Treatment regimen for chronic trichomoniasis. Who are Trichomonas, types of Trichomonas

Trichomoniasis) is the most common disease not only in our country, but throughout the world, which is sexually transmitted. According to statistics, about 10% of the world's population is infected with trichomoniasis. Every year, approximately two hundred million people are infected and treated with it, and most of of them are women.

What is this disease?

Trichomoniasis belongs to a number of inflammatory diseases genitourinary system. Its manifestation is provoked by a single-celled protozoan, which adapts very well to the conditions of the body and even to some medical drugs, but under the influence external environment dies very quickly.

Stages of development

The dynamics of the formation of this pathology have been clarified a long time ago. The scientists who conducted the research divided the microscopic picture of the course of the disease into three main periods:

Let us consider in more detail what each stage of the disease is, and what changes occur in the body of a person infected with Trichomonas.

initial stage

It is extremely rare. All of the following abnormalities in the smear indicate that inflammation of the genitourinary system is progressing in the patient’s body.

• The number of Trichomonas (the causative agents of the disease) is increasing.
• The number of rods and Doderlein epithelial cells decreases.
• The number of leukocytes in the blood increases.
• There is almost no foreign flora.

Trichomonas culminating

It appears quite often and is characterized by:

• Purulent discharge with a huge content of trichomonas, leukocytes and foreign flora.
• The Doderlein bacillus disappears completely, although epithelial cells are present, but in small quantities.
• The discharge is liquid, with gas bubbles, yellowish-green in color, and has a putrid odor.

This process in the body can last from several weeks to several months, sometimes even years. In the absence of proper treatment, it becomes chronic.

Chronic Trichomonas

At this stage of disease development, the following changes occur:

Treatment of Trichomonas in this case is extremely necessary, otherwise the disease may become latent.

Pathogen

For normal life, the microorganism needs moisture; in a dry environment it dies instantly. In favorable conditions, Trichomonas can live for about three hours: either in the pool or on the surface of the toilet. Moreover, the microorganism is able to survive and thrive at an air temperature of +40 degrees Celsius. It easily tolerates the effects of antiseptics and survives even in scorching solar radiation.

There are the following types of Trichomonas:

• intestinal;
• vaginal;
• oral.

Treatment for Trichomonas is prescribed by a doctor, taking into account the type of pathogen and the stage of development of the disease.

Symptoms of Trichomonas in women

Destruction of the mucous membrane in the vagina with further spread to the urethra and bladder - this is how Trichomonas is formed in women. Symptoms, treatment, timely diagnosis diseases are the main components successful therapy. Incubation period lasts from three days to one month, while the woman may not feel anything.

An examination by a gynecologist is the main and surest way to prevent and timely diagnose the disease, especially after accidental sexual contact.

The main symptoms of female Trichomonas:

• Possible redness of the genitals or perineum with or without swelling. When diagnosed, severe irritation of the vaginal walls may develop, sometimes accompanied by bleeding. The mucosal surface may be granular with the appearance of condylomas.
• Strong foamy, yellowish-green and very acrid discharge, sometimes with traces of blood. During this period, Trichomonas intensively produces carbon dioxide, so the discharge foams.
• Frequent urge to urinate. Colic when going to the toilet indicates damage to the urethra by Trichomonas.
• Pulling painful sensations in the lower abdomen or back.
• Itching and burning of the outer labia.
• Pain during intimacy.
• With advanced disease, swelling of the labia is possible.

The main symptoms of Trichomonas in men

What is characteristic of Trichomonas in men? Symptoms, treatment and prevention of the disease will be discussed below. Male trichomoniasis is characterized by damage to the urethra by the pathogen, and less commonly, the prostate. Already on the second day after sexual contact with a sick partner, Trichomonas can be detected in 70% of men. After a week, it may still be present in only 30% of infected patients. This is due to the fact that the environment in urinary canals men are unfavorable for this microorganism, which leads to rapid death.

The symptoms and treatment of Trichomonas in men are identical to the female form of the disease. Signs may appear only during exacerbations. When the disease becomes chronic, the microorganism penetrates through the urethra and enters the prostate. As a result, the inflammatory process begins to develop rapidly.

Symptoms:

• Urination becomes difficult.
• Urine is released drop by drop.
• Constant feeling of incomplete release of the bladder.

As you can see, the signs of a disease such as Trichomonas in men look somewhat different. We will consider the symptoms and treatment of this pathology further.

How to treat?

What helps fight the spread of Trichomonas? Treatment. Reviews from doctors indicate that timely appeal Seeking medical help allows you to quickly and effectively get rid of the infection. Here's what the experts say:

To achieve results and completely get rid of a disease such as Trichomonas, a course of treatment medications need to go through completely. The main thing is not to miss a single dose of the prescribed drug.

Treatment of Trichomonas in men has some features. The patient must undergo a course of antiprotozoal therapy - this is the doctor's prescription of the drug "Imidazole". It must be taken orally or administered by injection.

How is the disease transmitted?

The most common way of transmitting the disease is sexual contact in all its variants:

Transmission of the disease occurs through the mixing of fluids: sperm, blood, saliva. Even kissing can be a way for a sick person to transmit infection to a healthy person. Considering the fact that a microorganism is able to live for several hours in external and favorable conditions for it, the source of charging can be:

• toilet lid in restrooms;
• swimwear;
• bathrobes and so on.

The effect of the disease on the female body

Treatment of Trichomonas is a mandatory procedure for any woman, since this disease can provoke the formation of more serious diseases:

• Chronic inflammatory processes of the genitourinary system.
• Disorders of the menstrual cycle and sexual life.
• The waste products of the pathogen have a toxic effect on almost all tissues of the female body.

Impact of the disease on men

The damage to the health of a representative of the stronger sex that Trichomonas can cause is very great. The most dangerous outcome is infertility. This is explained by the fact that sperm motility completely changes in a man’s body. And this significantly affects both the ability to conceive and family life generally.

