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, provided Ganlin wash solution, and mefenoxazole suppositories for insertion into the vagina. The doctor also 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 need to go to the hospital for another check-up after completing the three injections of medication? And do I need to continue using the mefenoxazole 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 mild acetic acid solution can be used for sitz baths (add 2 tablespoons of boiled vinegar to half a basin of warm water). Common medications include metronidazole 200–400 mg, inserted deep into the vagina nightly, for a course of 7–10 days. Alternatively, traditional Chinese medicine ingredients such as 15g each of oak bark, Sophora flavescens, root of toon tree, cinnabar fruit, atractylodes rhizome, and phellodendron bark can be decocted and used for sitz baths daily.
(2) Systemic medication
Metronidazole 200 mg, taken three times daily, for a 7-day course, or 400 mg 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 utensils should be boiled during treatment. Due to the high recurrence rate 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 may be necessary. Patients with prolonged, unresolved cases should have their urine or prostatic fluid tested for trichomonads, and metronidazole should be administered orally if detected. A cure is confirmed only when trichomonads are negative in vaginal discharge after three consecutive menstrual cycles.