, urination disorders (burning, pain, cramps) may appear, there are also frequent urges to urinate, which may indicate the development of urethritis.

Also, almost all patients complain of burning and itching in the vagina, its swelling and redness.

Rarely enough, but there are complaints about the presence of pain in the lower abdomen.

During a vaginal examination, hyperemia of the vaginal mucosa is observed, while vulvovaginitis is present, the cervix is ​​in a softened state and bleeds easily when the mirror is touched. In addition, the ingress of vaginal whites on the inner surface of the thighs and the skin of the perineum causes irritation of the skin and their ulceration, abrasions and sores of various sizes appear. With trichomonas cervicitis, a colposcopic conclusion is characteristic - strawberry cervix. The cervix is ​​visualized with a large number of capillary hemorrhages.

Signs of chronic trichomoniasis

The chronic form of trichomoniasis is a consequence of the neglect of the disease, or its transition from an acute form to a chronic one, due to the lack of treatment of this disease in a woman or her sexual partner. A characteristic feature of chronic trichomoniasis is the presence of periodic exacerbations and the duration of the course.

Relapses of the disease contribute to:

ovarian hypofunction;

decreased immunity (hypothermia, general diseases);

alcohol consumption;

sexual contacts;

menstruation;

non-compliance with the rules of personal intimate hygiene and other factors.

The course of trichomoniasis without exacerbation is characterized by mild symptoms. Patients complain of an increase in the number and volume of vaginal whites, a feeling of discomfort in the vagina, which intensifies at the time of sexual intercourse. The period of exacerbation of the disease has similar symptoms with the acute form of trichomoniasis.

Complications of trichomoniasis

Chronic trichomoniasis can cause such consequences:

the formation of a malignant process in the cervix;

complications of pregnancy (antenatal and intranatal fetal death, chorionamnionitis, prenatal rupture of water, premature birth, miscarriage);

sexual disorders (anorgasmia, frigidity);

female infertility - obstruction of the fallopian tubes, chronic inflammation of the uterine appendages.

Today, researchers argue that trichomonas can cause many diseases, including: oncology of the female reproductive organs, mastopathy, allergic manifestations, and diabetes mellitus. Some of the statements are confirmed in the course of research.

Treatment of trichomoniasis

To get rid of the infection, both sexual partners must undergo treatment, even if one of them has no signs of the disease. First of all, for the period of treatment, it is necessary to abandon the use of alcohol and spicy foods. It is also necessary to observe sexual rest during the period of therapy and until laboratory confirmation of a negative result, in order to avoid reinfection.

With trichomoniasis, drug treatment in a woman should only be prescribed by a doctor, since self-medication is not allowed. Medicines should have a spectrum of action against anaerobic organisms. In other words, the use of agents belonging to the group of 5-nitroimidazoles is required. These drugs include:

"Metronidazole" and its analogues ("Ornidazole", "Ternidazole", "Tinidazole", "Flagil", "Trichopolum").

All drugs against trichomoniasis are effective only when administered internally in combination with local therapy (Metrogyl gel, vaginal). They also carry out invaginal therapy with suppositories, one per day for 7-10 days. It can be: "Betadine", "Klion-D", "Terzhinan".

A variety of treatment regimens for trichomoniasis are used:

"Fasigine" 150 mg 2 r / day for a week;

"Tinidazole" 0.5 grams - 4 tablets at once, a single dose;

"Trichopol" 0.5 grams or 1 tablet 2 r / day. The duration of the course is 7-10 days.

Treatment of the chronic stage of the disease practically does not differ from the treatment of the acute stage. In addition to antitrichomonas drugs, therapy involves taking adaptogens (aralia tincture, eleutherococcus tincture, Aloe extract), vitamins and immunostimulating agents.

Control tests after a negative response to trichomoniasis are taken for another 3 months during each menstruation.

Prevention measures

Prevention of trichomoniasis infection practically does not differ from other urogenital infections and is as follows:

passing a regular gynecological examination (at least twice a year);

compliance with the rules of intimate hygiene;

use of barrier contraceptives (condoms);

confidence in the health of the sexual partner;

the presence of a permanent sexual partner (one).

In the case of unprotected intercourse, the following drugs can be used as an emergency prevention measure for infection: Betadine, Miramistin, which reduce the risk of infection by 70%, provided that the treatment of the genital organs and washing of the vagina was carried out no later than 2 hours after intercourse.

To do this, it is necessary to introduce a solution of "Betadine" or "Miramistin" (no more than 5 ml through the urological nozzle) into the vagina or douche with a weak solution of potassium permanganate. The external genitalia must be carefully treated with an antiseptic - Miramistin or Chlorhexidine. Such procedures can only be carried out as an emergency protection, since they are not a way to protect against sexually transmitted infections.

The most common questions from patients

Do people who have successfully undergone trichomoniasis develop strong immunity?

No, Trichomonas infection can occur repeatedly.

Why is it forbidden to drink alcohol during the treatment period?

How to use vaginal suppositories during menstruation, if they are prescribed as a treatment for trichomoniasis?

If, according to your calculations, the period of menstruation will soon begin or has already begun, the use of vaginal suppositories should be postponed until they end. Suppositories can be administered only in the absence of bleeding.

Is it possible to conduct therapy for trichomoniasis during pregnancy and should it be interrupted due to the presence of such a disease?

