Trichomoniasis disease than to treat. Trichomoniasis: symptoms in women, first signs, treatment and prevention. Methods for determining the disease, laboratory diagnostics

AT Russian Federation over the past 5 years, the incidence of STIs in the population as a whole has significantly decreased, but trichomoniasis still has the largest weight in their structure (24.7%).

Trichomoniasis refers to diseases with sexual transmission, which is the main and practically the only one for men and women. The danger of trichomonas infection lies in the negative impact on reproductive function, there is evidence of the relationship between trichomoniasis and prostate cancer in men.

Other routes of transmission are possible, such as:

1. 1 Intranatal - infection of the fetus during childbirth through contact with an infected mother's mucosa.
2. 2 Contact-household way. Rarely occurs when using infected personal hygiene items - towels, sponges, wearing someone else's underwear, in contact with contaminated surfaces (oilcloths, boats, toilet seats).

Almost one third of the symptoms of infectious vulvovaginitis, finds they have a Trichomonas infection. The prevalence of the disease among the sexually active population of both sexes reaches 30-50%. The incubation period ranges from 3 days to several months, the first symptoms are forced to attract attention from about 10 days of infection.

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  1. Factors affecting the severity of symptoms

  Will a bright clinical picture infectious disease, is determined by the interaction of two factors:

  1. The aggressiveness of the pathogen, which increases with an increase in the infectious dose,
     pathogenicity of the strain, the presence of combined or mixed infection.
  2. 2 The immune status of the organism of an infected person (features of the immune response, the presence of background somatic diseases).

  With the full functioning of the protective-barrier mechanisms of all systems of the human body, the introduction of the pathogen - Trichomonas vaginalis and its associated microflora, will not lead to the development of infection, and the disease proceeds in the form of Trichomonas carriers or with minor symptoms of inflammation.

  With a decrease in the immune status, the body cannot restrain the attack of the infecting agent and an inflammatory reaction is formed. varying degrees gravity. Local and general immunity may decrease due to physiological and pathological reasons (see table 1).

  

  Table 1 - Causes of reduced immunity in trichomoniasis

  The disease can manifest itself as a monoinfection, mixed (caused simultaneously by several different pathogens) or combined infection (successive development of two or more infections). From what will be clinical manifestations, the degree of the body's response to the action of the pathogen and the duration of infection, there are several forms of trichomoniasis (see table 2).

  

  Table 2 - Classification of trichomoniasis

  In most cases, the disease proceeds in a chronic form in the form of monoinfection with minor complaints or their complete absence, in the form of Trichomonas carriers. But sometimes an acute form of infection develops (see table 3).

  

  Table 3 - Forms of Trichomonas infection. To view the table, click on it.

  2. What if I have trichomoniasis?

  The first thing to do when identifying any signs of vaginosis is to consult an obstetrician-gynecologist. At the reception, be sure to tell about the timing of the onset of symptoms, the etiological relationship of the disease with sexual intercourse or another source of infection.

  Then the doctor, assessing the situation, will external examination and a study in the mirrors to detect specific symptoms of trichomoniasis: liquid foamy discharge, a symptom of a "strawberry" cervix; take a smear for microscopy, bacterial culture and material for analysis for STIs.

  The fact of the presence of Trichomonas will help to establish additional diagnostic methods: microscopic, cultural, PCR method.At a positive result analysis for Trichomonas vaginalis, which can be both with and without symptoms, it is necessary to immediately begin complex treatment:

  1. 1 General antiprotozoal therapy;
  2. 2 Local sanitation and correction of the vaginal biocenosis;
  3. 3 Correction of the body's immune status.

  General therapy eliminates the pathogen throughout the body, local therapy will quickly relieve the symptoms of irritation and restore the normal balance of microflora, and immunocorrective therapy will restore the protective barriers of the body. Additionally, especially when the process is chronic, physiotherapy is prescribed.

  For a complete cure, it is necessary to conduct a full course of therapy, which on average lasts 10-12 days, however, in the case of combined, mixed or chronic infection multiple courses of treatment may be required.

  As a rule, from the moment the treatment is started, the symptoms of the disease noticeably subside, but it is not recommended to rejoice early and stop taking the drugs, since as a result of incorrect therapy there is a risk of incomplete elimination of the pathogen and the formation of resistance to the drug.

  As a result, an effective drug will not act on Trichomonas, and you will have to switch to a stronger group of drugs, loading the already infected organism.

  During the treatment of trichomoniasis, you must adhere to a few more rules:

  1. 1 Treatment should be started even if there are no complaints, but the test results revealed the presence of Trichomonas vaginalis.
  2. 2 It is necessary to treat urogenital trichomoniasis together with a partner, as in other diseases with sexual transmission. Even if the partner does not clinical symptoms and there are negative results of laboratory diagnostics.
  3. 3 After effective treatment, re-infection is possible, as an unstable immunity to the pathogen is formed. With ineffective treatment or an incompletely completed course, reactivation of the infection is possible.
  4. 4 Cure acute trichomoniasis is much easier than chronic and complicated.
  5. 5 At the time of treatment, try to exclude sexual intercourse, even with the use of barrier methods. Be more careful than usual in personal hygiene, daily water procedures, change of underwear.
  6. 6 Refuse self-treatment at home! Do not use folk remedies and recipes to treat infections! Visit an OB/GYN doctor, get (or don't get) laboratory confirmation, and strictly follow the prescriptions.
  7. 7 At the time of taking antiprotozoal drugs, it is necessary to refuse alcoholic beverages, even in small doses. This group drugs (with the exception of ornidazole) can interfere with the excretion of alcohol from the human body, acting like drugs for the treatment of alcoholism. Therefore, alcoholic beverages during therapy can lead to a lot of discomfort, a decrease in the effectiveness of treatment and a danger to the life of the patient.
  8. 8 Raise your immunity: proper nutrition, compliance with labor standards, healthy sleep, moderate physical activity, walks in the fresh air - all this can be supplemented by taking immunomodulatory drugs (prescribed by a doctor) and herbal tinctures - leuzea, eleutherococcus, ginseng and magnolia vine.
  9. 9 Most drugs have a negative effect on the embryo, so they are contraindicated for use before 20 weeks of pregnancy.

  After the full course of treatment and the patient's compliance with all the rules, control tests are carried out: 14-20 days after the completion of treatment, then twice more with an interval of 1 month. The disease is considered completely cured in the absence of clinical manifestations and the pathogen in a laboratory study after 1-2 months in men and 2-3 months in women.

  3. Why is treatment necessary? What are the consequences?

  Firstly, under the cover of Trichomonas, other pathogenic microorganisms, most often gonococci, may be present in the body. As a result, both infections are transmitted through sexual contact.

  Treatment gonococcal infection is complicated by the fact that the drug effect is only on free pathogens, and those phagocytosed by Trichomonas are resistant to ongoing therapy and retain the ability to reproduce and infect.

  This reason is due to the most frequent combination of trichomoniasis and gonococcal infection. In some cases, gonococci are detected in control smears after successful completion of treatment for trichomoniasis - an example of a co-infection.

  Secondly, the constant, even asymptomatic, persistence of an infectious agent in the human body leads to depression, first of all, of local immunity and creates excellent conditions for the introduction of other STI pathogens and reproduction. opportunistic flora up to an increased risk of HIV infection.

  Thirdly, in the absence of treatment, even with Trichomonas carriers, ascending infection with damage to the proximal genitourinary tract is possible. Trichomoniasis in women can be complicated by the development of colpitis, bartholinitis (inflammation of the Bartholin gland, dangerous abscess formation), chronic endometritis- inflammation of the mucous membrane of the uterus.

  Endometritis also sometimes occurs long time asymptomatic, but leads to complications - atrophy of the uterine mucosa, violation of its receptor apparatus, which ultimately can cause infertility and miscarriage.

  In men, the most formidable complication of an ascending infection is the occurrence of prostatitis ( inflammatory disease prostate), vesiculitis (inflammation of the seminal vesicles), epididymitis - the main causes of male infertility.

  So, trichomoniasis should be treated immediately when it is detected. It is better at the stage of trichomonas carriers or minor clinical manifestations, preventing ascending infection and the development of complications, the treatment of which is much more expensive or no longer possible.

