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Trichomoniasis is one of the most common diseases of the genitourinary system, and the most common sexually transmitted disease. It affects both men and women (however, women are much more likely). Effective treatment of this disease is often delayed, since it is poorly diagnosed (especially by gynecologists). However, you can recover from it quite quickly, and the prognosis is favorable if competent, timely treatment is prescribed. Most often, gynecologists and urologists prescribe metronidazole for trichomoniasis.

1. Metrogyl (injection solution), price about 200 rubles;
2. (90 rub.);
3. Nycomed (50 rub.);
4. Klion (80 rub.).

It is also sold under its own name Metronidazole.

Mechanism of action

There are several regimens for taking this drug for trichomoniasis. The difficulty is that some types of Trichomonas are not sensitive to this substance and it is very important that the doctor is able to promptly recognize this resistance and prescribe other treatment. Typically, the body’s response to the drug (as well as a decrease in the symptoms of the disease) occurs when at least 2 g of the active substance has entered the body. If after such a dosage there is no improvement, then it is pointless to continue treating trichomoniasis with this drug.

You can take the medicine in different regimens, differing in duration and volume of daily dosages. Only a doctor can select the correct regimen.

1. A single dose of 2 g of the drug at once;
2. Take 0.25 g of the drug twice a day, morning and evening, for 10 days;
3. Take 500 mg twice a day (that is, 1 g per day) for 7 days;
4. On the first day, 0.5 g of trichopolum twice, on the second day, three times 0.25 g of trichopolum, from the third to the sixth day - 0.25 g twice a day;
5. 250 mg of trichopolum twice a day for 5 days;
6. From the first to the fourth day - 0.25 g of metronidazole three times a day, from the fifth to the eighth day - 0.25 mg of metronidazole twice a day;
7. Treatment with metronidazole 2 g daily at a time for three days;
8. Four doses of 0.5 g of trichopolum over five days;
9. Metronidazole for trichomoniasis, 1 g twice a day, morning and evening, for a week;
10. On the first day, four doses of trichopolum 0.75 g, on the second day - 0.5 g trichopolum 4 times a day.

The chronic course of the disease requires special treatment. If it is prolonged and has mild symptoms, then you need to take the medicine differently. It is necessary to use Metrogyl injection solution, which contains 500 mg of metronidazole. It must be administered intravenously through a dropper for 5-7 days. The daily dosage volume (in one dropper) is 100 ml and it should last 20 minutes.

Of course, these doses are quite approximate and can only be used in the general case and in uncomplicated cases of the disease. But in each specific case, treatment must be prescribed by a doctor. Especially in case of chronic, recurrent, complicated course, the patient has chronic diseases etc.

Contraindications

Despite the fact that the drug is considered quite mild and safe for humans, it nevertheless cannot be taken in some cases. You should refrain from taking medications with metronidazole in the following cases:

1. The presence of individual intolerance to the components of the drug or the main active substance (including a history);
2. Epilepsy and some severe lesions of the central nervous system;
3. Tumors and other diseases of the brain (in some cases, admission is acceptable, but after consultation with your doctor);
4. Disorders of the liver associated with its functioning, including failure;
5. First trimester of pregnancy and breastfeeding.

You should not self-medicate with this drug. In particular, in the presence of certain chronic diseases, this can cause significant damage to health. Only a doctor will be able to select an effective and safe treatment regimen in each specific case.

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Metronidazole for trichomoniasis allows you to effective treatment sexually transmitted disease. The drug has a detrimental effect on the causative agent of the disease (Trichomonas), and deprives it of the ability to further live.

General information and benefits of metronidazole

Metronidazole belongs to the group of antiprotozoals and antimicrobials With wide range actions. The main active ingredient of the drug (metronidazole) has a destructive effect on the DNA of bacterial cells, inhibits protein synthesis, thereby leading to the death of pathogens.

The product is available in tablet form, as a solution for injection and vaginal suppositories. May also be given in the form of other medicines:

• Kliona;
• metrogyla;
• nobody.

Metronidazole is considered a fairly mild medicine. However, its use should be avoided in patients with epilepsy, brain tumors, and liver failure.

How to take and dosage for trichomoniasis

The metronidazole treatment regimen is selected individually in each specific case. The tablets should be taken only after meals. Failure to comply with this point significantly increases the likelihood of developing side effect medicines.