Treatment of Trichomonas folk remedies or medications is carried out effectively and efficiently. The infection responds well to therapeutic measures, so getting rid of the disease is possible and necessary.

Prevention

• Careful observance of personal sexual hygiene.
• Timely treatment of diseases that weaken the body.

Casual sexual intercourse and drinking strong drinks before intimacy are extremely undesirable. Remember, alcohol is a powerful catalyst.

But swimming in ponds and baths, on the contrary, is encouraged - it is very effective traditional treatment. It is very easy to destroy Trichomonas in this way, since it dies very quickly in water.

Decoction baths are very effective medicinal herbs. Such procedures are prescribed for preventive purposes, as well as when identifying an infection such as Trichomonas. Treatment at home with sitz baths or douching helps relieve vaginal inflammation caused by the disease. This is a good and effective way to help the body cope with the consequences.

Advice: use traditional methods of prevention more often; with their help you can protect yourself from many diseases. Trichomonas is treatable, and you can get rid of it once and for all. It is very important to identify this disease in time and urgently take the necessary measures to get rid of the harmful microorganism. And for this it is necessary to regularly conduct examinations and examinations in medical institutions.

Summarizing

We hope that our article clearly explained to readers what Trichomonas is, how it is formed and transmitted, by what signs it can be recognized, and how to deal with this disease. Beware of casual sexual contact, maintain personal hygiene and regularly visit your doctor - this is the most effective prevention of Trichomonas. Remember, no one will take care of your health better than you.

– a disease that occupies a leading position among many STDs. According to statistical calculations, women suffer from this disease many times more often than gonorrhea or syphilis.

The source of infection is protozoa. The inflammatory process begins on the vaginal mucosa. This disease is the cause of many diseases of the genitourinary system.

Treatment of trichomoniasis in women should be carried out by a qualified specialist. Since immunity to this disease is not developed, infection can occur at any time.

If you leave this problem without any attention and do not carry out the necessary course of treatment, then complications and chronic diseases cannot be avoided.

Trichomonas vaginalis is mobile, due to this it can penetrate the urethra, causing inflammation. Microorganisms die when exposed to direct sunlight, heating and drying. In the absence of a favorable environment, they can remain viable for several hours.

Infection most often occurs through sexual contact; to obtain infection in another way, you must regularly neglect all the rules of personal hygiene.

It can take quite a long time from the moment you receive the infection until the first signs appear, up to 1-2 months. Most often they begin to appear already on the 10th day.

Sometimes, any changes and discomfort do not torment a woman at all. She is only a carrier of the disease and can infect sexual partners.

However, women are quite rare carriers.

Sometimes people find out about such an illness only after a planned medical examination. And while the woman did not know about it, she could infect other people.

This once again proves the importance regular checkups at the gynecologist, especially with an active sexual life.

When the disease begins to develop, the following symptoms are observed:

• Yellow or green discharge, which also has an unpleasant odor. Foam forms, this is what you should pay attention to, because this symptom will be a characteristic difference;
• Feeling of itching and discomfort on the external genitalia;
• Pain and cutting sensations when urinating;
• Frequent urination;
• Redness of the vestibule of the vagina, sometimes swelling appears;
• Sexual intercourse is painful;
• Mild pain in the lower abdomen.

How to treat trichomoniasis in women and what the duration of therapy will be determined only by the attending physician, There is no point in trying to solve the problem on your own. This is fraught with terrifying consequences and protracted course diseases.

Diagnosis of trichomoniasis

Before starting treatment, it is necessary to carry out diagnosis of the disease. The gynecologist uses the following methods to conduct the study:

1. Questioning the patient to find out about the presence of previous diseases of the genitourinary system, about possible diseases sexual partner;
2. Initial examination of the external genitalia to determine the presence of redness or swelling;
3. Inspection using a special gynecological speculum to carefully examine the condition of the walls of the vagina and cervix;
4. Bimanual examination of the appendages and uterus.

Indications for testing:

• acute inflammation and chronic infections genitourinary system;
• spontaneous miscarriage and infertility;
• pathological course of pregnancy;
• partner has an STD.

If the presence of the disease is suspected, the following tests are prescribed:

• general blood and urine analysis;
• smear test;
• PCR research;
• determination of sensitivity to medications.

Diagnostics and further treatment trichomonas in women, includes an assessment of signs of the disease at the time of testing.

How to cure the disease

It doesn't matter if there are characteristic symptoms, treatment is prescribed to each patient with this diagnosis based on the results of tests and examination by a doctor.

Medicines are prescribed only after full examination and productions accurate diagnosis . Otherwise, due to such ineffective treatment, antibiotics may not work in further treatment.

The acute form of the disease is more effectively treatable than the chronic form of the disease.

When trichomoniasis affects the organs of the reproductive and urinary systems, complete sanitation of the vagina, urethra, and cervix is ​​carried out.

The most effective drug for treating this disease is Metronidazole. The substance is capable of destroying simple microorganisms.

Treatment regimen for trichomoniasis in women in several types with the drug Metronidazole:

If the drug is intolerant, the patient is prescribed tinidazole And ornidazole.

• Tinidazole is prescribed for 7 days, 1 tablet 2 times a day.
• Ornidazole is used once at a time, in an amount of 2 g.

Sometimes there is a need to prescribe alternative medicines, such as:

• Application nitazole comes in the form of tablets, vaginal suppositories and a special sprayer. The course of treatment lasts up to 2 weeks. Take 100 mg orally in tablet form. substances, 3 times a day. 2 times a day it is necessary to insert suppositories into the vagina, and also treat with a spray substance. After introducing the drug into the vagina, it is advisable to remain in a lying position for 20-30 minutes. The main feature of this medication is that this therapy is repeated 2-3 months after the end of menstruation;
• Intravaginal administration 250 mg. osarsola 2 times a day;
• Reception furazolidone required in the amount of 2 tablets, 4 times a day, the general course is 3 days.