It is necessary to treat trichomoniasis during pregnancy, while therapy will depend on the trimester of pregnancy. The doctor will prescribe the appropriate treatment option. If the pregnancy is desired, then it is not necessary to terminate it.

Trichomonas were found in the smears, but the analyzes of the sexual partner are “clean”, there are no complaints. Does he need to be treated?

Treatment of the disease must be carried out without fail for both, regardless of the results of the analyzes of the sexual partner.

is a parasitic disease known since ancient times, sexually transmitted and causing inflammation of the mucous membrane of the genitourinary organs of women and men.
The basis of the disease is a special type of microorganisms called protozoa. There are many types of protozoa found in nature. Some of them live in water, soil, others parasitize in organisms of animals and humans.

Who are Trichomonas, types of Trichomonas

Protozoa- unicellular organisms, unlike other unicellular organisms, are capable of locomotion due to the presence of flagella and independent existence outside the infected organism. In their structure, the simplest resemble ordinary cells, the totality of which makes up an integral organism. The difference lies in the fact that protozoa, despite the simplicity of their structure, exist as a separate holistic organism.
The name trichomoniasis comes from the protozoan organisms called Trichomonas, which cause specific local pathological phenomena.
Trichomonas, which parasitize in the human body, are of three types:
Trcihomonas elongata - lives in the oral cavity.
Trichomonas hominis - lives in the human intestine, feeds on various bacteria, erythrocytes (blood cells).
Trichomonas vaginalis - is found in the lower urinary tract:

• Urethra
• Vagina
• Prostate

The first two species (Trichomonas hominis, Trichomonas elongata) do not cause any harm to humans. The third type, which is also the most pathogenic, is the most active and causes local discomfort, as well as inflammatory processes.

Ways of infection with Trichomonas

Trichomoniasis is a very common disease. There is no such place on earth where this microorganism would not exist. According to some reports, trichomoniasis occurs in both men and women, young and mature, who are sexually active. The disease is transmitted mainly through sexual contact, that is, through unprotected sexual intercourse. Detailed and understandable about trichomoniasis

Trichomonas colpitis (vaginitis)
Colpitis- inflammation of the superficial layers of the vaginal mucosa. The term colpitis is borrowed from the Greek language. There is also a second name characterizing inflammation of the vaginal mucosa, of Latin origin - vaginitis.
Acute trichomonas colpitis is characterized by:

• Intolerable itching, burning in the vaginal area, around the labia. Itching is explained by the irritating effect of Trichomonas on the walls of the vagina and foamy discharge (secret).
• Redness and scratching of the skin in the perineal region, labia (large and small). Appear due to itching in these areas.
• Foamy discharge with a characteristic unpleasant odor. The volume of secretions depends on the phase of the course of the disease. From abundant leucorrhea (discharge) of yellow color, with an acute progressive course, to scanty gray discharge, with a chronic sluggish process. Foaminess and an abundance of secretions appear as a result of vital activity in parallel with Trichomonas, a special type of bacteria that emit gas.

With good high immunity, the disease can proceed in a latent chronic form. In this case, one or another symptom may be absent, or all symptoms are mild or absent. Inflammatory changes are also minor. The chronic process can be aggravated periodically. Most often this occurs in the period before the start of a new menstrual cycle, a few days before the onset of menstruation. The exacerbation is associated with a decrease in the amount of estrogens, which are actively involved in the renewal of the surface cells of the vaginal mucosa, in addition, they contribute to the acidification of the internal vaginal environment, and Trichomonas feed on glycogen, with the help of which, during the vital activity of lactobacilli, the internal environment of the vagina becomes acidic.

Trichomoniasis in the menopausal period.
In menopausal women, the incidence of trichomoniasis varies widely. The lack of estrogen causes atrophy (decrease in function, thinning of the walls) of the mucous membrane of the vaginal walls. Accordingly, the microflora of the inner surface of the vagina is disturbed, local immunity is reduced, and favorable conditions are created for the growth and development of not only Trichomonas, but also many pathogenic microorganisms. The main clinical symptoms are expressed as:

• Mucopurulent discharge, sometimes streaked with blood
• Itching in the vestibule
• Rarely, minor bleeding after sexual intercourse

Pregnancy and trichomoniasis

As a rule, trichomoniasis causes inflammatory changes at the local level, that is, at the level of the genital organs. Thus, negatively affecting the course and course of pregnancy. May cause complications such as: spontaneous abortion and premature birth. The essence of abortion lies in the fact that Trichomonas cause inflammatory changes, in which special substances called prostaglandins are released into the blood. Prostaglandins cause increased contractions of the uterine muscles, thereby contributing to the expulsion of the fetus from the uterine cavity.

Central nervous system (CNS) disorders
Inflammatory damage to the mucous membrane, the addition of a secondary purulent infection and profuse fetid discharge from the vagina affect the quality of sexual intercourse. Sexual intercourse becomes painful and impossible. The long-term chronic course of the disease can eventually cause frigidity not only due to pain, but also emotional discomfort, causing in some cases a violation of the woman's psycho-emotional state.

