Did You Catch It Again or Was This STD Trichomonas Resistant to Treatment?

Trichomonas vaginalis is the most common curable sexually transmitted infection worldwide! And it can cause a fairly raging discharge and infection, or just be sitting quietly around for your gyno to stumble on during your pap smear. And it can be similar in men: from lots of symptoms to not many symptoms of infection at all. There are no FDA approved DNA tests that help us make that diagnosis, but often the organism can be found scooting across the slide during direct microscopic examination of vaginal discharge. When gynos examine the discharge they perform a test called a wet mount which suspends the discharge in a droplet of saline fluid so that the organisms can be seen better. Trichomonas vaginalis, also called Trich, is an STD, caught through sexual contact, but it's not a virus or a bacteria but a parasite that exclusively infects the urogenital tract. A new report from Medscape claims that Trich is getting exceedingly common, in fact new statistics indicate T vaginalis infections in the USA is estimated to be 3.1% overall and is higher in certain risk groups. It's not just important to treat Trich before it is spread to your sex partner; it is important to treat because trichomoniasis is associated with other adverse gyno outcomes of pregnancy and increased risk for HIV infection. You may suspect you have this if your  discharge is frothy and either yellow or green and a lot of irritation and some itching.It has been a standard to use metronidazole for treatment, but we are seeing some resistance and we now also use tindazole. The vaginal gels do not have the potency of oral medication, and we are getting away from recommending the vaginal gel. For those women who are resistant to the standard medicines we can try compounded medication using paromomycin cream can be an alternative, as can using vaginal boric acid. Use of the spermacide nonoxynol-9 and betadine douches do work in some cases, but usually not. the resistance of trichomonas to standard treatments is going to be a topic we will be watching to gab about with you, so tune back from time to time on this topic!


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