Patient's question:
I went to the gynecology department today, and the white discharge test revealed trichomoniasis. The doctor gave me three injections of medication, mainly for trichomoniasis vaginitis. She also provided Ganlin wash solution and metronidazole suppositories for insertion into the vagina. The doctor said that in the next three months, I should go to the hospital for a follow-up after my period. I would like to ask if I still need to go to the hospital for a check-up after completing the three injections of medication? And do I need to continue using the metronidazole suppositories after they are finished?Doctor's answer:
Trichomoniasis is the most common type of vaginitis, caused by the protozoan Trichomonas vaginalis, which thrives in environments with lower acidity. It is primarily transmitted through public baths, bath utensils, swimming pools, toilet facilities, sexual intercourse, and improperly disinfected medical instruments.Treatment
(1) Local Medication
For initial treatment, the vagina should be washed with soap solution, followed by rinsing with 0.5% to 1% lactic acid or acetic acid before medication, which can enhance therapeutic efficacy. If this condition is not available, a sitz bath with diluted acetic acid can be used (add 2 tablespoons of boiled vinegar to half a basin of warm water). Common medications include metronidazole 200–400 mg, administered deeply into the vagina once daily for 7–10 days as a course. Alternatively, traditional Chinese medicine can be used: each of the following herbs— Cortex Cinnamomi, Radix Sophorae Flavescentis, Radix Toosendan, Fructus Cnidii, Atractylodes Rhizoma, and Cortex Phellodendri—15g each, decocted in water and used for sitz baths, taken once daily.
(2) Systemic Medication
Metronidazole 200 mg, taken three times daily, for 7 days as a course, or 400 mg, taken twice daily, for 5 days. In some cases, 1–2 g may be taken in a single dose.
(3) Precautions During Treatment
To prevent reinfection, underwear and laundry should be boiled during treatment. Due to the high risk of recurrence after treatment, a follow-up examination should be conducted 3–5 days after menstruation. If follow-up is not possible and symptoms reappear after menstruation, retreatment should be administered. For cases that do not improve with prolonged treatment, a check of the patient’s and partner’s urine or prostatic fluid should be performed. If trichomonads are detected, metronidazole should be administered orally concurrently. A cure is confirmed only if trichomonads are negative in vaginal discharge tests after three consecutive menstrual cycles.