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STDs (Expert Forum)
Questions about Trichomonas
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Questions about Trichomonas
by klukaia, May 11, 2006 12:00AM
Dr. HHH, I hope you will allow me to post this as my second question as you had said that my previous second post didn't need to be posted separately. After this, I will not post another new question for at least six months.
My questions are:
1) How prevalant is trichomonas in Canada (I live in Toronto) and the U.S.?
2) Why is it so hard to diagnose in men?
3) I read that trich usually doesn't cause any symptoms in men but this drop-in clinic I visited says that I probably would have noticed something if I was infected. They didn't collect any urine samples to view but did examine my urethra and said it looked normal. Would they be able to tell anything from that?
4) If you may recall my situation, like many others, I received unprotected oral from two pros. While I have read that trich can only be transmitted through unprotected vaginal intercourse, is there any liklihood that I could get it if the two women performed oral sex on each other until they orgasmed and then immediately performed unprotected fellatio on me? Have you ever heard of any cases of transmission this way, or is this along the lines of genital to hand to genital type improbability? I ask cause the hands do not have mucosa membranes whereas the mouth and tongue do, and I have read that trich can survive outside of the body for some time.
5) Lastly, I was told by the clinic that they would normally prescribe 2 grams of Flagyl to be taken all at once to treat trich. They said that if I was anxious about it, they would prescribe it to me so I don't have to worry about it. Is this a common dosage and is it safe? Everything that I have read about side effects seems to mention the risk of seizure. Has anyone taken Flagyl and experienced any side effects beyond the basic diarrhea, stomach aches, and light-headedness and nausea?
Thank you.
My questions are:
1) How prevalant is trichomonas in Canada (I live in Toronto) and the U.S.?
2) Why is it so hard to diagnose in men?
3) I read that trich usually doesn't cause any symptoms in men but this drop-in clinic I visited says that I probably would have noticed something if I was infected. They didn't collect any urine samples to view but did examine my urethra and said it looked normal. Would they be able to tell anything from that?
4) If you may recall my situation, like many others, I received unprotected oral from two pros. While I have read that trich can only be transmitted through unprotected vaginal intercourse, is there any liklihood that I could get it if the two women performed oral sex on each other until they orgasmed and then immediately performed unprotected fellatio on me? Have you ever heard of any cases of transmission this way, or is this along the lines of genital to hand to genital type improbability? I ask cause the hands do not have mucosa membranes whereas the mouth and tongue do, and I have read that trich can survive outside of the body for some time.
5) Lastly, I was told by the clinic that they would normally prescribe 2 grams of Flagyl to be taken all at once to treat trich. They said that if I was anxious about it, they would prescribe it to me so I don't have to worry about it. Is this a common dosage and is it safe? Everything that I have read about side effects seems to mention the risk of seizure. Has anyone taken Flagyl and experienced any side effects beyond the basic diarrhea, stomach aches, and light-headedness and nausea?
Thank you.
Doctor's Answer
by H. Hunter Handsfield, M.D., May 11, 2006 12:00AM
, May 11, 2006 12:00AM
1) Trich is a very common STD in all countries. An estimated 5 million new infections occur annually in the US. My guess the frequency in Canada is proportional to the population vs the US, but I don't know.
2) Infected men tend to have few organisms compared to women, making them harder to detect.
3) You either misunderstood or were given misinformation. Most trich in men is asymptomatic and negative exam and urinalysis doesn't rule it out.
4) You cannnot get trich by oral sex or by the tortuous indirect mechanisms you ask about. Period.
5) It is irrational and likely a sign of an emotional disorder for you to focus so intently on an impossible infection that is basically harmless. It would be poor medical judgment for the doc to prescribe metronidazole (Flagyl) just because you request it. But if you insist and want to take it, it wouldn't harm you. It's a benign drug; few people get the side effects you mention and almost nobody gets severe ones.
Please do not follow with "yes, but" or "what if?" replies. I will not respond.
HHH, MD
2) Infected men tend to have few organisms compared to women, making them harder to detect.
3) You either misunderstood or were given misinformation. Most trich in men is asymptomatic and negative exam and urinalysis doesn't rule it out.
4) You cannnot get trich by oral sex or by the tortuous indirect mechanisms you ask about. Period.
5) It is irrational and likely a sign of an emotional disorder for you to focus so intently on an impossible infection that is basically harmless. It would be poor medical judgment for the doc to prescribe metronidazole (Flagyl) just because you request it. But if you insist and want to take it, it wouldn't harm you. It's a benign drug; few people get the side effects you mention and almost nobody gets severe ones.
Please do not follow with "yes, but" or "what if?" replies. I will not respond.
HHH, MD
Anyway, I seriously, seriously doubt you have trich; you certainly aren't going to get it from any hand job, regardless of fluids, and I'm not sure why you're so obviously concerned about it.