  4. Features of the management of pregnant women

  Pregnancy is accompanied by many changes in the body, including changes in the biocenosis of the woman's vagina, local immunity decreases, which can provoke the development of pathogenic and conditionally pathogenic microbes. A pregnant woman may become infected with Trichomonas for the first time or be a carrier.

  Trichomonas vaginalis themselves do not have a rough effect on the fetus and do not cause specific symptoms of the disease in him, but any infection in the genital tract increases the risk of threatened abortion, premature birth, and intrauterine infection.

  The waste products of Trichomonas and other microorganisms associated with them form an aggressive environment in the vagina, which can lead to "melting" of the presenting membranes, ascending infection and the occurrence of intrauterine pneumonia and / or the most formidable complication - chorionamnionitis, which can even end in antenatal fetal death.

  Infection in a woman's genital tract increases the risk of premature rupture of the membranes and the onset of preterm labor. Most often, Trichomonas act as a "reservoir" in which other microorganisms are delivered to the intrauterine world and develop their vigorous activity there.

  May occur during childbirth through naturally infected birth canal. Despite the fact that trichomoniasis in a newborn is less dangerous than in a fetus, antiprotozoal therapy is still required in the first weeks of life.

  Any medical preparations interfere with the formation immune system baby, therefore, in parallel, activities are carried out that support the microflora of the body and strengthen its immune status.

  Similar situations of infection of the fetus and newborn are rare and are more common in cases of advanced trichomoniasis. If a woman is registered in time women's consultation, regularly visits a doctor and passes all the tests, it is much easier to correct the situation. In any case, a pregnant woman needs treatment.

  The use of antiprotozoal drugs general action for the treatment of trichomoniasis in the first trimester is not allowed, therefore, drugs are used topically in the form of suppositories (with the exception of metronidazole preparations).

  With the ineffectiveness of therapy from 20 weeks, it is possible to use complex local and general treatment, as well as correction of the immune status of the woman's body.

  5. Drug therapy

  5.1. Antiprotozoal drugs

  The first line of therapy for urogenital trichomoniasis includes drugs of the nitroimidazole group with proven efficacy and high sensitivity to the pathogen. The most commonly used are their representatives such as: metronidazole, ornidazole, tinidazole.

  Their mechanism of action is due to the destruction of nucleic acids DNA of microbial cells by toxic metabolites of the active substance, formed under the influence of Trichomonas enzymes.

  Nitroimidazoles are well absorbed orally and vaginal application and have high bioavailability. To a small extent, they form bonds with blood plasma proteins and are able to penetrate into biological fluids and tissues: they are excreted with mother's milk, pass through the hematoplacental barrier.

  The evidence base supporting negative impact nitroimidazoles per fetus, per this stage no, but given their ability to overcome the placental barrier and be determined in the amniotic fluid, their teratogenic properties, their administration in the first trimester of gestation is categorically not recommended.

  In the second and third trimesters, treatment with them is acceptable if the need is higher than the risk and more safe methods are not effective. At the time of taking the drug, breast-feeding better to limit. The resumption of feeding is possible after 12-24 hours when using metronidazole and after 3 days when taking tinidazole.

  Nitroimidazoles are metabolized in the liver by binding to glucuronic acid, therefore they have hepatotoxicity. They should be used with caution in the presence of chronic liver diseases and under the control of a biochemical blood test.

  Excreted from the body for a long time for 10-20 hours, mainly by the kidneys, with urine 60-80% and with bile up to 30%.

  5.2. What are the possible side effects?

  Often there is a dyspeptic syndrome - nausea, vomiting, bitterness in the mouth. In second place in terms of frequency are cerebral phenomena - headache, dizziness, drowsiness.

  In some cases, especially in the presence of chronic blood diseases, they can provoke inhibition of hematopoiesis. With vaginal application, itching, burning, and increased discharge are sometimes disturbing.

  A characteristic feature of this group of drugs is their incompatibility with alcohol, the intake of which will have to be stopped for the duration of treatment. Nitroimidazoles inactivate alcohol dehydrogenase (a liver enzyme that breaks down alcohol into less toxic components), as a result, alcohol deactivation is impaired and toxic acetaldehyde accumulates in the body.

  This leads to teturam-like reactions, which are clinically manifested by a feeling of heat, tightness in the chest, pain in epigastric region, chills, palpitations, dizziness and other symptoms.

  The only representative of the nitroimidazole group that does not have such an effect is ornidazole. Self-administration of medications for the treatment of trichomoniasis is contraindicated! It is necessary to consult a specialist and strictly follow his recommendations.

  For acute trichomoniasis, the following schemes treatment (see table 4).

  

  Table 4 - Treatment regimens for acute trichomoniasis. To view the table, click on it.

  One of the reasons for the ineffectiveness of the treatment of trichomoniasis may be other microorganisms found in the vaginal discharge. For example, B-hemolytic streptococcus is able to interact with metronidazole and reduce its effectiveness.

  In this case, before starting a second course of antiprotozoal therapy, it is necessary to conduct an empirical study in order to eliminate the coccal flora. antibiotic therapy amoxiclav 625 mg 3 times a day or erythromycin.

  In most cases, one full course of antiprotozoal therapy with metronidazole is enough to completely destroy Trichomonas. With treatment failure, an increase in the dose of metronidazole or the use of tinidazole is indicated.

  It is better to take metronidazole after meals with large quantity water in the dosage prescribed by the attending physician. Trichomonas resistance to metronidazole is rare, but it can be substituted for tinidazole. If standard schemes are ineffective, the following combinations are used:

  Table 5 - Alternative regimens for the treatment of trichomoniasis
  

  And laboratory confirmation of treatment is carried out at any time, and if nothing bothers, it can be delayed until 37 weeks of gestation (preparation for childbirth through the natural birth canal).

  As a rule, the following schemes are used for treatment: metronidazole tablets at a dose of 2.0 orally once and / or local sanitation. With intolerance to all drugs of the nitroimidazole group, there are alternative schemes:

  1. 1 Nitazol - in tablet form 100 mg 3 times a day up to 14 days or in the form vaginal suppositories 2r/day.
  2. 2 Preparations of the nitrofuran group (Furazolidone) - according to the scheme 100 mg 4 times a day for 3-5 days.

  5.3. Local treatment

  If trichomoniasis proceeded as standard without complications, then general antiprotozoal therapy within one course is sufficient for a complete cure. With rapidly flowing acute infections or a protracted chronic course, a combination of general treatment with local sanitation is indicated. The following preparations are used (table 5 below).

  

  Table 6 - Preparations for the local treatment of trichomoniasis. Click on the table to view.

  Sometimes complex antimicrobial and antiprotozoal drugs are used: Macmiror, Klion-D, Neo-Penotran, Terzhinan, Ginalgin and others.

  5.4. Immunocorrection

  In particularly difficult cases that cannot be standard schemes therapy, it is recommended to supplement the treatment with the use of the SolkoTrichovac vaccine. This is a concentrate of lyophilized inactivated atypical strains of lactobacilli.

  Its introduction into the human body provokes the production of specific antibodies against atypical lactobacilli, pathogenic microorganisms and Trichomonas including (cross-reaction is provided by a similar antigenic composition due to the long-term cohabitation of members of the biocenosis in the same environment).

  As a result, the growth of unwanted microorganisms is inhibited against the background of favorable conditions for the growth of representatives normal flora. The antibody titer begins to increase gradually within 14 days after the injection, so the first positive effects are observed no earlier than 14-20 days later. The vaccine is administered by deep intramuscular injection three times with an interval of 2 weeks.

  Re-vaccination is possible after 1 year with a single dose, if indicated, after 2 years. To supplement the complex of treatment of uncomplicated trichomoniasis, you can take immunocorrective drugs (see table 6).

  

  Table 7 - Immunomodulators used for trichomoniasis

  Currently, in medical practice there is a fairly wide arsenal of immunocorrection drugs, so you should follow the doctor's recommendations and not self-medicate. Of herbal preparations, it is worth mentioning Eleutherococcus tinctures, Leuzea extract, Echinacea and Chinese Limonica.