Microscopic method
For diagnosis, confirming the presence of Trichomonas in the genital tract, it is necessary to take smears from the vaginal mucosa. Swabs are preferably taken from three different places:
Among women

• Posterior fornix of the vagina
• cervical canal
• Urethra

In men, it is being studied:

• Scraping from the urethra
• prostatic fluid
• Sperm

To take the prostate fluid, they usually resort to a light massage of the prostate gland.
Laboratory studies should be carried out no later than 30 minutes after taking smears, since Trichomonas are very unstable in the external environment and die quickly.
The taken material is placed on a glass slide, a 0.9% sodium chloride solution is dripped, covered with a cover slip and placed under a microscope. In some cases, for better detection of trichomonas, smears are pre-stained. Microscopic examination is the most rapid method for diagnosing trichomoniasis and allows you to make a diagnosis after only 15-20 after taking the source material.

Cultivation of Trichomonas
As one of the three modern methods for determining a pathological pathogen, it has several advantages, such as:

• Allows you to determine the initial number of Trichomonas in the test material. Indirectly reflects the degree of the inflammatory process.
• It reveals to which drugs Trichomonas are sensitive, which is very important when prescribing the correct and optimal treatment. It also allows you to adjust the already started treatment.

Cultivation is carried out by sowing the contents of smears from the vagina, urethra on special artificial, nutrient media. At the same time, Trichomonas enter a favorable environment and begin to multiply intensively. The grown colonies are then subjected to microscopic examination.

PCR method in the diagnosis of trichomoniasis
A very valuable method for the detection of Trichomonas. The advantage of this method is that in the chronic course of the disease, the pathogen is very difficult to detect by conventional microscopic methods. In addition, any biological fluid of the body is suitable for research, whether it be blood, saliva, scraping of the mucous membrane of the urethra or vagina.
The method is based on the fact that Trichomonas DNA, that is, genetic material, can be easily detected in the material under study. The accuracy of the analysis is 100%. The results appear the very next day, which allows you to start effective treatment in a timely manner.

Treatment of trichomoniasis

To fully recover from trichomoniasis, the following conditions must be met:

1. Both sexual partners should be treated at the same time
2. During the course of treatment, any sexual contact is excluded.
3. Apply special antitrichomonas agents (metronidazole, tinidazole)
4. In parallel with the treatment, hygiene rules for the care of the genitourinary organs are observed:

• Daily washing of the genitals using antiseptics (a weak solution of potassium permanganate, furacilin solution) or detergents, that is, ordinary toilet soap.
• All movements during washing are carried out from front to back, that is, from the side of the vagina to the anus. This is necessary in order to avoid the introduction of infection into the urethra.
• Individual use of toiletries (soap, washcloths, towels).
• Daily change of underwear

1. Mandatory treatment of other, simultaneously occurring diseases of the genitourinary organs of infectious and inflammatory origin.

Below are several treatment regimens for trichomoniasis using antitrichomoniasis drugs.

Scheme using metronidazole (Trichopolum)
The first day, take 1 tablet 4 times inside with water.
From the second to the seventh day inclusive, take 1 tablet 3 times a day, also inside with water.

Metronidazole- antiprotozoal, antimicrobial drug.

Mechanism of action It consists in a depressing effect on the genetic apparatus of bacteria. At the same time, all biological processes of the cell gradually stop and the microorganism dies.

Contraindication is pregnancy and hypersensitivity to the drug.

Scheme using tinidazole
Once taken immediately 4 tablets of 500 mg each. Or
For 7 days, 1/3 tablet 2 times a day

Tinidazole
A drug from the same group as metronidazole with a similar mechanism of action and side effects.
Contraindications –

• hematopoietic disorders
• pregnancy and lactation
• hypersensitivity to the drug

Scheme using Klion - D
Klion - D- a combination drug that contains equal parts of metronidazole and miconazole (an antifungal drug). The drug is very effective in mixed infections of the genitourinary apparatus of bacterial and fungal origin.
Assign in the form of vaginal suppositories, 1 piece at night for 10 days.

Monitoring the effectiveness of treatment antitrichomonas agents are carried out as follows:

• For 2-3 months after treatment, smears of the contents of the vagina and urethra are taken for microscopic examination for the presence of vaginal Trichomonas
• Swabs should be taken 1-3 days after menstruation

Prevention of trichomoniasis

Preventive measures imply a comprehensive approach aimed at protecting against possible infection not only with trichomoniasis, but also with all sexually transmitted diseases, be it gonorrhea, chlamydia, syphilis and many others.

• Prevention should begin with educational activities about a healthy lifestyle, the importance of contraceptive methods, and the ways of transmission of infections that cause inflammatory diseases of the genital tract. These measures are primarily aimed at preventing the occurrence of infectious inflammatory diseases of the genitourinary organs for categories of people and adolescents. Medical workers, teachers in schools, professors in lyceums and universities without fail carry out educational activities in this direction among high school students, students of universities, vocational schools.

• Categories of young and middle-aged people who are sexually active should be careful in choosing a sexual partner. Promiscuous sexual contacts are not welcome. The ideal option is an intimate relationship with one sexual partner. Not the last role is played by the use of condoms, as a means of preventing the occurrence of unwanted pregnancy and the transmission of trichomonas infection during sexual contact.

• Preventive control at the gynecologist at least once a year, with taking smears from the urethra, posterior fornix of the vagina, cervical canal. The contents of these places are subjected to microscopy, thereby determining the presence of a possible infection and at the same time determine the degree of purity of the vagina.

• Treatment of concomitant diseases of the genitourinary organs caused by other types of pathogenic microorganisms that reduce local immunity and increase the risk of perceiving trichomonas infection.