Therapy during pregnancy

During pregnancy, a woman's body undergoes multiple changes, including a decrease in immune functions, which in turn provokes the development of unwanted microorganisms. A woman may become infected for the first time or be a carrier of the disease.

Microorganisms do not have a detrimental effect on the fetus, however, any inflammation of the genital organs leads to the possibility of termination of pregnancy, getting an infection in the womb.

The development of microorganisms creates an aggressive environment that is unacceptable for bearing a fetus. Due to this, the destruction of the membranes occurs, which in some cases led to development of pathologies or fetal death.

Treatment with metronidazole can be carried out only from the 2nd trimester of pregnancy.

Treatment regimen for a pregnant woman:

1. Introduction of vaginal suppositories with metronidazole, 1 time per day, preferably before bedtime, general course – 7 days;
2. Ornidazole in the amount of 1.5 mg, once.

IMPORTANT! Beyond the 1st trimester of pregnancy, there is a danger of prescribing these drugs several weeks before giving birth.

During pregnancy, only the attending physician can decide how to treat trichomoniasis in women. Because in each individual case therapeutic measures will be different.

Quick Treatments

If there is a need to quickly get rid of the infection, metronidazole is prescribed in the form of injections or droppers, 500 mg, 3 times a day, for 7 days.

In the chronic form of the disease, there is a need for immunotherapy. The administration of a vaccine such as Solcotrichovac is prescribed. This therapy helps improve antibacterial processes. When carrying out the full course, the disease does not occur within 1 year.

You can quickly cure trichomoniasis using traditional medicine methods in combination with drug therapy.

Traditional methods of treatment

Leaves of bird cherry, calendula, celandine in equal proportions, 20g each, brew with 1 cup of boiling water.

Let the herbs steep for 20 minutes, after which the cooled solution can be used to douche the vagina or urethra.

In case of infection from pets, it is necessary to prepare calendula tincture:

Take 60 grams of calendula flowers, add alcohol and let it brew in a dark, cool place for a week. Take a small amount of this product orally 30 minutes before meals.

Preventive measures

Following the rules of prevention, venereal diseases can be easily avoided.

• Use barrier methods of contraception during casual sexual contact;
• Have regular sex life with only one partner. Have a joint examination every six months;
• Comply with all necessary standards of genital hygiene;
• If you notice the first signs of the disease, immediately contact a specialist.

Conclusion

There are many effective ways how to treat trichomonas in women. Still, it is better to prevent the formation of infection than to treat the consequences.

Every woman is obliged to closely monitor the condition of her genitourinary system.

However, some people may go years without treatment for STDs, or may not know about them at all. In this case, there is a risk of developing infertility, as well as malignant tumors.

In contact with

Knowing what the treatment of Trichomonas is is useful for any person, because trichomoniasis is the most common sexually transmitted infection.

In many cases, the disease has a vague or asymptomatic course, so it is more difficult to recognize - this is how trichomoniasis manages to become chronic. Having become chronic, the infection can cause severe complications that will not be easy for doctors to deal with. And yet, with the right approach, trichomoniasis can be defeated.

We tell you how trichomoniasis is treated in women (treatment, medications, etc.) and men, how the success of treatment is assessed, and how the disease affects later life.

Principles of treatment of trichomoniasis

If a person suspects a Trichomonas infection, they should seek advice from dermatovenerologist. He is a specialist in diagnosis and treatment of this disease. Often to healing process Additionally, urologists or gynecologists are involved.

Treatment should begin only after a final diagnosis has been established. It is important to understand from the very beginning that the sexual partner (or partners) of the person diagnosed with trichomoniasis should also be treated. Moreover: for treatment to be successful, both partners must take a course of medication at the same time.

Unlike many sexually transmitted infections, trichomoniasis can be treated at home. Typically, the patient takes the medications himself and follows the doctor's instructions. But in some severe cases the patient may be hospitalized.

Indications for treatment in hospital:

• complicated course of the disease when the pelvic organs become inflamed;
• threat of pregnancy failure.

How to cure trichomoniasis: features of therapy

Trichomoniasis - infection. Its causative agent is Trichomonas vaginalis, a protozoan single-celled creature. This microorganism is more complex than ordinary bacteria, which is why traditional antibiotics do not work on it.

The fact is that antibiotics chemically interact with special molecules in the bacterial shell, disrupting their vital functions. important processes. But the structure of Trichomonas is completely different. Therefore, to combat this microorganism, scientists selected a different class of compounds.

All of these compounds are derived from a substance called 5-nitroimidazole:

• metronidazole- the first drug of this class, which was most often used earlier;
• ornidazole- The most common modern analogue metronidazole;
• tinidazole- a drug that acts not only on Trichomonas, but also on many bacterial infections;
• tenonitrozole, has an additional antifungal effect;
• secnidazole- a drug wide range actions; like tinidazole, it inhibits the growth of not only Trichomonas, but also most pathogenic bacteria.

The mechanism of action of all drugs in this group is similar: they disrupt the respiratory activity and metabolism of Trichomonas. This directly leads to the death of pathogens.

In addition, recent studies have shown that these medicinal substances can inhibit the reproduction of trichomonas, stopping their production DNA: A single cell can no longer divide. After this, the cells of microorganisms die quite quickly.

Trichomoniasis and alcohol

Almost all of the drugs listed incompatible with alcohol. They disrupt the processing of ethyl alcohol in the liver, which leads to acute poisoning.

Poisoning manifests itself:

• dizziness;
• loss of consciousness;
• nausea and vomiting;
• a sharp drop blood pressure;
• general weakness and lethargy.

However, alcohol does not affect the effectiveness of the antiprotozoal drugs themselves.