  6. Prevention of infection

  With regard to any disease, it can be said that it is much easier to prevent their occurrence than to treat the consequences. Prevention activities
  trichomoniasis due to its belonging to the group of infections with sexual transmission.

  There are basic rules to follow:

  1. 1 Avoid casual sex. Relationships with various representatives of risk groups are especially dangerous: people suffering from drug addiction, women and male lung behavior, as well as people of non-traditional sexual orientation. The high risk of STIs in these groups is explained by the high number of not always protected sexual contacts with representatives of the same groups, and non-observance of personal hygiene rules. Loyalty to one's own permanent partner- this is a guarantee of healthy sexual relations.
  2. 2 Sometimes, unfortunately, representatives of the medical field (nurses, doctors) can also be considered a risk group for the possibility of infection with sexual infections, given the doctor's close contact with blood and other biological fluids patients due to their professional activity. But under aseptic conditions, the risk of infection is reduced to zero.
  3. 3 When having sexual intercourse with a new unknown or random partner, be sure to use a barrier method of contraception - a condom. The cell size of Tr.vaginalis exceeds the size of the pores in the condom material, so its use provides the maximum guarantee of protection.
  4. 4 Observe personal hygiene and do not use sponge towels, underwear of other people, and also be careful in public toilets, showers, pools. The contact-household transmission route is, of course, rare, but not completely excluded. Don't start the disease. If you have any signs of bacterial vaginosis, see your doctor immediately. If the diagnosis of trichomoniasis is confirmed, warn your sexual partner and only start treatment together, as unilateral treatment may subsequently lead to re-infection.
  5. 5 Lead healthy lifestyle life: eat right, play sports, keep a sleep schedule and, if necessary, support yourself with immunomodulatory drugs and seasonal multivitamin complexes. Be true to your partner!

In the structure of all sexually transmitted infections, urogenital trichomoniasis occupies one of the first places in the world. In developed countries, the incidence of infection among women without obvious clinical signs ranges from 2 to 10%. The ratio of women and men with this pathology is 4:1, respectively. It is found in 18-50%, and sometimes in 80% of women who turn to gynecologists for discharge from the genital tract, and among men with inflammation of the urethra of a non-gonococcal nature - in 30-35%.

Cause and development of the disease

Infection in baths, pools, open reservoirs, subject to the usual hygiene rules, is impossible due to the low concentration of the pathogen in the aquatic environment. Outside the human body, trichomonas vaginalis is unstable, although it can persist in urine, semen and water for up to 1 day.

Infected mainly people in active puberty, and most of them are unmarried or divorced (80%). So, trichomoniasis in men is most common in the age group from 15 to 30, and in women - from 18 to 30 years.

The causative agent in the course of its life activity secretes a complex protein CRF (cellular uncoupling factor), which leads to a significant loosening of tissues. As a result, he himself, as well as accompanying microorganisms and toxic products of their metabolism freely penetrate into the intercellular space.

CRF is active in an environment with a certain acidity and estrogen concentration, and for the life of Trichomonas, fatty acids and iron are needed, which are abundant in menstrual blood. Therefore, trichomoniasis in women is manifested by severe symptoms during menstruation, especially immediately after they end.

All this can lead to the development of acute inflammatory processes in the mucous membranes, cause their weak reaction, or remain without obvious consequences. The severity of clinical manifestations depends on:

• virulence (activity) of vaginal Trichomonas and the intensity of its impact;
• state of the epithelial layer of the mucous membrane of the genital and urinary tract;
• acidity of the environment of the genitourinary system;
• association of trichomonas with concomitant pathogenic or conditionally pathogenic flora, its nature, the degree of activity and the number of bacterial agents that cause inflammation;
• the degree of response of the body; if it is higher than the degree of aggressiveness of the microorganism, the acute inflammatory process does not develop or is rather weakly expressed.

In addition, trichomonads secrete substances that neutralize blood T-lymphocytes and antibodies formed in the body of the infected, and are also able to absorb and concentrate plasma proteins on their surface. The latter does not allow the body's immune system to recognize the pathogen as a foreign substance. Therefore, permanent immunity is not developed. Although antibodies are found in the blood of those who have had the disease, the latter are unable to provide the body with adequate protection against re-infection.

Another property of Trichomonas vaginalis is its ability to capture and reserve other opportunistic and pathogenic microorganisms, which leads to a pronounced tissue reaction, damage and destruction of the epithelium, and the formation of dysplasia of the epithelial layer. With reduced immunity of the body and significant inflammation, hemorrhages and damage to the smooth muscle layers adjacent to the inflamed mucosa occur.

Clinical manifestations

Symptoms of trichomoniasis depend on the severity of the inflammatory process. At the same time, if it is caused by trichomonas vaginalis in isolation, there may be no symptoms. It is largely determined by the infection that almost always accompanies or is combined with trichomoniasis.

Fresh form with acute course

In men

At the time of infection, the pathogen enters the epithelial layer of the mucous membrane in the region of the external opening of the urethra. As a result of active movement, it spreads along the anterior and then along the posterior urethra, from where it enters the prostate tissue, into the vesicles of the seminal glands that produce seminal fluid, in the epididymis, in which spermatozoa accumulate and mature, and in bladder.

In the absence of symptoms and, accordingly, treatment, trichomonas vaginalis lives for a long time in the genitourinary organs and often leads to dysfunction reproductive system. A fresh form with an acute course is accompanied by:

1. Moderate frothy discharge from the urethra of a yellow-greenish color, which especially increases with light pressure on the glans penis.
2. Urethritis and cystitis with urination disorder, itching and redness of the mucous membrane in the area of ​​the external opening of the urethra.
3. Balanoposthitis (inflammation of the glans penis), accompanied by a sensation of itching.
4. Unpleasant sensations during intercourse.

Complications in the form of prostatitis, vesiculitis and epididymitis occur in 30-50% of men and occur with appropriate symptoms.

Trichomoniasis in women

It proceeds with damage to the mucous membrane of several parts of the genital organs and the urination system - from the urethra to the bladder, ureters and kidney tissue. All parts of the reproductive system can be involved in the inflammatory process - from the external genital organs (vulvitis) to the fallopian tubes, ovaries and peritoneum in the pelvic area, but more often it is limited to the area of ​​​​the internal cervical os. In addition, even rare cases (about 5%) of lesions of the mucous membrane of the upper dilated sections of the rectum located at the level of the sacrum (ampullar rectum) were noted.

Inflammation of the vaginal mucosa occurs as a primary acute or chronic infectious process, the exacerbation of which is characterized by the same clinical manifestations as in acute trichomoniasis. During vaginal examination, the phenomenon of colpitis (inflammation of the vaginal mucosa) is found in 40% of women with trichomoniasis. Of these, colpitis is isolated in 18%, in 15% it is combined with inflammation of the vaginal surface of the cervix, in 34% - with urethritis and inflammation of the cervical canal.

Main symptoms:

1. Yellow-green discharge from the genital tract of a frothy (12%) character.
2. Redness and itching of the external genitalia.
3. Dysuric disorders and dyspareunia.
4. At vaginal examination the most characteristic is redness of the mucous membrane of the vagina and cervix, combined with petechial hemorrhages. This most typical feature called "strawberry symptom", but it occurs in only 2% of infected women.

Complications - bartholinitis (inflammation of the Bartholin glands), salpingitis and salpingo-oophoritis.

Features of the disease during pregnancy

Trichomoniasis during pregnancy manifests itself mainly in the form of an acute course of a fresh form or an exacerbation of a chronic disease. Moreover, it, as a rule, is multifocal in nature: the urethra and often the bladder, vulva, vagina and rectal mucosa are affected.

In pregnant women, anatomical and physiological changes are aimed at protecting the developing fetus from the negative influence of the external and internal environment, and hence from the ascent of the infectious process. In this regard, there is an activation of the immune system of the body of the expectant mother, including the phagocytic response. Additional protective biological mechanisms are formed from the moment of conception and develop as the embryo and fetus grow.

Therefore, the degree of possibility of infection depends on the timing of pregnancy. From the very beginning, there is a change in the nature of the mucus of the cervical canal. An increase in its viscosity creates a significant obstacle to the penetration of Trichomonas and other infectious agents ascending way and for further dissemination.