The following are common ways to take metronidazole:

Duration of admission	Dosage
1 day	2 g once
3 days	2 g daily
5 days	0.5 g four times a day
7 days	500 mg twice daily
7 days	1 g morning and evening
10 days	0.25 g twice throughout the day

According to the instructions, the drug can be used in another way - 0.25 mg three times a day for 4 days. From days 5 to 8, the same dose is reduced to two doses. Simultaneously with taking the tablets, it is recommended to use hepatoprotectors that protect the liver. Metronidazole in the form of vaginal tablets is used once a day for a 6-day course.

In more than 90% of cases, in patients who completed a full course of metronidazole therapy, after 4 weeks there was a complete disappearance of unpleasant symptoms and traces of the causative agent of trichomonas infection in the blood.

Is it effective for chronic trichomoniasis?

In the chronic form of trichomoniasis, characterized by a protracted course and mild symptoms, the drug is used for intravenous drip administration. In this case, it will take 6 to 10 days to heal.

A single injection will require 500 metronidazole. The procedure should last for 20 minutes. Between sessions it is necessary to maintain a time interval of at least 8 hours.
To avoid the development of a fungal infection, the medicine should not be mixed with other medications.

With drip administration of metronidazole, there is a possibility of developing leukopenia, which requires periodic monitoring of the patient’s blood condition. After drips, it is possible to develop such phenomena as deterioration of coordination and weakening of attention, and therefore it is recommended to refrain from driving immediately after the procedure vehicles or high-precision mechanisms.

Metronidazole during pregnancy

Trichomoniasis during pregnancy poses a threat to the unborn fetus if the infection in the mother's body is mixed. In this case, simultaneously with trichomonas, chlamydia, ureaplasma, gonococci, etc. can be detected in the patient’s blood.

Metronidazole is contraindicated in the first trimester of pregnancy and the lactation period. Starting from the 4th month of gestation, it can be used in case of acute disease, but requires constant monitoring by an obstetrician-gynecologist. During this period, it is recommended to use forms of the drug intended for vaginal administration. If all instructions are followed, no toxic effects on the fetus are observed, embryonic development is not disrupted, and the child is born completely healthy.

The last trimester of pregnancy is considered the safest period for treatment with metronidazole. In the remaining weeks of gestation, the medicine can be prescribed in any form, since the risk of complications becomes minimal.

Despite the relative harmlessness of metronidazole in the second and third trimesters, many experts prescribe this drug only in extreme cases.

At any stage of gestation, one-day therapy with this drug is completely contraindicated, since a high concentration of the active substance in the blood plasma can penetrate into the fetus’s body.

Dosage for pregnant women

Most often, pregnant women are prescribed metronidazole tablets, which allow them to quickly achieve the desired therapeutic effect. The dosage in this case will be as follows:

• Chronic form of trichomoniasis - 250 mg (1 tablet) twice a day for a 10-day course.
• Acute course of the disease - the dose remains the same, but treatment is shortened to 8 days and supplemented with the introduction of vaginal suppositories.

If during therapy a woman experiences discomfort in digestive tract, it is recommended to switch from using the tablet form to using suppositories.

Drug price

Metronidazole is one of the available drugs. Various dosage forms products have the following prices:

• 20 tablets of 250 mg – $41;
• 20 tablets of 500 mg – $16;
• 10 vaginal suppositories 500 mg – $72;
• solution for intravenous administration 100 ml – $4.

In most pharmacies this medicine can be purchased without a doctor's prescription.

The use of metronidazole for trichomoniasis, as for most diseases of infectious origin, is considered the drug of choice, because it differs from other medications in its high level of effectiveness and relatively low price. This drug is very often used for the treatment of venereological diseases, as it is endowed with a wide spectrum of action and activity against Trichomonas and numerous other types of bacteria.

Despite the fact that Metronidazole was invented back in the 60s of the last century, it is widely used in modern medicine. Almost all doctors prescribe it for the treatment of people with trichomoniasis. Given medicine Available in various dosage forms.

Nowadays, there are quite a lot of drugs that are made on its basis:

• Trichopolum;
• Trichosept;
• Flags;
• Batsimex;
• Nycomed;
• Medazol.

The positive aspects of Metronidazole are its high level effectiveness against Trichomonas and a slight toxic effect on the human body (after all, the drug is endowed with the ability to be quickly absorbed into the blood).

Treatment methods for trichomoniasis infection

During the period of remission of trichomoniasis, several drug treatment regimens can be used.

