STDs Expert Forum
Understanding Needed
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The STD Forum 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.

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Understanding Needed

Good morning Doctors,

I'm a heterosexual male in a happy long term relationship. Several months ago my partner and I were having some problems and I had two unprotected one night stands with different females. I tested at my local GUM clinic in the for all of the standard battery of tests and was negative for all.

My partner and I sorted our problems out and I put these incidents behind me. As my test results were all negative I didn't feel that my partner was at risk so didn't reveal the two out of relationship encounters to my partner as doing so would have ended our relationship.

However, I've recently heard about trichomonasias and having done some research have some questions i hope you can help with:

1) The NHS doesn't test for trich in males so i don't know if i have it or not. If i did pick it up from either of the 2 encounters would my partner be at any health risk that is worth me worrying about and risking my relationship for? We have had unprotected sex c.20 times since so there would have been plenty of time for me to infect her but she has not had any symptoms (that she has mentioned to me).

2) The NHS information site states that complications for women with trich are rare and I've read a couple of posts on your site that state that its not something to worry about and should be seen as an inconvenience rather than anything serious.  However, I've also read a post from Dr. Handsfield that states that some doctors are beginning to take it seriously. What is it they are taking seriously if complications are rare?

3) My main concern is that if I had given my partner trich she may develop PID and then chronic pelvic pain from me repeatedly infecting her with it - is this a potential concern i should consider?

4)  There are private home test kits available in the UK which can detect trich in males through a urine sample - one which has connections with Freedom Health and is very reputable. Would these be accurate in your view?
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Welcome to our Forum.  I'll address your questions and try to help although my sense is that part of the basis of your question relates to continuing guilt on your part related to exposures related to the time when your relationship with your current partner was troubled.

Trichomonas is relatively common infection in women which can be present with or without symptoms. When it is present much of the time it causes symptoms related to vaginal discharge in women.   In men the infection is less common, in part because the majority of men appear to clear the infection spontaneously without treatment.  It may be present in both women and men without symptoms however and when that is the case it would be detected only by testing.

In answer to your specific questions:
1.  While one cannot be completely sure, the risk that you are still infected after two encounters and in the absence of symptoms is rather low (but difficult to quantify).

2.  Serious biomedical complications are rare with trichomoniasis in women however the infection has recently received more attention. there are two reasons for this.  First is that while not medically "serious" it does cause itching and vaginal discharge in some women with infection.  There is no reason women should have to put up with this. Secondly, there are now commercially available tests which are better at making the diagnosis than the methods of testing available before the last year or two.  When tests are available, they get used.

3.  There is no meaningful association between trich and PID.  This should not be a concern.

4.  There are highly reliable tests now available for trich and I anticipate that whichever one is available through Freedom Health is quite reliable.  If you choose to pursue testing through them, the results will be reliable.

I hope these comments are helpful. EWH
7 Comments
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Avatar_m_tn
Thank you Doctor. This is very helpful. So just to confirm my understanding:

1) based on medical/health risk there is no need for me to inform my partner that she 'might' have trich and needs to be tested?

2) If i choose to purchase one of the home test kits and it's negative i can assume that both myself and my partner do not have trich?

Thanks again for the quick response and at a time which must be pretty early in the US!

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300980_tn?1194933000
Your first answer repeats my answer correctly.  Your second comment is wrong.  If you are tested with a reliable test, that provides reliable informatin that you do not have trich.  It does not tell you about your partner.  You had ?other partners, do you think she did not?  

If you choose to test however (which is not something I would necessarily even bother to do), and your test is negative. EWH
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Avatar_m_tn
Thats great, thanks for clarifying Doctor. All makes sense.

Enjoy the weekend !
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Glad to help.  EWH
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Avatar_m_tn
Sorry to reactivate this post, I hope you don't mind just clarifying one thing you've mentioned for my understanding. You said that if i tested negative for trich it wouldn't mean by partner didn't have it. However, assuming she didn't have any other encounters with others I was working on the assumption that given we'd had unprotected sex 20-25 times since my incident I would have infected her. Hence a negative test result for me would mean that she also wouldn't have the trich as surely we would be passing it back and forth?

This is really just for my understanding and that of others in a similar situations as my concerns about health risk have been allayed.

Thanks Doctor
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You are letting your anxiety get the best of you and it appears to be leading to "what if" games.  The fact is at any instant in time one of you might have infected and the other, while previously infected, might have eliminated the infecton through natural host responses.  Men tend to eliminate trich infections more rapidly than women, hence my response.

Time for us both to move on.  I will.  This will end this thread.  I suggest you do your best to also relax and move forward.  If you cannot, you do not need more testing, you either need counseling or to work this out directly with your partner.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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