The second barrier from the 16th week of pregnancy is the chorionic and amniotic membranes of the fetus, which cover the internal os of the cervical canal. If infection with trichomoniasis occurs before the closure of the internal pharynx, the probability of spread of the pathogen in an ascending way remains quite high. This threatens the development of endometritis and, most often, ends in spontaneous abortion. With a later infection, the ascent of the infection is extremely rare, and the therapy carried out contributes to the cure, the successful course of pregnancy, childbirth and the postpartum period.

Diagnostics

The symptoms of trichomoniasis listed above are not characteristic of this particular disease and cannot be used as reliable criteria. Most of them are also found in other infectious processes of the urogenital system. Besides, enough high percent This disease has a subacute and torpid course. Therefore, the final diagnosis and choice of treatment plan is possible only after laboratory diagnostic studies.

For these purposes, mainly three methods for detecting trichomonas vaginalis are used:

1. Microscopic.
2. Cultural, or microbiological.
3. Molecular biological.

microbiological method, the sensitivity of which is on average 50-65%, it is advisable to carry out two methods:

• studying a smear under a microscope in phase contrasting immediately after taking the material;
• examination under a microscope of a material stained according to a certain technique.

As a material for diagnosis, scrapings and mucus from inflammatory foci that are most suspicious for infection with Trichomonas are used - scrapings from the vagina, mucus and scrapings from the cervical and / or urethral canal, sperm, etc.

If in the study according to the first method only mobile microorganisms are taken into account, then in the second case - all forms of the pathogen, as well as indirect signs of inflammation (the amount of mucus, accumulations of leukocytes, etc.). Stained preparations slightly increase the percentage of sensitivity of the technique. In the same time, microbiological method insensitive to asymptomatic diseases. In addition, it gives many false positive and false negative results.

Cultural method considered highly sensitive (73-89%) and effective. It is based on the cultivation (growing) of microorganisms on special nutrient media, followed by their identification under a microscope. The microbiological method is of particular importance for:

• absence of symptoms (trichomonas carriers);
• atypical clinical signs;
• repeated negative microscopy results;
• detection by microscopic method of atypical forms of the pathogen;
• the need to evaluate the results of therapy.

However, studies using the cultural method require a long time - 3-5 days after sowing the culture, and with the first negative results - another 6-12 days.

Molecular biological analysis based on polymerase chain reaction (PCR) and NASBA test. They make it possible to detect the DNA and/or RNA of the pathogen at low concentrations - even in the presence of a single microorganism in the material. In this case, the viability of Trichomonas does not matter. The sensitivity of these assays is 97% and their specificity is 98%. The method is advisable to apply in the following cases:

• detection by other methods atypical forms trichomonas;
• doubtful result of the cultural method;
• the need for additional research in the presence of a mixed infection of the genitourinary system.

The full course of therapy for trichomoniasis should be completed by both partners, regardless of whether there are symptoms

How to treat trichomoniasis

With laboratory confirmation of the diagnosis, it is necessary to treat not only the sick person, but also sexual partners, regardless of whether they have clinical manifestations and the results of their examination. The choice of treatment tactics is influenced by the age of the patient, the localization of inflammation, the form of the disease, the nature of the concomitant infection, the immune state of the body.

The main treatment of trichomoniasis is carried out with specific preparations of the nitroimidazole group: Trichopolum, Metronidazole, Ornidazole, Flagyl, Tinidazole, Flunidazole, Seknidazole, etc. During their administration and within 1 day after the end of the course of treatment, it is necessary to refrain from drinking alcoholic beverages and products containing them. This is due to the possibility of developing a severe disulfiram-like reaction (nausea, cough, vomiting, decreased blood pressure, chills, severe general condition).

In the acute course of the disease, Metronidazole is prescribed at a dose of 0.5 g 3 times a day for 5 days.

There is an approved treatment regimen chronic trichomoniasis, as well as recurrent and various localizations: a single dose of 2.0 g of Metronidazole during the day for 7-10 days or 500 mg 3 times a day for the same number of days, Tinidazole - 2.0 g once daily for 3- x days.

Highly effective with good tolerability and a small number of possible side effects is Ornidazole, or Ornisol, at a dose of 0.5 g - 2 times a day for 10 days.

Other treatment regimens have also been developed, for example, intravenous drip of a solution of Metronidazole (500 mg) for half an hour 3 times a day for 5-7 days.

Treatment of trichomoniasis in pregnant women at any time is carried out by a single dose of 2 g of metronidazole in order to prevent early rupture of the membranes and the occurrence of premature birth.

Due to the resistance of the microorganism to these drugs in recent years, it is recommended to additionally apply them locally - Metrogyl vaginal gel, vaginal tablets"Klion-D 100", metronidazole cream.

Immunomodulating agents are also used, which also suppress the development of a concomitant infection, for example, fungal - 3 irrigations of the vagina and cervical zone with a 0.04% solution of Gepon at a dose of 5 ml - 1 irrigation each with a 2-3-day interval.

Treatment should be given to people who have trichomonas vaginalis, regardless of whether they have inflammatory processes. Also, a course of treatment should also be given to persons who have been in contact with infected people, even if there are no first clinical and laboratory signs of infection.

Trichomoniasis in women is a common disease that affects the genitourinary system. Trichomonas vaginalis can affect its development. It causes an inflammatory process in the genitals of a woman, or rather, it is formed on the mucous membrane of the vagina. How is trichomoniasis treated in women, the regimen of taking drugs, with which you can stop the symptoms and the cause of the development of the pathology.

From the moment the vaginal trichomonas arose, and before the first symptoms are formed, 2 months will pass. Moreover, a situation is typical when the clinical picture is completely absent.

In this case, a person serves as a carrier of the disease, while not suspecting that he is infecting his sexual partners. Although often the carriers of the infection are men. But this does not mean that among women such a phenomenon is impossible. Diagnostics must be performed to establish the media.

Trichomoniasis in women can be recognized by the following symptoms:

1. Vaginal discharge. Their color can be yellow-green, grayish-yellow, light yellow. They go plentifully, and still smell unpleasant. But most importantly, they have a foamy texture. Patients should pay attention to this Special attention, since the subsequent symptoms are nonspecific and character for any type of inflammation that affects the vagina.
2. Burning, itching in the vagina and external genital area.
3. Cutting while urinating, frequent urges to the toilet.
4. Hyperemia and swelling of the vulva.
5. Discomfort and pain during sexual intercourse.
6. Pain syndrome in the lower abdomen. It is of low intensity and has a whining character.

Medications for treatment

Metronidazole

The drug has an antimicrobial and antiprotozoal effect in the treatment of pathologies caused by infections. It is a vital drug. For the first 4 days, take 0.25 g 3 times a day. Then 4 days to take 0.25 g 2 times a day. In total, the course of therapy includes 5 g of the drug.

Tinidazole

It is an antiprotozoal and antimicrobial drug. It is active against many Trichomonas and anaerobic microorganisms. Its active components penetrate into the pathogenic microflora, where it inhibits their synthesis and damages the DNA structure. Take 4 tablets once or 1 tablet every 15 minutes for an hour. The course of therapy is calculated 2 g of medication.

Trichopolum

The main component is metronidazole. It has antiprotozoal and antibacterial effects. But in relation to many anaerobic bacteria, fungi, viruses, the drug does not have a bactericidal effect. Take the medicine for the 1st day, 0.75 g 4 times a day. After 0.5 g 4 times a day. In total, the therapeutic course includes 5 g of the drug.

Fazizhin

The drug has antibacterial and antiprotozoal effects. Active components are able to penetrate into the cells of pathogenic microflora, inhibiting synthesis and damaging DNA fibers. Effective treatment of trichomoniasis involves taking the drug 0.5 g 2 times a day. Take every day for 7 days.

Flagyl

The main component is metronidazole. You need to take it according to the following scheme:

1. The first day - 0.5 g 2 times a day.
2. The second day - 0.25 g 3 times a day.
3. The next 4 days - 0.25 g 2 times a day.

