What Cause Trichomonas Infection Treatment

What is a trichomonas infection?

An infection with trichomonads, also called trichomoniasis, is one of the most common sexually transmitted diseases (STD = sexual transmitted diseases). This is a parasitic infection especially in women.
Even if the infection asymptomatic in most cases typical symptoms, such as an unpleasant green-yellowish discharge, can occur.
The suspicion of an infection can be assumed based on the patient's medical history and confirmed by special tests.
The therapy takes place with an antibiotic, whereby the partner should always be treated as well.

Learn more aboutVenereal diseases.

Causes of Trichomoniasis

Trichomoniasis is the most common with 170 million people affected annually most common worldwidesexually transmitted disease (STD = sexually transmitted diseas). It is relatively rare in Germany, and patients in Germany are often infected through it foreign sex partners on holiday.
The pathogen is a pear-shaped protozoa named Trichomonas vaginalis. It is a parasite that can survive mainly in semen or vaginal secretions. So it comes during sexual intercourse to a direct transmission from one partner to the other. Often, however, it is not solely responsible for the infection, but leads to a so-called mixed infection with other bacteria.
In very rare In cases it can also lead to a indirect transmission come, for example when bathing in the swimming pool or on the toilet. Since in most cases the infection runs without symptoms for months to years, those affected often do not know that they are sick and unknowingly pass the parasites on if they have unprotected sexual intercourse. Often changing sex partners increase the risk of infection.

Transmission path

In most cases, the transfer is direct from host to host during unprotected sexual intercourse. Since the parasite lives in the semen or vaginal mucus, it can switch from one partner to the other through these fluids.
The acidic and moist environment in the vagina offers the parasite a good living space, while outside the body it cannot survive for long. The parasite can then stay in the female sexual organs via the vagina, but it preferably remains in the vagina. In men, it nests in most cases in the urethra, the prostate or the penile foreskin.


When making a diagnosis, the anamnese the most important role. If the patient speaks of frequently changing sexual partners or green-yellowish discharge after sexual intercourse abroad or with a foreign partner, the doctor can usually suspect a sexually transmitted disease. Because trichomoniasis is a common STD and the discharge is typical, this infection is quickly considered.
A smear the vaginal wall in women or the urethra in men, which is examined under the microscope. This then shows a so-called flagellate with flagellates. The diagnosis is thus secured. Even so, other sexually transmitted diseases such as chlamydia, syphilis, and gonorrhea should be excluded.

incubation period

From the infection to the onset of symptoms, it can vary between 5 days to 3 weeks last. In most cases (approx. 80%) do, however no symptoms where the parasite can survive in the host for months to years. In men in particular, the course is usually asymptomatic.

A trichomonas infection can be recognized by these symptoms

With the man the infection proceeds in most cases with no symptoms. In very rare cases it can lead to inflammation in the areas where the trichomonads have lodged, i.e. in the area of ​​the prostate or the urethra, what with Painful urination and itching can go hand in hand.
With the woman the infection usually leads to inflammation of the vaginal wall (Vaginitis) with one for the disease typical punctiform redness. One then speaks of a so-called "strawberry cervix", which can only be discovered through an examination by the gynecologist. The inflammation can be too Pain when urinating, burning sensation and itching to lead. Also Painful intercourse can occur. Also typical of the infection is a foul-smelling, green-yellowish discharge (fluorine) from the vagina, which strongly resembles the smell of rotten fish. If the inflammation continues upwards, it can also affect the uterus or fallopian tubes. In rare cases, infertility can also prevail during the infection.

Treatment / therapy

Treatment of an infection caused by trichomonads is primarily by means of a Antibiotic therapy. The antibiotic of choice is here Metronidazole, which is usually administered orally twice a day for 7-10 days or, in the case of severe infections, systemically, i.e. via the blood. The dosage requires the expert decision of a doctor.
In addition, it is important to treat the partner as well, even if he does not show any symptoms. As described above, an infection can often be asymptomatic. However, the parasite can survive unnoticed in the body for months to years and renewed sexual contact can lead to further transmission and infection. One speaks of the so-called Ping pong effectit too prevent applies. Sexual intercourse should be avoided during treatment.
After a week, well after the end of therapy, can be a Control smear to ensure that there are no more trichomonads living in the genital area.

Over-the-counter drugs

Metronidazole as an oral antibiotic not prescription-free in Germany but requires the doctor to issue a prescription. This is due to the numerous side effects and the fight against resistance through the use of antibiotics.
However, there are few drugs that contain the active ingredient in small amounts. These are drugs that come in the form of a Ointment or one Vaginal suppository can be used in women for local application in the vagina. A distinction is made between the drugs Eubiolac Verla, a vaginal suppository with the active ingredient "lactic acid", and Evazol and Fluomizin, a cream or a suppository with the active ingredient "Dequalinium".
However, they cannot replace intensive antibiotic therapy with metronidazole. A doctor or pharmacist should be consulted before taking such preparations.

What is the best antibiotic?

The antibiotic of choice for trichominiasis is Metronidazole, an antibiotic from the nitroimidazole group. It is mainly used in anaerobic bacteria and protozoa. It leads to DNA breaks in the pathogen's genes.
In trichomoniasis, it is usually used orally for 7-10 days with a dosage of 400mg twice a day. Alternatively, you can also take 2g once a day. However, the decision on the correct dosage rests with the attending physician.
Metronidazole has a good success rate in treating trichomonas infection. Like all antibiotics, however, it leads to some side effects, such as: diarrhea, headache, itching. But these are usually rare.

Long term consequences

The forecast a trichomonads infection usually very good. Antibiotic treatment is successful in most cases; only in rare cases are the check-ups still positive, so that the therapy has to be carried out over a longer period of time. There are, however no immunity after an infection, which means you can be infected again several times.
Although rare, complications of trichomonas infection are one ascending infection in the upper genital organs. An inflammation occurring there can lead to adhesions in the area of ​​the fallopian tubes and thus to the infertility to lead. In addition, trichomoniasis can die Infection with other bacteria or fungi favor. During pregnancy, a Transferring infection to the newborn and have serious consequences.
With a man, the Spread infection to surrounding organs and lead, for example, to inflammation of the prostate or epididymis.
However, the risk of chronic infection or infertility is very rare and usually only occurs if there has been no treatment for many years.

Trichomonas infection in pregnancy

Infection with trichomonads during pregnancy is not without risk.
For one thing, infection can do that Risk of premature birth, premature rupture of the bladder and a low birth weight increase. This can have far-reaching consequences for the child's life.
Second, the parasite can transmitted to the newborn at birth will and cause inflammation in the child. It often leads to inflammation in the vagina area, especially in female children.
Oral administration of metronidazole during pregnancy is contraindicated in the first trimester. You therefore tend to limit yourself to a local treatment or switch to another antibiotic, such as clotrimazole or amoxicillin. From the 2nd trimester, however, oral therapy is harmless, so that normal oral antibiotic therapy should be continued for 7 days.

Additional information

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Quality assurance by: Dr. Nicolas Gumpert | Last change: 03.04.2021