From the Guidelines
Trichomoniasis in men is a common sexually transmitted infection caused by the parasite Trichomonas vaginalis that can be effectively treated with a single 2-gram dose of metronidazole or tinidazole, and simultaneous treatment of sexual partners is crucial to prevent reinfection. Most men with trichomoniasis don't have symptoms, making it easy to unknowingly spread the infection 1. When symptoms do occur, they typically include irritation inside the penis, mild discharge, burning after urination or ejaculation, and occasionally itching or irritation.
Key Considerations
- The standard treatment has resulted in cure rates of approximately 90%-95% 1, and ensuring treatment of sex partners might increase the cure rate.
- Treatment of patients and sex partners results in relief of symptoms, microbiologic cure, and reduction of transmission 1.
- Men should abstain from alcohol during treatment and for 24 hours after taking metronidazole or 72 hours after tinidazole due to potential interactions.
- Testing for other STIs is recommended since co-infections are common.
- Trichomoniasis can persist without symptoms and increase the risk of HIV transmission and prostate complications if left untreated.
Prevention
- Consistent condom use and limiting sexual partners can help prevent infection.
- Patients should be instructed to avoid sex until they and their sex partners are cured 1.
- Metronidazole gel is not recommended for the treatment of trichomoniasis as it is less efficacious than oral preparations of metronidazole 1.
From the FDA Drug Label
Metronidazole tablets are indicated for the treatment of symptomatic trichomoniasis in females and males when the presence of the trichomonad has been confirmed by appropriate laboratory procedures (wet smears and/or cultures) T. vaginalis infection is a venereal disease. Therefore, asymptomatic sexual partners of treated patients should be treated simultaneously if the organism has been found to be present, in order to prevent reinfection of the partner The decision as to whether to treat an asymptomatic male partner who has a negative culture or one for whom no culture has been attempted is an individual one. Tinidazole is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis.
Trichomoniasis in Men:
- Metronidazole and tinidazole are indicated for the treatment of symptomatic trichomoniasis in males.
- Asymptomatic male partners of treated patients should be treated simultaneously to prevent reinfection.
- The decision to treat an asymptomatic male partner with a negative culture or without a culture is individualized 2, 3.
- Key Points:
- Trichomoniasis is a sexually transmitted disease.
- Treatment of asymptomatic male partners is necessary to prevent reinfection.
- Metronidazole and tinidazole are effective treatments for trichomoniasis in men.
From the Research
Trichomoniasis in Men
- Trichomoniasis is a sexually transmitted infection (STI) caused by the parasite Trichomonas vaginalis, which can affect both men and women 4.
- In men, trichomoniasis can cause symptoms such as urethritis, prostatitis, and epididymitis, although many men may be asymptomatic 5.
- The treatment of trichomoniasis typically involves the use of antimicrobial medications, such as metronidazole, which is the most commonly used treatment 4, 6, 7, 8.
- However, there is growing concern about the development of resistance to metronidazole, which can make treatment more challenging 4, 8.
- Alternative treatments, such as secnidazole, tinidazole, and ornidazole, have shown promise in treating trichomoniasis, particularly in cases where metronidazole is not effective or is contraindicated 4, 6.
Transmission and Prevention
- Trichomoniasis can be transmitted through sexual contact with an infected partner, and it is estimated that up to 50% of men who have sex with infected women will become infected themselves 5.
- The use of condoms can help prevent the transmission of trichomoniasis, as well as other STIs 5.
- Regular screening and testing for STIs, including trichomoniasis, is important for preventing the spread of infection and ensuring prompt treatment 5.
Treatment Considerations
- The treatment of trichomoniasis in men typically involves a single dose or a 7-day course of metronidazole, although the optimal treatment regimen may vary depending on the individual case 7, 8.
- In cases where metronidazole is not effective or is contraindicated, alternative treatments such as secnidazole, tinidazole, and ornidazole may be considered 4, 6.
- It is essential to ensure that sexual partners are also treated to prevent reinfection and to reduce the risk of transmission to others 5.