The therapeutic course involves the use of 3.75 g of the drug.

Efloran

Take an antibacterial and antiprotozoal agent 0.5 g 4 times a day. The duration of treatment will be 5 days. After that, switch to the following treatment regimen: 1 g 2 times a day. Take for 7-10 days.

If it is not possible to purchase these medicines or if a woman is allergic to them, then the treatment of trichomoniasis can be carried out with the help of such alternative medicines:

1. Atrikan 250. Take 0.25 g 2 times a day. The duration of the therapeutic course is 4 days.
2. Meratin. Take 0.5 g 2 times a day. The duration of therapy is 5 days. Intravaginally administer a tablet at bedtime. The maximum daily allowance is 1.5 g.
3. Naxojin. Reception is carried out once in the amount of 2 g, if there is an acute form of trichomoniasis in women, and for chronic dosage will be 1 tablet 2 times a day. The duration of treatment is 6 days.
4. Nitazol. Take 0.1 g per day. The duration of treatment is 2 weeks. Suppositories are used intravaginally, which contain 0.12 g of the drug. Enter them 2 times a day.

Local combined preparations

Apply such combined preparations for the treatment of trichomoniasis in women:

1. Klion D-100. The composition of the drug suggests the presence of two active ingredients - metronidzalone and miconazole nitrate. Take 1 capsule at bedtime. The duration of therapy is 10 days.
2. Neo-Penotran. These are candles that must be installed 1 suppository 2 times a day. In total, the treatment will last 2 weeks.
3. Terzhinan. The drug is based on ternidazole, nystatin and neomycin sulfate. Inside vaginal suppositories use at night. The duration of therapy is 10 days.
4. Meratin Combi. The drug is based on ornidazole, neomycin sulfate, nystatin and prednisolone. It is necessary to use 1 candle at night. The treatment lasts 10 days,

Candles to relieve symptoms

Metronidazole

These are synthetic vaginal suppositories, the action of which is aimed at destroying the DNA of pathogenic microflora. His active substances are quickly absorbed and guarantee a stable therapeutic effect.

But to use the drug for a long time, because of this, resistance to metronidazole is developed. This is especially noted in the chronic form of the disease. Use sci before going to bed. The duration of the therapeutic course is 10 days.

Ornidazole

These suppositories are famous for their antibacterial and antiprotozoal effects. Provides instant resistance to pathogenic microflora, suppressing their development and leading to their death. Apply one candle 1 time per day, preferably at bedtime. The duration of therapy will be 10 days.

Osarbon

These are antimicrobial suppositories that contain acetarsol as an active ingredient. It also contains arsenic and glucose. The function of these components is to block metabolic processes Trichomonas, as a result of which they die. The effect of suppositories on Trichomonas is due to the high sensitivity of microorganisms to arsenic compounds. But the glucose included in the composition creates reliable protection from exposure to a poisonous substance. In addition, the use of Osarbon leads to the restoration of the vaginal microflora and a decrease in the level of acidity. It is effective to use suppositories for colpitis, which is the most basic complication of trichomoniasis. Use one candle before bed. In total, the course of therapy will last 10 days.

Treatment of trichomoniasis in women during pregnancy

If a woman is infected with trichomoniasis before or during pregnancy, then the pathological process will develop rapidly, because immunity decreases during pregnancy.

It is possible to detect an infection after the first examination by a gynecologist. Trichomoniasis during pregnancy can cause complications:

• premature birth;
• rupture of the membranes;
• discharge of water ahead of time.

Treatment of trichomoniasis during pregnancy should be carried out by a doctor. He prescribes antibiotics to the woman with a minimum of side effects. They must be safe for the child and the expectant mother.

The task of a pregnant woman is to comply with the dosage. In addition, the expectant mother should inform the doctor about all changes in the state of health. If, after conducting a control study for trichomoniasis, the result is negative, then we can talk about complete cure. Additionally, drugs to increase the immune status may be prescribed in the therapy regimen.

In order not to harm the health of the expectant mother and her child, it is worth adhering to precautionary measures. They consist in the rejection of promiscuity and the use of condoms.

ethnoscience

Folk remedies in the treatment of trichomoniasis in women are used as supportive therapy to the main drug.

Herbal collection No. 1

Take 10 g of shepherd's bags, 30 g of bird mountaineer, 10 g of white mistletoe, 5 g of sweet clover, 10 g of mountain arnica. Take 10 g of raw materials and pour 200 ml of boiling water. Infuse for 15 minutes, filter. The daily norm is 200 ml, divided into 2 doses. The duration of therapy will be 2-3 weeks.

Collection for douching

Mix these ingredients:

• English oak - 20 g;
• mallow forest - 10 g;
• chamomile officinalis - 25 g;
• medicinal sage - 15 g;
• walnut - 25 g.

For 40 g of the mixture 200 ml of boiling water. Insist 4 hours. Use a filtered douche infusion every day. The total treatment will be 10 days.

garlic juice and glycerin

In Korean medicine, garlic juice is often used to treat this pathology in women. They combine it with glycerin in a ratio of 1:20. Suppositories are made and inserted into the vagina. It has been proven that after 4 days all Trichomonas die, and after 3-5 sessions the symptoms will completely disappear. In this case, there are no recurrences of the disease.

Collection for the chronic form

Using Trichomoniasis Treatment folk remedies in women, you can use an effective herbal collection. For its preparation, the following components are needed:

• common yarrow - 10 g;
• eucalyptus ball - 20 g;
• Japanese Sophora - 15 g;
• warty birch - 15 g;
• common tansy - 20 g.

For 20 g of the collection, 200 ml of boiling water is consumed. Infuse for half an hour, filter and take 70 ml 3 times a day. The duration of therapy will be 2-3 weeks.

Calamus tincture

Calamus is famous for its cleansing properties. Its root is in great demand in the treatment of trichomoniasis. You need to take a special vodka tincture. Use it 3 times a day. The use of calamus root is especially important for those people who have gastrointestinal pathologies. The tincture does not irritate the gastric mucosa.

bird cherry inflorescences

Bird cherry, or rather, its flowers, is an excellent cleanser. To prepare the tincture, you need to take 20 g of raw materials and pour 200 ml of boiling water. Set on fire and simmer for 5 minutes. Use at a dosage of 80 ml for microclysters. Another infusion can be injected into the urethra using a catheter. Thus, it is possible to improve the general condition of the patient.

Garlic

It is simple but one of the most effective ways for the treatment of trichomoniasis. You have to squeeze the juice out of it. Its daily norm is 15 g, divided into 3 doses.

onion swab

The medicine is used externally. Take the gruel from the onion, put it on the juice of a sterile bandage, form a tampon, and then insert it into the vagina. Keep 4 hours. If severe discomfort is felt during the procedure, then its duration can be reduced to 3 hours. The duration of therapy will be 10 days. In the presence of irritation, treatment is stopped.

Calendula

With strong and intolerable itching you can use tincture of calendula. It can be taken orally, but only the doctor can determine the dosage. And mono moisten the bandage in tincture and apply to the genitals as a compress. Keep it for 15 minutes.

Aloe

This plant heals many diseases. In the treatment of trichomoniasis in women, it is worth taking aloe juice 3 times a day. But the frayed leaves are suitable for compresses.

Honey

Take it every day for 150 g, dissolving under the tongue. The duration of therapy will be 7 days. You can drink honey with water, who can not absorb it.

horseradish root

To prepare the medicine, take 0.5 kg of roots, grind them on a grater. Add 1 liter of water. Infuse the mixture throughout the day in a dark place. Filter the infusion and apply a medicinal tincture to wash the affected organ.

Sea buckthorn oil

This is another effective product in the treatment of the disease. It should be used for douching the genitals. The oil effectively stops irritation, reduces itching, removes inflammation that has arisen against the background of Trichomonas. Use the product until complete recovery.

Garlic, onion, calendula

Using these products, you can get an effective antimicrobial swab. Grate 3 cloves of garlic, ¼ of the onion and a little calendula ointment. The resulting composition is applied to a gauze swab. Lead it directly into the vagina, but keep it no longer than 4 hours.