• An incomparably significant role in the spread of Trichomonas vaginalis is provided by the simultaneous use of toiletries (washcloth, towel) by two or more persons, one of whom has trichomoniasis. Therefore, it is necessary for each person to have their own body care products and use them individually.

• In preparation for pregnancy, tests should be taken for the possible presence of a latent urinary tract infection, both for a woman and a man. And also consult with your doctor about this. When planning a pregnancy, it is necessary to cure all possible foci of infection in a woman's body.

What are the possible consequences of trichomoniasis?

Most often, trichomoniasis gives complications during pregnancy:

• premature birth;
• low birth weight of the baby;
• transmission of the infection to the baby when it passes through the birth canal.

In addition, there is evidence that trichomoniasis increases the risk of contracting some dangerous infections, in particular the human immunodeficiency virus (HIV), which causes AIDS.

How to eat with trichomoniasis?

Features of nutrition are more associated not with the disease itself, but with the intake of antitrichomoniasis drugs with antibacterial activity. As with any antibiotics, nutrition must be complete, otherwise nausea, indigestion and other side effects may occur. You need to have a hearty breakfast, preferably porridge.

It is useful to take pancreatic enzyme preparations during the course of treatment, for example, Mezim-Forte. You can also take drugs containing bifidobacteria, since antibiotics can cause dysbacteriosis. For more detailed advice, contact your doctor.

Do not drink alcohol for 24 hours after taking metronidazole and within 72 hours after taking tinidazole. These drugs can cause a reaction to ethyl alcohol, like a "coding" for alcoholism. There is nausea, vomiting and other unpleasant symptoms.

Is it possible to have sex with trichomoniasis?

During the treatment of trichomoniasis, sex is completely contraindicated for two reasons.:

• Trichomoniasis is a sexually transmitted infection. So there is a risk of infecting a partner / partner.
• Sexual intercourse reduces the effectiveness of treatment.

Does a condom protect against trichomoniasis?

Condoms are one of the simplest, most affordable and effective means of protection against unwanted pregnancy and sexually transmitted infections. But they do not fully protect from either one or the other.

Condoms only prevent trichomoniasis by 90%. With constant contact with one sick partner, the likelihood of transmission of the infection increases even more.

Do not forget that during sexual intercourse, the condom can break, slip off the penis.

Is trichomoniasis transmitted during oral sex?

Theoretically, such a possibility exists, it may even develop trichomoniasis angina. In practice, this rarely happens. But it's still not worth the risk.

How is trichomoniasis coded in the ICD?

Trichomoniasis has several codes in the International Classification of Diseases of the 10th revision.:

Most sexually transmitted infections enter the body through unprotected sex. Among the most common is trichomoniasis. The right choice of medicine for trichomoniasis not only determines the success of treatment, but also reduces the risk of complications.

In the article we will tell you which drugs for the treatment of Trichomonas infection are most effective and which treatment regimen should be followed in order to cure the disease completely.

Ways to eliminate the infection

Trichomoniasis is an infectious disease that occurs when the mucous membrane of the genital organs is damaged by the simplest microorganism Trichomonas and is transmitted sexually. In the vast majority of cases, infection occurs due to direct contact with the pathogen during unprotected intercourse.

The development of the disease occurs against the background of a decrease in the body's immunity and other infectious diseases of the urogenital area.

As a result of infection, destruction of epithelial tissues occurs, multiple erosions, ulcers and inflammatory processes occur in the genitourinary organs.

Therefore, the treatment of trichomoniasis in both men and women involves taking drugs according to an individual scheme, taking into account the specifics of complications. The main objectives of therapeutic measures are unchanged:

• The use of antitrichomonas drugs for the complete elimination of infectious agents.
• Restoration of natural vaginal microflora.
• Normalization of the functions of the urinary organs.
• Appointment of funds to strengthen the immune system.
• Elimination of signs of the disease.
• Treatment of complications.

Do not self-medicate. Trichomonas are able to adapt to certain medications and provoke the development of a latent form of the disease, in which symptoms do not appear. It is better to let an experienced doctor determine how to treat trichomoniasis in each case.

The success of treatment depends not only on complex therapy, but measures aimed at preventing reinvasion are considered an important component of therapeutic measures. The best way to prevent reinfection or spread of infection is to ensure that all sexual partners of an infected person are treated.

Fulfillment of this condition is mandatory even if the symptoms of the disease do not appear. Trichomonas carriage is often observed in men and does not exclude the possibility of infecting other people.

be careful

Among women: pain and inflammation of the ovaries. Fibroma, myoma, fibrocystic mastopathy, inflammation of the adrenal glands, bladder and kidneys develop.

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Features of therapy

To determine how to treat a person infected with trichomoniasis, the doctor must take into account all the factors in the development of the disease - the symptoms, the duration of the pathology, the presence of additional infections in the body, the complications that have arisen.

The choice of medicines to eliminate trichomonas in women involves preliminary pregnancy testing, since the infection can be transmitted to the child or lead to miscarriage. In addition, it matters whether a woman has been treated for infectious inflammation of the genitourinary system before.

Do not self-medicate! At the first symptoms of the disease, immediately consult a doctor for medical help!

The consequences of infection with Trichomonas are eliminated not only with drugs, the optimal course of treatment involves various methods of influencing the infection:

• Droppers, injections, tablets.
• The use of local therapy - ointments, gels, suppositories.
• Washing the urogenital organs with special solutions in order to cleanse them.
• Irrigation of the urethra.
• The use of membrane stabilizers for the regeneration of cells of the affected epithelium.
• Physiotherapy.
• Taking drugs that increase vascular permeability.
• The appointment of vitamins and other means for greater effectiveness of therapy.