You can consume alcohol-containing drinks no less than in 1 day after the last dose of any 5-nitroimidazole derivatives. However, there is one thing here exception: Ornidazole does not affect the functioning of liver enzymes, which means it can be combined with alcohol.

How to treat trichomoniasis in men and women: standard regimens

The main course of therapy is general treatment 5-nitroimidazole derivatives in tablet form.

At the same time, the doctor can prescribe local therapy - that is, drugs for the area infectious inflammation (genitourinary tract). Most often, ointments or suppositories are used for trichomoniasis (for women).

It is important to understand that local treatment alone is not enough to get rid of trichomonas, so you will have to take pills in any case.

The goal of treatment with tablets is to get rid of the cause of the disease, vaginal Trichomonas, and not just to remove symptoms or prevent complications. Modern medicine considers this type of therapy to be the most effective.

Tablets for trichomoniasis for men and women, as well as the dose of the substance, are the same. For the treatment of acute, new-onset disease in adult patients, one of these regimens is used:

When treating chronic trichomoniasis in men and women, the following regimens are used:

How to treat Trichomonas in childhood is described in the following table. Children are usually prescribed metronidazole, and the treatment regimen depends on the age of the child:

Limitations and features of etiotropic therapy

It is also useful to know how Trichomonas is treated when it is combined with gonorrhea and other sexually transmitted infections. It is important to choose the right drugs and the order of their use. Read more about this.

Local therapy for trichomoniasis

For local treatment, the same 5-nitroimidazoles are used as in systemic therapy, but in the form of vaginal tablets or pellets. They contain 0.5 g active substance. They are used once a day for 6 days.

Alternative option: in women with trichomoniasis, use suppositories containing 0.5 g of ornidazole - once a day, 6 days.

Also used in local therapy nonspecific(i.e., effective against many diseases) methods and drugs - they not only destroy Trichomonas, but also relieve general inflammation.

• potassium permanganate, at a concentration of 1:10000;
• acridine, at a concentration of 1:10000;
• furatsilin, at a concentration of 1:5000;
• chlorhexidine, at a concentration of 1:5000;
• Miramistin, at a concentration of 1:10000.

If the urinary tract and surrounding tissues are swollen and inflamed - as can be seen on urethroscopy, then they are washed every other day:

• 0.25-0.5% silver nitrate solution;
• or 1-2% protargol solution.

If at chronic trichomoniasis hard scars have already begun to form in the urinary canal, then use bougienage. This is a mechanical expansion of the lumen of the urethra by introducing a bougie (a special metal probe). For trichomonas infection, bougienage is performed no more often than once every 2 days. It allows you to maintain patency urethra.

Important! If trichomoniasis was diagnosed for the first time, then in its acute phase do not use non-specific medications and procedures! They are prescribed only when symptoms subside - in the subacute stage or when the disease becomes chronic.

How else to treat trichomoniasis in women and men?

Trichomoniasis is best treated if, simultaneously with the main treatment, the antimicrobial defense of the entire body is strengthened. Drugs are prescribed for this interferon- they speed up the immune response to Trichomonas infection.

At the same time with basic course medications are also prescribed for local treatment of trichomonas colpitis in women. Colpitis is an inflammation of the cervix that can be relieved with non-steroidal anti-inflammatory drugs. Trichomoniasis itself cannot be treated with such medications, but they significantly alleviate the patient’s condition.

Natural biostimulants are also useful. Medicines are used more often here plant origin- For example, echinacea, eleutherococcus, ginseng etc. These drugs tone the body well and, thanks to this, improve its protection against infections.

We must not forget about vitamins: they strengthen the immune system, so treatment regimen for trichomoniasis, multivitamin complexes are often added.

Cost of treatment

Metronidazole in Russia is included in the list of essential and vital medicines. This means that the price of this medicine for Trichomonas is controlled by the state and cannot be too high.

Typically, a package of domestic metronidazole costs around 200 rubles. If trichomoniasis proceeds without complications, then it will be enough for the full course of treatment.

Of course, with chronic advanced trichomoniasis, with complications or combinations with other infections, the cost of therapy will be higher. This happens, firstly, because treatment takes longer, and secondly, because other medications may be needed for a complete cure.

How to get rid of Trichomonas: criteria for cure

Dermatovenerologists distinguish two “levels” of cure for trichomoniasis:

1. Clinical recovery, in which all manifestations of trichomoniasis subside significantly or completely disappear. The patient becomes much better, but he may still remain a carrier of the infection.
2. Etiological recovery is the complete destruction of all Trichomonas in the body. Accordingly, the symptoms also disappear, that is, actual recovery occurs. This option, of course, is the main goal of treatment. It is possible to confirm that the patient has achieved etiological recovery only with the help of laboratory tests.

When and what tests are taken after treatment for trichomoniasis?

A amplifier is a device with which PCR analysis is carried out.

These are the same tests that are used for the primary diagnosis of this disease:

• examination of a smear from the patient’s urethra under a light microscope - they look for live Trichomonas in the smear;
• examination under a microscope of the same smear, but with the addition of special dyes - this way Trichomonas can be more clearly identified;
• bacteriological examination (culture) - material obtained from the patient is placed on a nutrient medium, wait for the bacteria to multiply, and then determine whether it is Trichomonas or not;
• molecular biological and immunological detection methods - they are based on searching DNA trichomonas in material obtained from the patient.

The first two methods are quite fast and simple, but their reliability usually does not exceed 60%. Often this is not enough to confidently say that all Trichomonas have been destroyed.

Cure trichomoniasis for modern medicine- not particularly complex problem. The main thing is to notice in time dangerous symptoms and consult a doctor immediately. Then it will be possible to quickly make a diagnosis and carry out a short course of treatment with 5-nitroimidazole derivatives.