A decoction from the collection

To cleanse the body of bacteria, you can take lilac, bird cherry, celandine and calendula. For 40 g of raw materials 200 ml of boiling water. Pour, simmer on fire for 5 minutes, set for 15 minutes. Filter and apply for enemas. May be administered with a catheter.

collection tool

This recipe is more complex, but it is effective for home treatment trichomoniasis folk remedies. Take 80 g of eucalyptus leaves, the same amount of tansy, add 20 g of yarrow and 30 g of sophora fruit. Take the resulting mixture in an amount of 20 g and add 200 ml of boiling water. Wait half an hour, filter and take 40 ml 3 times a day. The duration of therapy is 3 weeks.

Chamomile infusion

For effective treatment, you can use chamomile decoction in combination with the above treatments. Drink it 2 times a day. To prepare, take 100 g of chamomile flowers, 2 cups of boiling water. Insist 2 hours.

Purslane garden

Take 100 g of raw materials, finely chop it, add protein and mix everything well. Reception lead inside 40-60 g every day. To obtain the effect, take it for 14 days.

Collection

Take 100 g of these components:

• birch leaves,
• horsetail,
• camomile,
• oats,
• mint.

For 100 g of raw materials 3 liters of water. Simmer on fire for about 5 minutes. As soon as the broth has cooled to room temperature, then pour it into a convenient container. You need to wrap yourself in a warm blanket, then the water will cool slowly. Squat over a bowl and sit like this for 10 minutes.

Disease prevention

In order not to waste time and money on the purchase of expensive drugs in the treatment of trichomoniasis, it is better to take care of quality prevention. The main route of infection is sexual. So you will have to adhere to the following preventive measures:

1. Avoid promiscuity.
2. Sexual contact should take place using condoms.
3. Have one regular sexual partner.
4. Visit your doctor regularly for preventive examination. This will allow timely diagnosis of sexually transmitted diseases.
5. If there was unprotected sexual contact with a casual partner or if the condom broke, then you should immediately go to the hospital for treatment. Only timely drug prophylaxis will prevent the development of pathology.
6. If there was a dubious sexual intercourse, then it is worth performing the treatment of the genital organs with the help of bactericidal agents. For this, drugs such as Chlorhexidine, Miramistin, Betadine are excellent.

There is a threat to pick up an infection even in a domestic way. Trichomoniasis in the external environment dies when high temperature. It must exceed 45 degrees. You can also kill it with antiseptics and disinfectants.

With a household method of infection, it is necessary to take the following preventive measures:

1. Pay due attention to cleaning the toilet and bathroom. For this you need to apply disinfectants. In rooms where humidity is high, thorough ventilation and ventilation must be ensured.
2. Follow the rules of personal hygiene regularly.
3. Use your own hygiene products. This includes linen, bedding, towels, which should always be washed and ironed.
4. The washcloth you use in the shower should be individual.

There are quite a few pathologies of the genitourinary system, but the most common physicians include trichomoniasis. According to statistics, more than 15% of the world's population suffers from this disease. However, first of all, it is advisable to evaluate the development of symptoms of trichomoniasis in women, since the disease is diagnosed in them more often than in men. This phenomenon can be explained by the fact that the representatives of the weaker sex more often undergo gynecological examination, and their symptoms are much more pronounced. In general, the disease develops equally in women and men, since it is transmitted during sexual contact, regardless of the method, be it oral-vaginal, anal or vaginal-anal.

It is extremely rare that infection occurs in a domestic way through washcloths, towels and other items, although this is quite possible, given that Trichomonas is able to survive in a humid environment for several hours.

Why the disease develops

woman negative phenomena arise due to exposure to Trichomonas vaginalis, which affects the organ of the same name along with the bladder. Most of the causes include:

• Promiscuous sex in combination with frequent change of partners, especially in the absence of barrier contraception. However, in some cases, a condom may not contain Trichomonas, for venereal pathologies, such an incident is not such a rarity.
• Sexual intercourse conducted in unsanitary conditions.
• A history of venereal diseases that the patient has recently suffered.
• Infections in the genital area, provoked by other pathogens.

The risk of trichomonas infection increases during menstruation and immediately after them, as there is a change in the acidity of the vaginal environment. Abortions or labor activity can prepare the ground for rapid infection - in both cases, there is a violation of mechanical protection against the background of the expansion of the muscles of the uterine cervix.

With trichomoniasis in women, depending on the duration of the development of the pathology and the signs that appear during this period, three forms of infection are determined:

• Trichomoniasis is primary, which is also divided into several groups - acute, subacute and asymptomatic.
• Chronic trichomoniasis, in which subtle clinical manifestations are observed, and the duration of the disease is two or more months.
• Trichomonas carriage, which is characterized by an asymptomatic course. As for Trichomonas, they are found in whites.

The main danger in the development of infection is the possibility of damage to the mucous layers. urinary organs, which threatens the formation of HIV. At the same time, there is an increase in the acidity of the vaginal secretion.

Symptoms of the disease

Having considered the causes, let's talk about the symptoms of trichomoniasis in women. After Trichomonas enters the body, it lasts for 5-20 days incubation period, sometimes the first signs of a problem appear later. At this stage, pathogens are just beginning their reproduction, without damaging the mucous layer too much in the process, the pathology is able to develop without discomfort.

Often, the first signs of trichomoniasis in women appear only during menstruation, in addition, the symptoms can largely mimic a fungal infection of the vagina. The first thing affected by trichomoniasis is the vaginal mucosa, the inner lining of the urethra along with the bladder. Not so often pathological processes affect excretory ducts, located near the entrance to the vagina, whose function is to secrete a secret that reduces friction during sexual contact.

When identifying and evaluating symptoms for prescribing treatment for trichomoniasis in women, consideration should be given to age group to which the victim belongs.

Mostly the disease is diagnosed in women aged 18-45 - this is reproductive age, and it is at this stage that active sex life. Pathology can develop during menopause, when carrying a child, the symptoms of trichomoniasis in women may differ slightly. Most often, representatives of the weaker sex are diagnosed with vaginitis, it is also trichomonas colpitis - the disease is an inflammatory process occurring in the upper layers of the vaginal mucosa.

With the development of acute vaginitis among the first symptoms of trichomoniasis in women:

• Unbearable itching and burning sensation not only in the vagina, but also in the area of ​​the labia. Itching occurs against the background of the irritating effect of pathological microorganisms and the appearance of a foamy secret.
• In the perineum, on the labia, due to itching, redness and scratching appear on the skin.
• This pathology is characterized by frothy whites with an unpleasant odor. The amount of secretion secreted depends on the stage of development of the disease. In an acute course that continues to progress, the secret can be profuse, colored in yellow. In the chronic form, scanty discharge may be gray in color. Allocations in trichomoniasis become abundant and foamy in case of attachment to the pathological processes of vital activity of special bacteria capable of releasing gas.

If trichomonas in women develops with high immunity, it can proceed chronically, in a latent form. In this case, the symptoms of trichomoniasis may be subtle, often some of the characteristic signs - and sometimes all - are absent. Inflammatory processes also do not manifest themselves clearly enough. In the chronic course of the disease, exacerbations occur - usually this phenomenon occurs before the start of the next menstrual cycle, which is associated with a low level of estrogen. These hormones not only help to renew the cells of the vaginal mucosa, but also acidify internal environment organ.

Pathology in menopause and childbearing

During menopause, the manifestation of pathology is not too rare, because with a lack of estrogen, the vaginal walls become thinner and the functionality of the organ decreases. Accordingly, there is a violation of microflora, immunity worsens, excellent conditions are created for the development of numerous pathogenic microorganisms. Signs of trichomoniasis in women in this case are as follows:

• In anticipation of the vagina, itching appears, urinating is not only unpleasant, but also quite painful.
• Purulent-mucous discharge is observed, in which bloody streaks may be present.
• In some cases, there may be some bleeding after intercourse.

Usually, with the development of the pathology under consideration, inflammatory processes take place at the level of the reproductive system, respectively, during pregnancy, the disease has a negative effect on its course. Among the complications that can cause trichomoniasis, premature labor and spontaneous miscarriage. Such a danger arises against the background of inflammatory changes caused by the release of special substances into the blood - prostaglandins, which provoke an increased contraction of the muscles of the uterus. Accordingly, the risk of expulsion of the fetus from the uterine cavity increases.

