Trichomoniasis: Vaginal Infection

Trichomoniasis

Vaginal infections are a common health problem. More than three quarters of all women will have a vaginal yeast infection in their lifetime. Bacterial infections may be even more common, especially in young and middle-aged women. About 3 out of every 10 women have bacterial vaginosis. And the vast majority of those don’t even show symptoms.

While vaginal infections are very common, many women find it difficult or embarrassing to talk about the health of their vaginas. A vaginal infection is nothing to be ashamed of, and no cause for alarm — but it does need to be treated, to prevent more serious consequences.

There are three main types of vaginal infections:

Bacterial vaginosis, caused by an overgrowth of bacteria
Candidiasis, or yeast infections, caused by the fungus Candida albicans or other Candida species
Trichomoniasis, caused by a very small parasite that is spread through sex

What Causes Trichomoniasis

There are three main types of vaginal infection, and each has a different cause.

Trichomoniasis is caused by a single-cell parasite that is not normally found in a healthy body. This organism is spread from person to person during sex.

Risk Factors For Trichomoniasis

Because they have different causes, different vaginal infections have different risk factors. All three types of vaginal infection can be spread during sex, so unprotected sex and sex with multiple partners can increase your risk for all types of vaginal infections. However, yeast and bacterial infections are often caused by organisms that already live inside your body, and you can get these infections even if you’ve never had sex, or if you’ve been faithful to one partner for years.

Trichomoniasis is spread mainly through sex. Aside from having more than one partner, the main risk factor is having had trichomoniasis or other sexually transmitted infections in the past.

Diagnosing Trichomoniasis

To diagnose a vaginal infection, your doctor will start by asking you about:

Your symptoms
Your medical history
Your sexual history
The hygiene products you use — particularly douches, which could upset the balance of bacteria, and harsh cleansers that may irritate the skin around your vagina

Your doctor will also perform a pelvic exam. Depending on your symptoms, your doctor may take a sample of the fluids from your vagina to send to a lab for testing. Lab tests are not always necessary for trichomoniasis or for simple yeast infections.

Symptoms of Trichomoniasis

Different types of vaginal infections have different symptoms, though there’s a lot of overlap. All three major types of vaginal infection can cause itching, irritation, and pain or burning when you urinate. They can all cause unusual discharge from your vagina, though the discharge may look different depending on the type of infection you have. Bacterial infections and trichomoniasis may cause an unpleasant smell, but most yeast infections are odorless. Sometimes a vaginal infection may not cause any symptoms at all.

Symptoms of trichomoniasis include:

A lot of foul-smelling white, gray, yellow, or green vaginal discharge
Redness, burning, or itching
Pain when you urinate or when you have sex

Note that 7 out of 10 people with trichomoniasis never develop symptoms.

Prognosis

Vaginal infections are usually not serious if they are identified early and treated. However, it is important to identify the infection and get the right treatment.

Untreated vaginal infections may cause pelvic inflammatory disease, or increase your risk of sexually transmitted diseases or complications after surgery. If you are pregnant, an untreated vaginal infection can lead to early birth. If you have trichomoniasis while you are pregnant, you may pass it on to your baby during birth.

Living With Trichomoniasis

For the most part, vaginal infections go away with treatment. You may need to abstain from alcohol temporarily, or take special precautions if you have sex during treatment, but most people don’t need long-term management.

Screening

Most medical guidelines don’t recommend routine screening for vaginal infections. Screening tests for trichomoniasis are available to your doctor and may be used if you are at high risk — for instance, if you have been diagnosed with another sexually transmitted disease.

If you are concerned that you might have a vaginal infection, but you’re not sure you should see a doctor, home tests are available that are similar to the tests your doctor would use. These tests are available at drugstores and pharmacies.

Prevention

Sometimes infections can happen no matter what you do, but there are steps you can take to make them less likely. Being careful about sex can prevent trichomoniasis and help you avoid some bacterial and yeast infections, but not all.

Common Treatment

Most vaginal infections can be cured with antibiotics or antifungal treatment. The specific type of treatment depends on the type of infection.

The standard treatment for trichomoniasis is the same oral antibiotics used for bacterial infections, metronidazole (Flagyl) or tinidazole (Tindamax). However, instead of a course of treatment, these antibiotics are given as a single large dose, all at one time.

Avoid alcohol for 1 day after taking metronidazole or 3 days after tinidazole. Make sure your sexual partner is treated as well, and avoid unprotected sex for a week after treatment.

Complementary and Alternative Treatment

A very common home remedy for vaginal infections is yogurt. The idea is to restore the proper balance of bacteria by introducing new Lactobacillus bacteria into your body — either by mouth or directly into your vagina. This method has not been as extensively studied as medical treatments, but it seems to work in small studies and according to word of mouth.

If you use yogurt to treat a vaginal infection, be sure to choose a brand that says on the package that it contains live, active cultures. And use only plain yogurt — nothing with extra sweeteners or fruit mixed in. You can also purchase Lactobacillus acidophilus as a pill or suppository. If you suffer from frequent yeast or bacterial infections, you may want to make yogurt a regular part of your diet, or even apply it topically once a week to prevent infection.

Other home remedies for vaginal infections include:

Garlic supplements, or a clove of garlic a day, taken by mouth or as a vaginal suppository
Vitamins C and E
Eating more fish and nuts, and cutting back on fats from land animals
Calcium and magnesium, as supplements or in food
Pau d’arco bark tea as a drink or cooled off and applied directly to the vagina
Pearl barley tea (about 1 tablespoon of barley boiled in a full saucepan)

Always tell your doctor about any treatments you use, including complementary and alternative treatments. Some of these treatments may have side effects, or they can affect the way other medicines work.

Care Guide

Vaginal infections generally clear up with treatment. If you have recurrent yeast or bacterial infections, there are steps you can take to make them happen less often. Things you should avoid to prevent yeast or bacterial infections include:

Douches
Hot tubs and very hot baths
Harsh or scented soaps
Wet clothes
Artificial fibers

You may also want to consider introducing more yogurt or acidophilus supplements into your diet, or trying another of the home remedies listed in the Complementary and Alternative Treatments section.

When To Contact A Doctor

Vaginal infections often clear up with over-the-counter treatment, but they should not be ignored. Call your doctor if:

This is the first time you’ve had a vaginal infection, or the symptoms seem different from past infections
Your symptoms don’t clear up with over-the-counter treatments
You’ve recently had sex with a new partner

Questions For Your Doctor

Your gynecologist or your primary care doctor can treat most vaginal infections. If you don’t have a gynecologist, you can find one in the online directory provided by the American Congress of Obstetricians and Gynecologists (ACOG).

Questions For A Doctor

When you go to see your doctor, it’s good to have a list of the questions you’d like to have answered. Take a moment to write down some of the things you want to know. Your questions for your doctor might include some of these:

What is causing my symptoms?
What treatment do you recommend?
Should I watch out for this sort of infection in the future?
What signs and symptoms should I watch for?
Is there anything I can do to prevent future infections?
What should I do if my symptoms return?

Is there anything else I should know about my vaginal infection?

Resources

Other useful resources to help you learn about vaginal infections and take charge of your treatment can be found at:

ACOG’s Patient Information page – information for you from one of the preeminent professional organizations for doctors specializing in women’s health

Women’s Health.org, a nonprofit organization devoted to improving women’s health