Trichomonas vaginalis

A sexually transmitted parasite – the most common non-viral STI worldwide. Yellow-green, frothy discharge, itching.

How Trichomonas vaginalis lives

Trichomonas vaginalis is a flagellate that does not form a resistant dormant stage and dries out quickly outside the body. It is therefore transmitted almost exclusively through sexual intercourse. In women it colonises the vagina, urethra and cervix, in men the urethra and prostate. It lives without oxygen and generates energy in its own cell components, the hydrogenosomes. It needs a lot of iron to grow, which it takes from red blood cells and iron-binding proteins; during menstruation it produced more adhesion proteins in studies.

How Trichomonas affects the mucosa and the immune system

Trichomonads attach to the mucosal cells, take on an amoeba-like shape in the process and damage the cells with protein-cleaving enzymes and through direct contact. They also eat lactobacilli, causing the pH in the vagina to rise. Unlike in bacterial vaginosis, many neutrophil granulocytes migrate in – a genuine inflammation develops, with redness, burning and discharge; pinpoint bleeding can become visible on the cervix. At the same time, the pathogens break down antibodies and evade the complement system. Many infections nevertheless cause no complaints, especially in men.

What happens when Trichomonas vaginalis goes unnoticed for a long time?

In women, the infection can persist for months to years. The ongoing inflammation draws immune cells into the lining and makes it more permeable; in studies, Trichomonas infection has therefore been linked with a higher risk of transmitting and acquiring HIV, as well as with premature births and low birth weight. In men it can trigger inflammation of the urethra and prostate. Trichomonads often carry viruses or mycoplasmas within them, which can further intensify the inflammatory reaction.

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