Trichomonal vaginitis is a vaginal infection caused by the protozoa Trichomonas vaginalis.
Trichomonal vaginitis is usually sexually transmitted.
It can cause a green or yellow discharge, which may be profuse, smell fishy, and be accompanied by itching or irritation.
If symptoms suggest a vaginal infection, doctors examine a sample of the discharge and/or fluid from the cervix and test it for infectious organisms that can cause infection.
Always using a condom during sexual activity can help prevent this infection.
(See also Overview of Vaginal Infections.)
Protozoa are a type of parasite. The protozoa Trichomonas vaginalis can cause symptoms soon after they enter the vagina, or the protozoa can remain in the vagina or on the cervix (the lower part of the uterus that opens into the vagina) for weeks or months without causing any symptoms. The bladder may also be infected. In men, the protozoa usually cause no symptoms and may remain in the urinary tract for a few days or weeks without causing symptoms. Thus, women and men may be unaware that they are infecting their sex partners.
Causes of Trichomonal Vaginitis
Genital infections with Trichomonas (trichomoniasis) are almost always sexually transmitted. Women can be infected through sexual contact with men or women. But men can be infected through sexual contact only with women, not with men. Many people who have this infection also have gonorrhea or another sexually transmitted infection.
Because the protozoa can remain in women for a long time without causing symptoms, determining when the infection was acquired and thus from whom can be difficult or impossible.
Trichomoniasis may occur in children. If it does, the cause may be sexual abuse.
Symptoms of Trichomonal Vaginitis
Women with trichomonal vaginitis may have a green or yellow vaginal discharge that is sometimes frothy, profuse, or both. It may smell fishy. The genital area may itch, and the vagina may be red and tender (irritated). As a result, sexual intercourse may be painful. Urination may also be painful if the bladder becomes infected.
The infection can lead to pelvic inflammatory disease and, in pregnant women, preterm labor and delivery.
Diagnosis of Trichomonal Vaginitis
A doctor's evaluation
Examination of a sample of the discharge and/or fluid from the cervix
If girls or women have a vaginal discharge that is unusual or that lasts for more than a few days or have other vaginal symptoms, they should see a doctor.
Doctors suspect trichomonal vaginitis based on symptoms, such as a green or yellow frothy discharge. They then ask questions about the discharge, other symptoms, and possible causes (such as sexually transmitted infections).
To confirm the diagnosis, doctors do a pelvic examination. While examining the vagina, the doctor takes a sample of the discharge with a cotton-tipped swab. The sample is examined under a microscope. With information from this examination, the doctor can often identify the cause of the symptoms.
Usually, the doctor also uses a swab to take a sample of fluid from the cervix to test for other sexually transmitted infections.
If children have trichomonal vaginitis, doctors evaluate them to determine whether sexual abuse could be the cause.
Treatment of Trichomonal Vaginitis
During sexual intercourse, condoms should be used until the infection resolves to help prevent transmission of the infection.
Prevention of Trichomonal Vaginitis
Always using a condom correctly during oral, anal, and genital sex can help prevent this infection from being transmitted. However, Trichomonas vaginalis protozoa can infect areas that are not covered by a condom. So condoms do not fully protect people from being infected.
The following general measures can also help prevent trichomonal vaginitis:
Decreased risk of exposure to STIs by using safer sex practices (limiting the number of sex partners, not having high-risk sex partners [people with many sex partners or who do not practice safer sex]) or practicing mutual monogamy or abstinence
Prompt diagnosis and treatment of the infection (to prevent spread to other people)
Identification of the sexual contacts of infected people, followed by counseling or treatment of these contacts