The development of a scheme for the complex treatment of trichomoniasis is provided by the attending physician. During the entire period of therapeutic and preventive measures, sexual intercourse and alcohol consumption are prohibited.

Pills and shots to fight infection in women and men

The first and main stage in the treatment of infection is etiotropic therapy - the process of eliminating the cause of the development of pathology. Prescribed drugs for causative agents of trichomoniasis.

When choosing a medicine for oral administration, doctors prefer imidazole-based tablets. Metronidazole is considered an effective means of this group.

The pharmacological action of Metronidazole is to act on pathogens of protozoal infections. The active substance of the drug penetrates into the pathogenic cell and stops the division process.

Eliminating trichomoniasis in both men and women, including pregnant women, the drug has the ability to accumulate in the blood in a volume that is detrimental to Trichomonas.

The use of the drug in trichomoniasis is especially effective in the treatment of a fresh form of infection, but can be prescribed to eliminate acute and chronic forms.

Due to the physiological characteristics of the body, the treatment regimen for trichomoniasis in women involves the use of other types of drugs than in men.

For the treatment of trichomoniasis in women, metronidazole vaginal suppositories are additionally used. Combined treatment regimens involve the simultaneous use of Metronidazole with other types of antibiotics.

Metronidazole is drunk according to the following schemes:

• Day 1 - 2 tablets of 250 mg every 12 hours. 2nd day - one tablet every 8 hours. In the next 4 days, the daily dose is 500 mg, which corresponds to taking one tablet every 12 hours.
• A single dose of 8 tablets (2 g) of the drug.
• 4 tablets every 12 hours for a week.

Which of the schemes is preferable is determined by the attending physician - in each case, the methods and means of treatment may differ depending on the individual characteristics of the patient and the course of the disease.

Drugs for the treatment of trichomoniasis in men and women are different from each other!

Tiberal is characterized by increased absorption and is able to reduce the symptoms of the disease already three hours after ingestion.

Tiberal is indicated both for the treatment of trichomoniasis and for its prevention. During etiotropic therapy, Tiberal is taken twice a day, one tablet. To effectively treat trichomoniasis in women, Tiberal is combined with local treatment - vaginal suppositories.

Tinidazole - antibacterial tablets for trichomoniasis in women and men. They provide antiprotozoal action by destroying the structure of Trichomonas DNA and inhibiting its synthesis.

Tinidazole tablets are taken only as prescribed by a doctor in accordance with one of the schemes:

• Single dose of 4 tablets of 0.5 g.
• Take one tablet of 0.5 g every 15 minutes for an hour.
• 0.15 g every 12 hours for a week.

Tinidazole is given to children, calculating the dose - 50 mg per kg of the child's weight.

Along with this, trichomoniasis is treated with injections - their use significantly increases the effectiveness of therapy.

Ceftriaxone is the most commonly used broad-spectrum intramuscular antibiotic.

Ceftriaxone belongs to the cephalosporin series and has antimicrobial activity against anaerobic, aerobic, gram-positive and gram-negative microorganisms. With trichomoniasis, Ceftriaxone can be administered both intramuscularly and intravenously - by stream or drip.

Ceftriaxone is an effective remedy for trichomoniasis for men, as it quickly eliminates inflammation in the prostate gland, providing tangible relief almost instantly. The dose for one injection is calculated by the attending physician, depending on the specifics of the pathology.

With a particularly difficult course of the disease, Solkotrikhovac is prescribed. The daily dose of intramuscular injection of the drug is 0.5 ml.

The specifics of local therapy

The use of local therapy provides an additional effect of treatment, removing the symptoms of pathology and preventing tissue destruction.

The list of effective medicines for trichomoniasis infection in women includes:

• Vaginal suppositories Ornidazole. Scheme of application - daily single injection during the week.
• Vaginal cream Clindamycin. Apply to remove the manifestation of inflammatory processes in the vagina, for 4 days.
• Intravaginal tablets Ginalgin.
• Vaginal tablets Klion-D.

Additional remedies for trichomoniasis for women are sitz baths with herbs, douching, laying tampons soaked in a combination of urogyronin and levomycetin.

Given that male physiology is different from female physiology, some local therapies that are relevant for women are not available to men. Therefore, the relevant manifestations of pathology in men are eliminated by introducing therapeutic agents with antibacterial action into the urethra.

You can also use the methods of traditional medicine, but only as an additional treatment, coupled with the main one!

In addition, in the treatment of inflammation of the male genitourinary system, the use of creams, ointments and gels is indicated - Clotrimazole, Hexicon, Metrogyl-gel.

Traditional medicine and homeopathy are not able to provide a lasting effect in eliminating the infection, but they make it possible to achieve a temporary improvement in the condition during the period of acute development of the disease.

A common sexually transmitted infection. It is especially common in women. According to statistics, this diagnosis is made by approximately 55-65% of the fairer sex. Among men, patients are much less - about 15%. The disease is quite dangerous, as it can cause severe complications, including infertility and even cancer. They occur only if the patient avoids treatment. Is it possible to completely cure trichomoniasis in women and what drugs are required for this?