But this is not the only danger that occurs in the female body during pregnancy. For a woman during childbirth or in the process of abortion, the risk of the spread of infectious processes to internal organs reproductive system - uterus, fallopian tubes, ovaries. It has already been said above that Trichomonas often "absorb" pathological microorganisms, therefore, in the case of the development of vaginitis during pregnancy, the threat of complications when the infection passes to the higher parts of the reproductive system looks quite real.

Against the background of the development of a chronic form of pathology, temporary infertility can form.

In the process labor activity In some cases, the disease can be passed from mother to child. In order for Trichomonas to grow and develop, they need glycogen - this substance is produced by Dederlein sticks, in other words, lactobacilli. A certain amount of estrogen is also required, their function is to ensure the normal functioning of the rods. Both rods and a small amount of estrogen are transferred to the baby who was born, which ensures the creation of a favorable environment for the formation of Trichomonas. It is reassuring that by the third or fourth week, the level of estrogen decreases, against which the Dederlein sticks disappear. So even if Trichomonas enters the child's vagina, their development is impossible. However, during puberty, estrogens and progesterone are actively produced by the teenage body, which creates favorable environment for the reproduction of lactobacilli and increases the risk of infection with the pathology in question.

Other forms of pathology and associated dangers

There are a number of other dangers, including disorders that affect the central nervous system. flowing into inner layers inflammatory processes, the formation of purulent secondary infections, pathological abundant vaginal discharge also negatively affects sexual life due to painful intercourse. With a prolonged chronic course of the disease, women may experience the appearance of frigidity, which causes not only physical discomfort, but also a negative emotional state.

• The penetration of pathogens into the vaginal cavity.
• If the victim is not treated, the pathological process passes into the urethra, then into the bladder area.
• Signs of trichomonas urethritis develop, which include soreness and burning during urination, a purulent-mucous substance with an unpleasant odor is released from the urethra.

• Feeling of incomplete emptying of the bladder.
• Difficulties in the appearance of urine - it can stand out almost drop by drop.

Gradually, such signs disappear, the excreted secret becomes mucous, the course of the process passes into the chronic stage.

Diagnosis of the disease

Before engaging in the selection of drugs in the treatment of trichomonas in women, it is necessary to diagnose the pathology. The difficulty lies in frequent absence characteristic or obvious signs. In order for the therapy to be timely and the treatment adequate, there is no need to wait until the undoubted signs of a problem appear, you should regularly visit a gynecologist, especially in the case of frequent changes of partners. The presence of the disease is determined by examining the victim on the gynecologist's chair and using laboratory tests:

• When viewed on a chair, the attending physician determines the irritation of the mucous membrane of the vaginal layer, accompanied by a characteristic reddish tint.
• There may be ulceration of the mucous layers on the genitals, an increase in their fullness with blood.
• Due to inflammatory processes in the vagina, local hyperthermia may become apparent.
• When selecting a vaginal smear, its light examination is carried out, in which the use of a microscope allows you to track moving microorganisms. Trichomonas can be detected in a smear for 15 minutes after the selection of the material.
• Bacterial culture is necessary if the disease is a sluggish or asymptomatic process. The selected samples are placed in specially created favorable conditions. This method does not cause particularly unpleasant sensations, but its disadvantage is the length of the period during which the infectious agent will grow.
• A vaginal colposcopy may be done, which will need to look at dilated capillaries. When pressed, they break.
• The most reliable method is PCR; during the polymerase chain reaction, a sensitivity of 84% is achieved, which makes it possible to detect the presence of the genetic material of the infectious agent.
• When conducting a laboratory study of a pathological secret, an increase in the level of alkali is observed. In its natural state, the vagina is acidic.

In cases where there are other infections or vaginal dysbiosis when infected with Trichomonas, additional research. Only when the existing symptoms are fully identified, the doctor will be able to decide on therapy.

Traditional treatment of the disease

• It will be necessary to conduct simultaneous therapy for both the lady and her partner.
• When treating trichomoniasis in women, it is necessary to warn the victims about the inadmissibility of any sexual contact.
• Therapy of pathology should be carried out against the background of strict observance of personal hygiene.
• The genitals should not only be kept clean, but antiseptics should also be used for this purpose - a weak manganese solution or furatsilin along with detergents, in other words, toilet soap.
• When washing away, they observe a certain direction of movement - from the vagina towards the anus, which is necessary to eliminate the risk of infection being transferred to the urethra.
• Toiletries are used individually, no exchange of soap, bath towels or washcloths.
• Change underwear every day.
• It must be remembered that symptoms and treatment are closely related - if there are signs indicating the development of other infectious and inflammatory pathologies in the genitourinary system, their mandatory therapy should be started.

As for how to treat trichomoniasis in women, the most effective remedies are Tinidazole (500 mg) or Metronidazole (250 mg). The duration of their use will be up to two weeks, the first dose includes 1 tablet, it should be taken three times throughout the day. Further reception is carried out in the morning and evening hours. For local sanitation, candles are used, in particular, the Macmirror complex. The introduction of candles is carried out before going to bed and after an intimate toilet. The duration of therapy reaches a week.

What other tablets will provide treatment for trichomoniasis? To carry out high-quality prevention of infectious infection of the urinary tract, Nalidixic acid is added to the preparations. The duration of treatment can be up to 7 days. You need to take a multivitamin. It should be remembered that self-medication is inadmissible in order to avoid various kinds complications. When taking antitrichomonas substances, treatment will be carried out subject to a number of conditions:

• Within a few months after the treatment, it will be necessary to regularly take smears from the urethra and vagina for examination.
• Smears should be taken 1-3 days after menstruation.

When trichomoniasis occurs in women, the gynecologist determines how to treat the pathology, although in some situations an examination by a venereologist may be required, and if necessary, treatment of concomitant inflammatory processes is prescribed by a urologist.

Using traditional medicine recipes

Before you start using herbal medicines, you should remember a few rules:

• Traditional medicine, for all its effectiveness, cannot be an independent method of treatment, it is recommended to use it as additional remedy to increase the effectiveness of traditional therapy.
• Before using any prescription, you should discuss this possibility with your doctor.
• It is required to take into account the possibility of an allergic reaction to the components of the funds.
• Need to study possible contraindications before using decoctions and infusions.

• To get a therapeutic effect, you need to use garlic by squeezing the juice from several of its cloves. The product should be drunk in half a small spoonful in the morning, afternoon and evening, while a fresh portion of juice is squeezed out before each procedure. The duration of such treatment is a month, while it is necessary to take into account the irritating effect of garlic on the stomach, respectively, each dose is carried out in the process of eating.
• Aloe belongs to the universal medicines. For the treatment of trichomoniasis, juice is squeezed from one leaf, which is then drunk in a small spoon three times a day. After that, at least half an hour should pass before eating. The duration of treatment is selected individually.
• To prepare a medicine from chamomile, five large spoons of the crushed component are brewed in 400 ml of boiled liquid and kept under the lid for two hours, wrapping the container in a warm cloth. Then the drink is filtered and taken in the morning and evening hours. The volume of each serving should be 120 ml.
• Aloe leaves can be used to make tampons before going to bed. It is done like this - juice is squeezed out of aloe, in which the bandage is then soaked. Then it is rolled up and inserted overnight into the vagina. The duration of treatment is a month, then a ten-day break is necessary, after which, if necessary, the course is repeated.
• From trichomoniasis, a collection based on eucalyptus helps well. You should mix four large spoons of dry leaves of the plant, add the same amount of tansy flowers, two spoons of dry yarrow grass, three small spoons of sophora fruits. After mixing the components, a large spoonful of the mixture is brewed in 250 ml of boiling water and infused for another 25 minutes. After the remedy is filtered, it should be taken before meals three times a day. The volume of each serving is two large spoons. The duration of treatment is three weeks.
• You can use an infusion of calendula color, which has a powerful antimicrobial effect. To prepare the product, 60 grams of color is poured into 250 ml of medical alcohol and the liquid is infused for two weeks in the dark, shaking the container daily. After the end of the period, the drug is filtered, it should be taken half an hour before meals, one serving is two large spoons. The duration of treatment reaches two and a half weeks, after which they arrange a ten-day break and after it the course is resumed, if necessary.