But if trichomoniasis develops into chronic stage, then the treatment will take much longer and there will be a high risk of complications. Therefore, you should not delay visiting the doctor. Timely consultation with a venereologist and simple laboratory analysis— the main conditions for successful treatment of trichomoniasis.

The main thing in treating trichomoniasis is to notice dangerous symptoms in time and immediately consult a doctor.

Some patients also use other names: trichomoniasis, trichomonas, trichomoniasis, trichomoniasis, trichamonases, trichomanases, trichomonas, trichomanas. We will use the term trichomoniasis.

Trichomoniasis is a systemic infectious and inflammatory disease of the genitourinary system, which is caused by the protozoan Trichomonas. Today it is recognized as the first most common among typical infections sexually transmitted diseases and diseases of the genitourinary system.

Trichomoniasis occurs several times more often than chlamydia, syphilis, and HIV infection. All this suggests that treatment of trichomoniasis is an important and urgent task.

Many researchers argue that the incidence of trichomoniasis in men and women is approximately the same and amounts to about 10% of the adult population, but in men the disease is often transient, asymptomatic, more difficult to diagnose, and therefore is registered much less frequently than in women. For example, in England in 1975, the ratio of women with trichomoniasis and gonorrhea was 1:1.14, men - 1:23.7, respectively. This may be due to the different approaches to diagnosing trichomoniasis in different countries and other factors.

Trichomonas

• urogenital;
• oral (Trichomonas tenax);
• intestinal (Trichomonas hominis).

Urogenital trichomonas are an independent species, morphologically and culturally different from oral and intestinal trichomonas. The causative agent of urogenital trichomoniasis is vaginal Trichomonas - Trichomonas vaginalis. Trichomonas vaginalis is a mobile single-celled organism that has adapted in the process of evolution to life in the organs of the human genitourinary system.

Urogenital Trichomoniasis is an infection, usually sexually transmitted and often combined with gonococci, chlamydia, ureaplasma, Gardnerella vaginalis and Candida fungi.

The source of infection is only people with clinically significant or asymptomatic trichomoniasis. As a rule, infection occurs through sexual contact. Rectal and orogenital contacts do not lead to infection, since Trichomonas vaginalis does not survive in oral cavity and rectum.

The water route of infection is currently completely rejected. As an extremely rare exception, the possibility of infection of women when bathing together in baths with low-mineralized water (salt concentration close to an isotonic solution) is allowed.

Infection of newborns from mothers with trichomoniasis during childbirth has been described, which some authors observed in 5% of cases. In this case, newborn girls experience transient, usually self-healing vaginitis and urinary tract infections.

How can you become infected with trichomoniasis?

• unprotected sexual contact;
• a large number of sexual partners;
• previously suffered or not fully cured sexually transmitted diseases.

The development of trichomonas in the body is facilitated by hormonal imbalances, metabolic disorders, and a decrease in the body’s immune response. Immunity to trichomoniasis is not developed, so you can become infected again.

Among the others venereal diseases Trichomoniasis is the only one that is transmitted through household contact.

Transmission of trichomoniasis is possible in the following ways:

• most often, trichomoniasis is transmitted sexually (vaginally, as well as orally, anally; in addition, through contact with blood, vaginal secretions or sperm of a patient);
• from mother to child (during passage through the birth canal or during intrauterine development);
• there is a chance of contracting trichomoniasis in saunas or baths.

Symptoms of trichomoniasis

Infection with trichomoniasis occurs in 2/3 of cases during extramarital sex. Often trichomoniasis is asymptomatic, unnoticed by patients with trichomoniasis. During pregnancy, after childbirth or abortion, a cold, excessive sexual activity or drinking alcohol, a latent form of trichomoniasis can develop into an acute form of trichomoniasis.

Symptoms of trichomoniasis in women

In women, the first sign of trichomoniasis is copious liquid, often foamy, yellowish leucorrhoea, often with unpleasant smell . Some, for example, in old age, have discharge after sexual intercourse mixed with blood. Corrosive leucorrhoea contributes to pain in the genital and vaginal area and causes a feeling of itching and burning.

Can appear pain in the lower abdomen, in the lumbar region, during urination, sexual intercourse, so strong that sexual contact becomes impossible.

In some cases, there are signs on the labia painful superficial ulcers.

It happens that the infection spreads to the cervix, causing erosion and inflammation. Women begin to experience pain when urinating, burning after it.

With further progression of trichomoniasis, acute inflammation of the uterine mucosa is possible:

• pain appears in the lower abdomen;
• leucorrhoea intensifies, often mixed with blood;
• the menstrual cycle is disrupted.

Symptoms of trichomoniasis in men

In men, the form of trichomoniasis begins with itching, tickling, burning, sometimes pain when urinating.

Appear urethral discharge that may be clear or grayish-white, very rarely foamy. Sometimes they take on the appearance of a large transparent spherical drop, as if rolling out of the external opening of the urethra, the lips of which are swollen and inflamed.

With the latent form of Trichomonas urethritis, patients complain of intermittent scanty discharge from the urethra and then only in the morning in the form of a drop.

Unpleasant sensations when urinating intensify after drinking alcoholic beverages and spicy foods. The discomfort may spread to

• glans penis;
• scrotum;
• crotch;
• rectum;
• lumbar region.

Trichomoniasis in men can cause complications: the head of the penis turns red, foreskin swelling, then wounds, abrasions, and sometimes ulcers form on the penis.

With phimosis, the penis, increasing in size, takes on the shape of a pear and becomes painful. Due to the swelling, exposure of its head becomes impossible. Trichomonas epididymitis is possible, which occurs in 7-15% of patients. Some of them have fever, pain in the scrotum and testicle.

At the same time, the man himself may not feel anything for years, not suspect that he has trichomoniasis, but infects women with trichomoniasis during sexual intercourse.