The female body is much more complex than the male. This is expressed, for example, in the fact that the causative agent of trichomoniasis may not cause illness and not disturb the girl in any way, but will make her a carrier of the infection. In addition, women have more complex immunity and metabolism, which complicates therapy. Based on this, several distinctive features of the treatment of trichomoniasis in women can be distinguished:

• If a man can have sexual intercourse during therapy, albeit with protection, then it is advisable for ladies to completely exclude sex for this time.
• Taking medication should not last more than 10 days. If this time is not enough, then the doctor prescribes other methods of treatment.
• Women should undergo additional diagnostics after the end of the course. This is done over three menstrual cycles.

The main condition for getting rid of trichomoniasis is an integrated approach. The reason is that Trichomonas over time can develop resistance to certain medications, which means that one medication is not enough.

The permanent sexual partner of the patient should undergo a parallel course of treatment. If a woman has a disease, then her man is almost guaranteed to have it too.

The scheme of treatment of trichomoniasis in women

The causative agent of trichomoniasis as such is not a bacterium. For this reason, the use of antibacterial drugs almost never brings a positive effect. In general, the treatment of the disease consists in the following activities:

• elimination of microorganisms with the help of antitrichomonas drugs;
• restoration of normal vaginal microflora;
• restoration of the functionality of the genitourinary system;
• strengthening immunity by taking special means and normalizing the diet;
• the final elimination of the symptoms of the disease.

If trichomoniasis managed to give complications, then the last stage of therapy should be to eliminate them. Most often it will look like a treatment for another disease, the source of which has already been cured pathology.

The key to success is an integrated approach to therapy. If you ignore something from the list indicated above, then all treatment will need to be started anew, and this is an additional burden on the body. In addition, the risk of developing severe complications will increase significantly. Only a doctor can prescribe the correct treatment.

In addition, it is worth following the correct course of therapy.

and the patient's sexual partner. If he does not pass the course of treatment or completely ignores it, then re-infection is a matter of time. Moreover, relapse is more difficult to treat, since Trichomonas develop resistance to the active substances of medicines.

Folk remedies in the treatment of this disease are acceptable, but their task is to strengthen the body and restore the microflora of the vagina. It is not worth completely replacing special preparations with such means.

Medicines for treatment

The basis of treatment is taking pills. Injections, which are sometimes used in therapy, are an additional tool. Below we consider the main means used to treat trichomoniasis:

• Metronidazole

The drugs in this group also include:

1. ‎From 122 to 924 rubles;
2. "Klion". About 83 rubles;
3. "Trichopol". ‎ From 97 to 340 rubles.

These pills have a detrimental effect on all varieties of the causative agent of the disease. They are especially effective against urogenital Trichomonas. After ingestion, the active substances are quickly absorbed into the bloodstream through the stomach. Accumulating in the body, the agent reaches a concentration that is harmless to humans, but kills microorganisms.

These medicines are produced in the form of tablets of 0.25 and 0.5 g, as well as in the form of vaginal suppositories of 0.5 g. There are two regimens for taking the drug:

1. On the first day of treatment, three 0.5 g tablets should be taken at eight-hour intervals. On the next day, the dose of the drug is reduced by one tablet. After 6 days, the course stops, and the total dose of tablets taken should be 3.75 g.
2. Two tablets of 0.25 g should be taken twice a day with a twelve-hour interval. The treatment lasts for 10 days. The subtlety is that in parallel it is required to use one vaginal suppository (0.5 g) per day.

• Tinidazole

It can also be found under the names Triconidazole and Fazizhin. Its effect is almost identical to metronidazole. The drug should be taken according to one of two schemes:

1. one-time 4 tablets of 0.5 g;
2. every 15 minutes for an hour, one tablet.

Please note that this medication should not be used during the first trimester of pregnancy, nursing mothers and active CNS disease. The cost of packaging ranges from 20 to 35 rubles.

This tool cannot boast of a variety of application schemes. Take 300 mg of the drug twice a day. Of these drugs, clindamycin is the most effective and fast-acting. Contraindications are identical to those when taking tinidazole. The cost of the drug corresponds to the effectiveness - from 400 to 550 rubles.

You can not use these drugs without a doctor's prescription. Otherwise, serious side effects are possible. In addition, the effectiveness of therapy can be significantly reduced.

Additional treatments

To reduce the intensity of symptoms and quickly restore the affected tissues, doctors often prescribe topical creams and vaginal suppositories. They are used only for additional impact, they cannot be considered the main means:

• "Ornidazole". Available in a dosage of 0.5 g. It should be used once a day for 6 days. The cost of packaging is about 150 rubles.
• "Ginalgin". vaginal tablets. Used once a day for 10 days. Price - from 250 to 350 rubles.
• "Clindamycin". Cream of local action, which is used to relieve inflammation. You need to apply once a day for no more than 4 days in a row. The cost is about 550 rubles.

As such, these drugs do not cause side effects. However, a doctor's consultation is necessary. Please note that clindamycin is a prescription drug.

Treatment during pregnancy

• "Polygynax". From 380 to 649 rubles;
• "Ginezol";
• "Terzhinan". From 362 to 475 rubles;
• "Clotrimazole". 16 to 172 rubles;
• "Betadine". 167 to 818 rubles.

These medicines are completely safe for the unborn child. They are not able to lead to defects in the fetus, and also do not interfere with its normal development.