This is not a complete list of recipes, you can find them on almost any medical site. But the main thing is to remember the rules and follow the dosages and methods of using such drugs.

It is not enough to know how to cure trichomoniasis in women, it is necessary to nullify the possibility of infection with this pathology. To this end, experts recommend adhering to the following treatment recommendations:

• It is required to give up numerous casual sexual contacts.
• You should use contraception using a condom, which is especially important if you have a new sexual partner.
• Must be adhered to justifiably strict rules intimate hygiene.
• Partners will be required to pass a control analysis twice during the year.

When the first symptoms of trichomoniasis appear, you should immediately contact a specialist, preventing the transition of the pathology into a chronic form. If the woman has been treated for the disease in question, her partner also needs therapy, otherwise the treatment may be pointless.

Trichomoniasis is an infection sexually transmitted(STI), formerly known as "venereal disease".

According to the World Health Organization (WHO), every year more than 200 million people are affected by trichomoniasis. In the structure of the entire pathology of the genitourinary system, this disease is in first place, and is also the most common sexually transmitted infection.

Trichomonas infection is present in 30-70% of the total female population, and almost half of the patients have characteristic symptoms of the disease are absent or mild.

The prevalence of trichomoniasis in men has been studied worse due to the fairly frequent asymptomatic course of the disease and the development of trichomonas carriers. According to some reports, more than 10% infectious pathology in men it is trichomoniasis.

The incubation period for trichomoniasis ranges from several days to one month or more. On average - 7-10 days.

THE REASONS

In nature, there are more than 50 species of Trichomonas. However pathogenic properties only Trichomonas vaginalis (Trichomonas vaginalis) has it. The remaining species, living mainly in open water, do not pose a danger to humans.

• Sexual. In the vast majority of cases, infection with trichomoniasis occurs precisely through unprotected sexual contact.
• Domestic. It is extremely rare. Basically, this route of transmission is implemented when the basic rules of personal hygiene are not observed (using one towel, washcloth, linen with a sick person).

CLASSIFICATION

The most common clinical classification of trichomoniasis is the division of the disease into clinical forms, given its duration and severity of the inflammatory response.

Forms of trichomoniasis:

• Fresh - up to two months.
• Chronic. It is characterized, as a rule, by a torpid course lasting more than two months.
• Carriage of Trichomonas infection. In the laboratory detection of Trichomonas, there are no clinical symptoms diseases.

Types of the course of a fresh form of trichomoniasis:

• Spicy.
• Subacute.
• Torpid or asymptomatic.

SYMPTOMS

The manifestations of the acute course of trichomoniasis are quite specific, especially in women.

Symptoms of trichomoniasis in women:

• The appearance of abundant vaginal discharge yellowish-green in color, having a liquid consistency.
• Often these discharges have a frothy appearance and are accompanied by an unpleasant odor.
• In most cases, severe discomfort, burning, intense itching appear in the vulva.
• Often dysuric manifestations - pain or burning during and after urination.
• Often there is pain during sexual intercourse.
• Also, pain can occur in the lower abdomen and lower back, especially when the infectious process spreads to the upper genital tract.

When the disease passes into a subacute or chronic form, the amount of discharge decreases markedly, they acquire a whitish color. Exacerbation of chronic pathological process provokes menstruation, alcohol intake, spicy dishes. The menstrual cycle is often disturbed, infertility occurs.

In men, in the vast majority of cases, this pathology is asymptomatic or with mild manifestations.

Common symptoms of trichomoniasis in men are dysuric manifestations and discharge of clear or whitish drops from the urethra, especially in the morning. Sometimes there is redness and swelling of the external opening of the urethra.

DIAGNOSTICS

Diagnosis of trichomoniasis should begin with the collection of anamnesis and patient complaints. A history of unprotected sexual intercourse, combined with typical complaints, makes it possible to suspect a sexually transmitted infection.

Methods of examination for trichomoniasis:

• Gynecological examination. Allows you to identify a sharp hyperemia and swelling of the mucosa of the vulva, vagina and often the cervix. In the vaginal vaults, an accumulation of typical secretions is detected, which often oozes from the vagina and has irritant effect on the skin of the perineum.
• Colposcopy. When conducting this study, a specific symptom of trichomoniasis is often revealed - a "strawberry" (or "strawberry") cervix. The mucous membrane of this organ and the vagina is covered with multiple small hemorrhages, which makes them look like this berry. Also, with the help of colposcopy, true erosions and other inflammatory and destructive lesions of the cervix and vagina are revealed.
• Examination in men is usually uninformative.
• With the defeat of Trichomonas infection of the internal genital organs, structures urinary system Various additional diagnostic methods are used: ultrasound scan, cystoscopy, etc.

The diagnosis must be confirmed by laboratory.

Laboratory methods for detecting trichomoniasis:

• microscopic examination specially stained or native smears from posterior fornix vagina, cervix, urethra and rectum. Used mainly in women. When using this diagnostic method in men, a false negative result is often formed.
• Cultural method. Material from the vagina and cervix in women is examined, and in men - discharge from the urethra, urine and semen. The disadvantage of the method is the duration and complexity of execution.
• Serological methods eg, immunofluorescence reaction, complement fixation, direct hemagglutination. The latex agglutination reaction is often used to determine the chronic form of the disease and Trichomonas carriers.
• Polymerase chain reaction (PCR). Modern Method to detect all forms of trichomoniasis.

To detect trichomoniasis, usually comprehensive laboratory research . This is especially true for the diagnosis of latent forms and carriage of infection.

TREATMENT

In the process of treating the disease, several mandatory principles should be followed in order to increase the chances of a successful cure.

Principles of treatment of trichomoniasis:

• Antitrichomonas therapy is subject to absolutely all cases of detection of Trichomonas vaginalis, regardless of clinical manifestations.
• Treatment of trichomoniasis is also mandatory for the sexual partner of the patient, even if he did not have trichomonas during the examination.
• For the period of treatment, sexual activity is prohibited.
• For the treatment of trichomoniasis, drugs of the 5-nitroimidazole group are used for complex systemic and local use. The type and dosage of the drug is prescribed individually.
• Monitoring the effectiveness of treatment is carried out after 10-14 days and is repeated for two to three menstrual cycles in women.
• When diagnosing trichomoniasis during pregnancy, treatment is usually carried out starting from the second trimester.

Unfortunately, approximately in 1-5% of cases, treatment is ineffective. This, in all likelihood, is associated with the development of resistance of the causative agent of trichomoniasis to a particular type of drug. In this case, with the exclusion of other factors (for example, the absence or insufficient treatment sexual partner), therapy with another drug of the 5-nitroimidazole group is prescribed.

COMPLICATIONS

Untimely detection and treatment of trichomoniasis often leads to quite serious consequences.

Complications of the course of trichomoniasis:

• Acute or chronic inflammatory lesions of the genital area in women and men: salpingo-oophoritis, urethritis, prostatitis, etc. This is due to the fact that Trichomonas contribute to the transmission and transport of gonococci, ureaplasmas, chlamydia and other pathogenic microorganisms.
• During pregnancy, the risk of miscarriage, premature birth, infection of the fetus, and the development of purulent-septic complications of the postpartum period increase.
• Male and female infertility.
• Increased risk of contracting other sexually transmitted infections. It has been proven that the presence of trichomoniasis in women doubles the risk of infection with herpes viruses of the second type and human papillomavirus infection, as well as HIV.

PREVENTION

To prevent infection with trichomoniasis, it is necessary avoid casual sex and apply reliable barrier methods contraception such as condoms.

It is also necessary to strictly observe the basic rules of personal hygiene.

PROGNOSIS FOR RECOVERY

With early detection and proper treatment diseases the prognosis for recovery is favorable. After curing trichomoniasis persistent specific immunity absent, so the chance of re-infection is very high.

In the chronic course of the disease and the presence of complications, the prognosis is less favorable due to the development of structural changes in the organs of the female genital area.

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