Sometimes patients with trichomoniasis experience a feeling of heaviness and dull pressure in the anus, itching in it and in the urethra, pain in the perineum. Vision and orgasm are often weakened, and premature ejaculation occurs.

With Trichomonas inflammation of the bladder, patients are forced to urinate every 15-30 minutes. Urination is accompanied by sharp pain and the release of a few drops of blood.

Symptoms of trichomoniasis in children

Quite rarely (from 0.8 to 3.8% of cases) trichomonas are found in children, often causing urogenital vulvovaginitis - inflammation of the vulva and vaginal mucosa. In newborn girls, it can spontaneously heal due to the peculiarities of the vaginal microflora.

Trichomoniasis in children is manifested by itching of the vulva, less often by discharge mixed with blood. Purulent foamy discharge is observed in quite large quantities, swelling, redness and soreness of the vulva and vagina. There is a risk of ulcers forming on the mucous membrane of the urogenital area and even on inner surface hips

Diagnosis of trichomoniasis

The diagnosis of trichomoniasis must be confirmed by the presence of pathogens by direct microscopy of pathological material or by culture on artificial nutrient media.

Serological methods were not obtained due to inconsistency of results practical application, although there is evidence that the immunosorbent method (ELISA) more often detects anti-Trichomonas antibodies in patients and survivors of trichomoniasis than immunofluorescence and hemagglutination reactions.

No single method ensures the detection of Trichomonas in all cases of the disease, but cultural studies significantly increase the reliability of diagnosis. Thus, with the help of cultures on the CDDS medium, 51.4% of patients with trichomoniasis were additionally identified (71.2% of men and 43.1% of women) compared with the results of microscopy of stained smears.

Collateral successful diagnosis serve:

• a combination of various techniques (microscopy of stained and native preparations and cultures);
• repeating tests multiple times;
• taking material from different foci of invasion (urethra, prostate gland and seminal vesicles in men, vagina, urethra, paraurethral ducts, ducts of Bartholin glands in women) in combination with analyzes of freshly released urine;
• correct technique for collecting material and transporting it to the laboratory and strict adherence to standardized laboratory research methods.
• The experience and perseverance of the laboratory assistant play an important role.

5-7 days before taking the material, patients should not use protistocides or any local procedures.

In men, trichomonas are much more difficult to detect than in women, since they are usually present in small numbers and often in a sedentary (amoeboid) form. In addition, in men, Trichomonas often disappear spontaneously.

Rational approach to diagnosing trichomoniasis

The rules of a rational approach to diagnosing trichomoniasis are as follows:

1. Physical examination of the patient (gynecological in women) and collection of material for research - a native (fresh or wet) smear from the vagina in women and from the urethra in men. Why a native smear, despite its low sensitivity? Because this is the cheapest diagnostic method, as well as the fastest: examination of the discharge under a microscope must be carried out in a matter of minutes. If trichomonas are detected in the native smear, additional examination not necessary. Of course, it is necessary to take into account complaints and inspection results.
2. If the native smear is negative, a rapid antigen test or one of the amplification tests can be performed. Such tests are more expensive, but the result can be obtained within 10-30 minutes or several hours (in some laboratories within several days). If the result is positive, treatment can be prescribed.
3. If the result of rapid diagnostics is negative, most doctors recommend using cultivation if there are complaints and signs of trichomonas infection.

Using more diagnostic methods to diagnose trichomoniasis is not recommended. Of course, each doctor may have his own principles for diagnosing trichomoniasis, but the passion for reinsurance should not dominate the examination and treatment.

Trichomoniasis in men

In men, symptoms of the disease are most often not expressed. A man can be a source of infection throughout his life, infecting women, but not getting sick himself.

In some cases, inflammation may occur in the urethra, prostate gland and seminal vesicles, as well as in the testicles. In rare cases, may occur slight discharge from the urethra or the presence of a small amount of blood in the urine. These phenomena can be observed for one to two weeks and then disappear, although the disease does not disappear, but becomes chronic.

As a result of untreated trichomoniasis, men suffer from complications such as:

• sexual dysfunction;
• infertility;
• prostatitis;
• inflammation of the penis.

Sperm viability decreases. In particular advanced cases trichomoniasis leads to anemia, destruction of the hematopoietic system, exhaustion, general oxygen starvation, vision loss.

Trichomoniasis in women

Leakage acute form the disease is accompanied by a bright clinic, which manifests itself in the form heavy discharge with an unpleasant odor, burning and itching. The presence of discomfort should be a reason to immediately visit a gynecologist.

Chronic trichomoniasis

In case of untimely and poor-quality provision medical care or in the absence of treatment, after an average of 2-3 months, trichomoniasis becomes chronic. It is characterized minimal manifestations vaginal discharge milky color, or even their complete absence. But it continues to develop on the mucous membrane pathological process. Sometimes, when the immune system is weakened, periodic exacerbations are observed. They can be caused by vitamin deficiency, menstruation, and even alcohol abuse.

Trichomonas abuse

The greatest danger to women reproductive health provides trichomoniasis. The insidiousness of this type of disease is the absence of any manifestations clinical signs. Therefore, many infected people do not even suspect that they are carriers of this pathogen. And during sexual contact they infect all their partners.

To date, the exact number of carriers of vaginal Trichomonas has not been established. According to statistical data, this form of the pathogen occurs in 50% of cases in women diagnosed with urogenital trichomoniasis. One of the properties of Trichomonas is the absorption different types microorganisms located directly inside it. Due to this, they become inaccessible not only for diagnosis, but also for many medications.

Concomitant infections

In most cases, trichomoniasis is accompanied by the following infections:

• gonorrhea;
• bacterial vaginosis;
• chlamydia;
• mycoplasmosis;
• fungal infections (thrush in women).

This information should be taken into account when prescribing the appropriate course of therapy. Timely treatment will save any woman from this type of infection and prevent the development of a chronic form of the disease.