In the second and third trimester, treatment with agents containing imidazole is allowed. These include:

• "Atrikan";
• "Tinidazole". From 23 to 52 rubles;
• About 303 rubles;
• "Metronidazole". ‎From 43 to 177 rubles.

A doctor's consultation in the treatment of illness during pregnancy is necessary. Moreover, therapy should be carried out strictly under the supervision of a specialist. Doses are prescribed minimal, the course of treatment is short. The peculiarity of this regimen is that the likelihood of relapse is significantly higher than with classical therapy. At the same time, the drug load on the body of the mother and her child is significantly reduced.

Although self-medication elements are acceptable in some cases, it is forbidden to use them during pregnancy.

Prevention

Trichomoniasis occurs due to the penetration of the simplest microorganisms into the body. The situation is aggravated in case of weakened immunity and concomitant colds. The means of prevention are simple:

• no casual sex (if you really want to, you should use a condom);
• do not use other people's towels and underwear;
• you need to follow the rules of personal hygiene;
• you should regularly be examined by a gynecologist and venereologist;
• It is recommended to diversify the diet with vegetables and fruits to strengthen the immune system.

In addition, you can not abandon the treatment of previously identified trichomoniasis. Otherwise, relapse is almost inevitable.

Trichomoniasis is very common among women. After identifying the disease, you should undergo a course of therapy, which includes not only getting rid of the causative agent of the disease, but also strengthening the immune system, as well as relieving symptoms. During pregnancy, special care must be taken - some drugs can harm the unborn baby. You can watch this video to learn more about trichomoniasis, its causes, and treatment options.

In the distant Soviet times, when nothing was known about viral hepatitis C, about HIV infection, and the problem of homosexual transmission of sexual infections was not even discussed at all by specialists, there were three venereal diseases. The place of honor was occupied, of course, by syphilis. Second was gonorrhea. Trichomoniasis closed the top three. This disease was known among the general public, who spoke of the process of infection only as "catching trishki." Yes, there was also a fourth disease - a soft chancre, but it was rare.

In our time, the situation has changed: trichomoniasis is practically the leader among other sexually transmitted diseases. The maximum peak incidence occurred in 1995: then, during the year, one person out of three hundred fell ill. Then the situation began to improve, and now one person in a thousand falls ill every year. What is this disease, and why is it so "popular" among the people?

What is trichomoniasis and how is it transmitted?

This is what the causative agent looks like

Trichomonas, although the simplest, but in their kingdom belong to higher beings, to the class of flagellates. The size of the organism is 0.01 mm in length, and it has 5 flagella. If unfavorable conditions arise, then the pathogens shed their flagella and "pupate".

Despite the fact that the causative agent of the disease is named trichomonas vaginalis, the disease is four times less common in women than in men. This does not mean at all that trichomonas "love" the male body, but indicates that in men the disease is more difficult to detect: men have a longer urethra, and there are no open areas of the mucous membrane of the genital organs, as in women.

Comparing trichomonas, for example, with gonococcus, one can understand: trichomonas do not like to leave their food source, they need the secret of the genital tract. But gonococci will survive wherever there is an epithelium. Therefore, gonorrhea is much more dangerous.

The causative agents of trichomoniasis do not know how to form cysts, therefore, once in the external environment, they quickly die. Drying and direct sunlight are extremely detrimental to them.

Transmission routes

The disease is almost always transmitted sexually, and the likelihood of infection is high, both for men and women. Rarely, household infection is possible (for example, through a common towel, linen contaminated with lumps of mucus and pus of patients, and until these lumps are dry).

Infection can occur in newborn girls who become infected while passing through the birth canal of a sick mother. But this risk is low - about 10% of cases.

Why are trichomonas so tenacious?

The reasons for the widespread distribution of trichomoniasis are also that it is rare to find bright and manifest forms. Much more often, including in women, an erased course, sluggish and ambiguous symptoms, and even a completely asymptomatic carriage are detected. This is due to a significant decrease in immunity and the presence of chronic diseases among the general population.

In addition, Trichomonas constantly "resist" the drugs used (drugs for the treatment of diseases caused by protozoa are called protistocidal). They develop resistance to metronidazole, which several decades ago was guaranteed to help against this infection.

But perhaps the most unpleasant thing is that Trichomonas can absorb microorganisms (which are much smaller than protozoa) inside themselves, keep them alive and protect them from the effects of antibiotics. It can be gonococci, ureaplasma, mycoplasma, and other pathogens. Not only are pathogenic microorganisms inside the protozoa: for example, gonococci multiply there, and then freely go outside! With full right, trichomonas can be called an "incubator" of infections.

That is why a mixed infection (for example, trichomoniasis + gonorrhea) is much more difficult to treat than both diseases separately. In this case, you must first cure trichomoniasis, and then you can be taken for a second infection. The only thing that cannot be done is to leave the treatment of trichomoniasis for “later”.

An additional factor of "survivability" can be called the production of special antigens by the simplest, which "paralyze" the antibodies of our body. As a result, there is no strong immune response, which means that the development of immunity to the disease is impossible.

Characteristic signs and manifestations of the disease

Trichomonas do not "sparkle with originality": there are no special symptoms peculiar only to them, just as there are no specific changes in the affected tissues. Symptoms of trichomoniasis in women consist of damage to several organs, sometimes pathogens are located in the ampulla of the rectum. Although the protozoa are not far from the nutrient medium, they can sometimes (by reflux) be carried away into the ureters and even into the renal pelvis.

