How can a person get infected?

[concerned25]

I've been recently diagnosed with trichomonas during my annual gyn. exam. I've been married for twenty two years and I've never had an extramarital relationship. My husband says he has not been unfaithful either and I honestly have not seen any changes in his conduct or habits or money expenses that could make me think he is lying. So if neither of us have had an extramarital relationship how did I get trichomonas? Is this possible?

[H. Hunter Handsfield, M.D.]

I'll try to help.  The first issue is how you were diagnosed; you should clarify this with your provider.  If you had no symptoms and the infection just showed up on a pap smear, the odds are good you don't have it.  Although some labs report trich on pap tests, it is often unreliable.  Similarly, if your provider didn't even test you but diagnosed trich by examination, that also is unreliable.  On the other hand, you developed a new, abnormal vaginal discharge and a culture or examination of the vaginal fluid under a microscope showed trichomonas organisms, that's highly reliable.  Even without the symptoms, observation of trich under the microscope is pretty reliable.



Now let's say a reliable test was done and positive.  Trich clearly can be carried for many years without symptoms.  If a graph is done of the age of women diagnosed with trich, there is a sharp peak from age 15-30, just as for all STDs, like chlamydia, gonorrhea, etc; and a second, broader peak at age 40-60.  Some of the latter are recently sexually acquired, and as you clearly understand, some women are infected by partners who, unknown to them, are having other partners.  But many (most?) of these are due to chronic infection that is picked up as women see their providers for other health problems.



Bottom lines:  1) Confirm that a reliable test was done.  If not, or if in doubt, ask for another test (although this won't help if you have already been treated).  2) If the diagnosis is firm, you'll just have to trust your judgment of your husband's fidelity.  But if you are confident in that, I would just let it pass.  (However, your husband also has to be treated.  Regardless of how long you have been carrying it, he also has it by now--and you'll just be reinfected if he isn't treated.)  3) To be safe, you need to be tested for other common STDs, like chlamydia and gonorrhea.  Your provider might have done that already.



I hope this helps.  Best wishes--  HHH, MD  

[orange621]

A related discussion, How long can a women be infected with Trichomonas before symptoms appear. was started.