Complications

If trichomoniasis is advanced or treatment is insufficient, complications are inevitable. In women, these are various inflammatory processes:

• endometritis (inflammation of the uterus);
• salpingitis (inflammation fallopian tubes);
• formation of adhesions as a result of inflammation of the ovaries;
• cystitis;
• pyelonephritis;
• spontaneous miscarriage;
• postpartum complications;
• birth of defective children;
• infertility.

Complications during pregnancy

• on early stages pregnancy high probability miscarriage;
• frozen pregnancy;
• birth of a child earlier than the established deadlines;
• discrepancy between the child’s weight and developmental dates;
• penetration of trichomoniasis into the fetal membranes;
• increasing the likelihood of infection through the mother's birth canal.

Prevention

Preventive measures include:

• detection and treatment hidden forms diseases and carriers of Trichomonas;
• barrier methods of contraception (condom) during sexual intercourse with an unreliable partner;
• the use of antiseptics after sexual intercourse;
• maintaining intimate personal hygiene.

Trichomoniasis is a treatable disease if its symptoms are noticed in time and treatment is started before consequences develop. To avoid the problem, you need to take care of prevention and undergo routine examinations at the gynecologist.

Treatment of trichomoniasis

Treatment of trichomoniasis must be carried out by both spouses (sexual partners) at the same time, even in the absence of trichomonas in one of them. During treatment and follow-up sex life prohibited.

Both patients with inflammatory phenomena and Trichomonas carriers are subject to treatment.

• In acute and subacute uncomplicated forms of trichomoniasis, therapy is limited to the administration of specific anti-trichomonas drugs orally.
• In protracted, complicated and chronic cases, general etiotropic treatment is supplemented with methods of nonspecific stimulation immune reactions body and local treatment of trichomoniasis.
• For mixed infections, antitrichomonas drugs are combined with appropriate antimicrobial agents.

Today, metronidazole is considered the most effective drug for the treatment of trichomoniasis. In terms of effectiveness, ornidazole, nomirazole, and tinidazole are almost as effective. It is recommended to douche the vagina with tincture of medicinal herbs: chamomile or calendula.

An important point is measures to restore normal vaginal microflora and increase local immunity. For this purpose, special vaccines containing lactobacilli are used. Additionally, topical medications are prescribed:

• fluomizin;
• terzhinan;
• hexicon;
• betadine;
• McMiror;
• ginalgin;
• Dalacin vaginal cream.

If the disease develops in a pregnant woman, taking metronidazole is prohibited. From 12 weeks you can only use local medicines. With earlier initiation of treatment, the effect active ingredients medications can cause various abnormalities in the development of the fetus, and in severe cases, its death. It is also impossible to refuse treatment. In this case, the risk of premature rupture of amniotic fluid, fetoplacental insufficiency and a number of other consequences increases.

Treatment of male trichomoniasis has its own characteristics. It is based on antiprotozoal therapy. Basically, patients are prescribed drugs of the imidazole group taken orally (the regimens may vary), as well as in the form of injections.

In the presence of a disease in a chronic or torpid form, it is advisable to use gonovaccines. After three injections, an antiprotozoal drug is prescribed. Acute excesses require local therapy: urethral lavage antiseptic solutions and instillation of drugs.

Group of diseases:

Questions and answers on the topic "Trichomoniasis"

Question:How to distinguish gonorrhea from trichomoniasis? I’m on a long business trip, where, alas, there are no venereologists. Are the treatments different from each other? Thank you very much for your answers in advance!

Answer: Hello. Treatment for gonorrhea and trichomoniasis is very different, and without additional tests it is impossible to distinguish one disease from the other. Unfortunately, you won’t be able to figure it out without the help of a specialist.

Question:Hello, we have prescribed a course of treatment for trichomoniasis and inflammation - betalgin suppositories, geneferon, terzhitan tablets, Unidox, ornizadol, Lavomax, treatment for 10 days, on the same day half of my period, can I start treatment? And how to combine all these candles?

Answer: Hello. You can start treatment after your period ends.

Question:Hello! Tell me, is it possible to get pregnant from a partner infected with trichomoniasis?

Answer: Hello. Yes, there is a possibility. Although trichomoniasis can cause infertility in men, many men with trichomoniasis are capable of conceiving.

Question:Hello. In 2005, I treated advanced trichomonas for more than six months, but it was still detected and stopped treatment. Then I got married and have two children. Two months ago I decided to get tested and took a smear test - negative. I passed it a week ago - again negative. Please explain the situation. Should I get treatment or not?

Answer: Hello. If in this moment the test results are negative, you do not have any symptoms (pain during urination or ejaculation, etc.), then you do not need treatment.

Question:A year ago I completed two courses of treatment for trichomoniasis and ureaplasma, but everything was in vain. She got married and became pregnant. Pregnancy 14 weeks. Diseases still exist, but I don’t want to treat them during pregnancy, since I still won’t be able to cure them in six months, I’ll only harm the baby. I ask a specialist for advice, should I still start treatment? Or give birth first and then recover?

Answer: Hello. It is necessary to treat trichomoniasis and ureaplasmosis during pregnancy, as these diseases can lead to premature birth and other unpleasant consequences.

Question:Trichopolum was advised to me, but I don’t know if it will help or not. I have a curd-like discharge, white, with a smell. Help, I don’t know what or how to drink.

Answer: Hello. Vaginal discharge should never be treated on your own. This is due to the fact that with your treatment you will only hide the symptoms of inflammation, while the infection itself will remain in the body. It is impossible to make a diagnosis and prescribe treatment based on the description of the discharge alone. Be sure to visit a gynecologist and get a smear for analysis. Some diseases manifested by vaginal discharge can cause infertility.

Question:Tell me please, is this a serious illness?

Answer: Hello. Trichomoniasis can lead to infertility, but is not life-threatening.