As for the genital organs, the disease can also spread to the ovaries, and even to the pelvic peritoneum, but this is very rare. They usually do not penetrate further than the internal os of the cervix.

The first signs and symptoms of trichomoniasis in women are most often manifested by vaginitis. If the course is manifest, then abundant discharge occurs, often greenish or yellowish, which can foam. The contents of the vagina become more acidic and the discharge can corrode. There is a vulvitis. In some cases, discharge on the inner thighs can cause symptoms of contact dermatitis. Women are concerned about itching and burning.

With a subclinical course, there is no such vivid picture, but small discharge and itching will disturb. On examination, you can find a "strawberry structure" of the cervix and vagina, with dotted spots of hemorrhage. This symptom is very characteristic of trichomoniasis, but is observed in only 2% of women.

Urethritis in women can be manifested by frequent urination, itching and pain. In some cases, inflammation of the cervix occurs - cervicitis, but the classic manifestations of cervicitis with secretions are rare, since the epithelium there has a different structure and is not susceptible to pathogens.

There are features of the course of Trichomonas infection in adolescent girls. Starting from the age of 11 (menarche) and up to the age of 16, when the hormonal function of the ovaries increases and the epithelium of the vagina changes, a vaginal secretion with a large amount of nutrients appears.

This "abundant food" leads to an increase in the incidence in girls. Nowadays, due to the early acquisition of sexual experience, infection can occur sexually, and with the preservation of virginity. Enough contact of the genitals.

It is at this age that an acute course is observed, with copious discharge, burning and itching. The vaginal mucosa is edematous and brightly hyperemic, but (as in other cases) the spread of infection is usually independently limited by the level of the cervix.

Diagnosis of urogenital trichomoniasis

You can identify urogenital trichomoniasis by the following "reference criteria":

• the discharge is frothy and yellow-green;
• dysuric manifestations and itching;
• pain during intercourse;
• "Strawberry view" of the mucosa.

These classic symptoms do not rule out the presence of other infections. Foamy discharge also occurs in 10% of all cases, and not in everyone in a row. Here methods of laboratory diagnostics of trichomoniasis come to the rescue:

1. Microscopic (viewing fresh, native and stained smears in order to visually detect protozoa) /
2. Cultural (material is sown on artificial media, and incubated for 72 hours at body temperature).
3. Immunological. It is of secondary importance: if immunoglobulins G are detected in the blood, the likelihood of a chronic infection increases /
4. Genetic diagnostics. PCR is carried out - a study for the presence of copies of genetic material. Discharges, smears, urine are taken, scrapings are performed from the epithelium of the genital organs.

It is desirable that several methods be used simultaneously to increase the reliability of the diagnosis, especially if the PCR is negative.

Research on trichomoniasis should be carried out not only in the presence of complaints of well-being. Thus, the main indications for the study are:

• signs of pyelonephritis;
• when planning a pregnancy;
• when establishing the causes of infertility;
• during preventive examinations of special population groups.

The treatment of acute inflammation is easier than the treatment of chronic trichomoniasis, especially with a blurred clinical picture. But, regardless of the form of the disease, it is necessary to simultaneously treat spouses or sexual partners, even if one of them has everything “negative” in the analyzes.

As in the case of gonorrhea, trichomonas, being "coddled" creatures, die with a single injection of ornidazole, tinidazole, metronidazole (naturally, one of the above). In the event that the process recurs, or is complicated by the bacterial flora, then the dosages are increased, and the drugs are taken for a week. "Injections" for trichomoniasis can be omitted.

Treatment of trichomoniasis in immunocompromised women is not limited to oral medications, you can add suppositories with immunomodulators that can be administered rectally. In addition, vaginal suppositories containing metronidazole and similar drugs can and should be administered to enhance the effect.

• Of course, after treatment, it is necessary to correct intestinal dysbacteriosis, which will occur as a result of taking medications.

Complications and danger of the disease

In fact, trichomoniasis is more of an unpleasant disease than a really dangerous one. Compared with gonococcal infection and syphilis, it can be considered just a "gift of fate." But, in a chronic or recurrent course in women, this pathogen can lead to infertility, as well as maintaining a constant sluggish inflammation in the female genital organs. Asymptomatic carriage of the pathogen is epidemiologically dangerous, especially for people who have an active sex life.

In addition, as mentioned above, trichomonas can be not only a reservoir, but also an incubator for other sexually transmitted infections. And in this case, you can get a serious illness, a decrease in immunity, as a result of which foci of various infections can occur in the body.

Prevention of trichomoniasis

There is nothing new in preventive measures regarding trichomoniasis. First of all, you need to be choosy in sexual relations, and refuse casual relationships with prostitutes, people who use drugs and are suspicious of bisexual orientation (if only because they have more partners). In addition, sex must be necessarily protected.

In the event that a condom is used, then trichomoniasis cannot be ill. In the same case, if you need to carry out emergency prophylaxis, then douching and treatment of the vaginal mucosa after hygiene measures with Miramistin and other local antiseptic preparations can be used. Most importantly, the time elapsed since intimacy should not exceed two hours.

Preventive measures that prevent the spread of this infection also include measures to prevent early sex in adolescents, timely screening of women preparing to become pregnant, as well as preventive examinations of laboratory workers, nurses, and other decreed contingents of the population who, on duty, are forced to communicate with an infected person. , contagious material, and can become infected.