Question:Hello! Tell me, how to treat trichomoniasis if you are allergic to metronidazole? Metrogyl was dripped into a vein and there was anaphylactic shock! From Atrican, not only the sclera turns yellow, but the whole body turns yellow, like an orange.

Answer: Hello. If the patient is allergic to Metronidazole and others (Tinidazole, Tenonitrozole (Atrican), Ornidazole, etc.), then antibiotics, for example Clindamycin, can be used in the treatment of trichomoniasis. Considering that you have suffered anaphylactic shock, Clindamycin should be taken ONLY under the supervision of a doctor and after an allergy test with a small dose of Clindamycin.

In the structure of all infections that can be sexually transmitted, urogenital trichomoniasis occupies one of the first places throughout 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 consult gynecologists about 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 bathhouses, swimming pools, and open reservoirs, subject to normal 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.

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

During its life, the pathogen secretes the complex protein CRF (cellular disconnecting factor), which leads to significant tissue loosening. As a result of this, 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 necessary, which are abundant in menstrual blood. Therefore, trichomoniasis in women manifests itself with severe symptoms during menstruation, especially immediately after its end.

All this can lead to the development of acute inflammatory processes in the mucous membranes, cause a 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;
• condition of the epithelial layer of the mucous membrane of the genital and urinary tract;
• acidity of the genitourinary system;
• association of Trichomonas with concomitant pathogenic or conditionally pathogenic flora, its nature, degree of activity and number of bacterial agents causing inflammation;
• the degree of the body's response; if it is higher than the degree of aggressiveness of the microorganism, the acute inflammatory process does not develop or is expressed rather weakly.

In addition, Trichomonas secretes substances that neutralize T-lymphocytes in the blood and antibodies formed in the body of the infected, and is also capable of absorbing and concentrating plasma proteins on its surface. The latter does not allow the body's immune system to recognize the pathogen as a foreign substance. Therefore, stable 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 during re-infection.

Another property of vaginal Trichomonas 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 mucous membrane occur.

Clinical manifestations

Symptoms of trichomoniasis depend on the severity of the inflammatory process. At the same time, if it is caused in isolation by vaginal trichomonas, symptoms may be absent. It is largely determined by infection, which almost always accompanies or is combined with trichomoniasis.

Fresh form with a sharp current

In men

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

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

1. Moderate foamy discharge from the urethra of a yellow-greenish color, which especially increases with light pressure on the head of the 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 feeling of itching.
4. Unpleasant sensations during sexual intercourse.

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

Trichomoniasis in women

It occurs with damage to the mucous membrane of several areas of the genital organs and the urinary 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 genitalia (vulvitis) to the fallopian tubes, ovaries and peritoneum in the pelvic area, but more often it is limited to the area internal pharynx cervix. In addition, even rare cases(about 5%) lesions of the mucous membrane of the upper dilated sections of the rectum, located at the level of the sacrum (ampullary rectum).

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

Main symptoms:

1. Yellow-green discharge from the genital tract of a foamy nature (in 12%).
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 pinpoint hemorrhages. This one is the most typical sign called the “strawberry symptom,” but it occurs in only 2% of infected women.

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

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 chronic disease. Moreover, as a rule, it is multifocal in nature: the urethra and often the bladder, external genitalia, vagina and rectal mucosa are affected.

In pregnant women, anatomical and physiological changes are aimed at protecting the developing fetus from negative influence external and internal environment, and therefore from the rise of the infectious process. In this regard, there is an increase in immune system 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 its 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 pathogens through the ascending route and to their further spread.

The second barrier from the 16th week of pregnancy becomes the chorionic and amniotic membranes of the fetus, which block the internal os of the cervical canal. If infection with trichomoniasis occurs before the internal pharynx closes, the probability of the pathogen spreading through the ascending route remains quite high. This threatens the development of endometritis and, most often, ends in spontaneous abortion. With later infection, the rise of infection occurs extremely rarely, and the therapy provided promotes cure and a successful course of pregnancy, childbirth and the postpartum period.

Diagnostics

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

For these purposes, mainly three methods for detecting vaginal Trichomonas 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 using two methods:

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

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

If in a study using the first method only mobile microorganisms are taken into account, in the second case - all forms of the pathogen, as well as indirect signs of inflammation (the amount of mucus, accumulations of leukocytes, etc.). Colored preparations slightly increase the sensitivity of the technique. At the same time, the microbiological method is insensitive for asymptomatic diseases. In addition, it produces many false positives and false negatives.

Culture method considered highly sensitive (73-89%) and effective. It is based on the cultivation (growing) of microorganisms on special nutrient media with their subsequent identification under a microscope. The microbiological method is of particular importance when:

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

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

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

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

Both partners should undergo the full course of treatment for trichomoniasis, 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 patient’s age, localization of inflammation, form of the disease, nature of the concomitant infection, and immune state of the body.

The main treatment of trichomoniasis is carried out with specific drugs from the nitroimidazole group: Trichopolum, Metronidazole, Ornidazole, Flagyl, Tinidazole, Flunidazole, Secnidazole, etc. While taking them and for 1 day after the end of the course of treatment, it is necessary to abstain from use alcoholic drinks 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 acute cases 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 for chronic trichomoniasis, as well as recurrent and various localizations: a single daily dose of 2.0 g of Metronidazole 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 days.

Highly effective, well tolerated and a small number of possible side effects is Ornidazole, or Ornizol, in a dose of 0.5 g - 2 times a day for 10 days.

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

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

Due to the resistance of the microorganism to these drugs in recent years, their additional local use is recommended - Metrogyl vaginal gel, vaginal tablets"Klion-D 100", metronidazole cream.

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

People who are diagnosed with vaginal Trichomonas should undergo treatment, regardless of the presence of inflammatory processes. Also, persons who have been in contact with infected people should undergo a course of treatment, even if the first ones do not have clinical and laboratory signs presence of infection.