The American method, or as it is commonly called the shock method, is based on taking metronidazole in the entire dose (2 g) at once. This scheme has many advantages compared to other methods. Most often, it is prescribed to representatives of the stronger half of humanity, who are forgetful and are not inclined to follow doctor’s orders for a long period of time.

A single dose reduces toxicity and accumulation of the active substance in the body. However, a significant number of doctors are inclined to believe that this method of treating trichomoniasis is ineffective and therefore do not use it. For women during pregnancy, this method is used only from the second half of pregnancy.

Five-day administration of the drug - if this method of treatment is chosen, the patient is prescribed metronidazole twice a day for five days. The dosage of the drug in this case should be 250 mg at a time.

A ten-day course of treatment requires taking the drug 250 mg twice a day. The negative aspect of this treatment regimen is the duration, but the method makes it possible to obtain a high level of concentration of the active substance in the blood plasma, and this, in turn, will lead to the death of the pathogen.

Seven-day use of metronidazole - in this case, the patient must be quite careful when taking the drug, because on the first day it must be taken twice a day, 500 mg, on the second - three times a day, 250 mg, from the third to the seventh day - 250 mg twice a day.

In the countries of the European Union, the most commonly prescribed treatment for trichomoniasis is metronidazole 250 mg twice a day (every 8 hours) for seven days. As for Russia, its doctors are more inclined to prescribe shock therapy, which involves a single dose of 2 g of the drug.

It should be noted that in any case, the choice of treatment regimen and drug should only be made by a qualified specialist. While taking metronidazole, drinking alcohol is prohibited, as this can cause a teturam reaction, which will be accompanied by vomiting, rapid heartbeat and a deterioration in the person’s general condition.

Features of treatment of trichomoniasis with metronidazole in women and children

Due to the anatomical features of the body structure of representatives of the weaker half of humanity, they are prescribed not only oral administration of drugs, but also their vaginal use in the form of suppositories made on the basis of metronidazole.

If available chronic form diseases, women are prescribed intramuscular administration of Trichopolum or intravenous administration Metronidazole. At the same time, vaginal medications are also prescribed:

• which must be inserted into the vagina;
• Trichopolum beads - administered once a day for six days;
• capsules called Klion - their dosage should be 1 g, that is, one capsule for five days;
• within two days;
• tablets called Ginalgin - they must be inserted into the vagina, 1 per day for ten days.

If necessary therapeutic therapy For children, they are prescribed drugs in lower dosages. The daily dose is calculated in the ratio of 20–30 mg per kg of body weight. The child must be under the supervision of a doctor throughout the entire course of treatment.

Cautions and contraindications

When prescribing drugs made on the basis of metronidazole, the doctor should emphasize that they are not compatible with alcohol-containing drinks. After all, even a small amount of alcohol, when ingested together with metronidazole, can lead to the formation of disulfiram-like reactions, which will manifest themselves in the form of:

• vomiting;
• breathing disorders;
• the appearance of intense pain in the head;
• heart rhythm disturbances;
• sudden rise and fall in blood pressure.

All these reactions of the body lead to a deterioration in the general condition of a person and can cause the formation of various complications.

Note! Drinking alcoholic beverages is allowed no earlier than two days after the end of treatment.

As for contraindications, it must be remembered that metronidazole should not be taken simultaneously with drugs that are classified as anticoagulants (drugs that interfere with the blood clotting process).

The drug should be prescribed with caution to patients who have a history of liver and kidney disease, women while pregnant and breastfeeding.

As a result, it should be noted that the presented article is only introductory material on how trichomoniasis is treated with metronidazole. Dosages of drugs and selection of the appropriate treatment regimen should only be carried out by a doctor separately for each specific case. Self-medication may not only not lead to the desired results, but also cause serious complications.

Trichomoniasis is caused by the protozoan Trichomonas vaginalis. Most men infected with T. vaginalis have no symptoms, although a small number have nongonorrheal urethritis. In women, most of whom are symptomatic, T. vaginalis causes a characteristic diffuse yellow-green discharge with unpleasant smell and vulvar irritation phenomena, although many women have minor symptoms. There is recent evidence of a possible association between vaginal trichomoniasis and adverse pregnancy outcomes, particularly early rupture. amniotic sac and premature birth).

Symptoms of trichomoniasis

Clinical manifestations in women are characterized by liquid vaginal discharge, greenish-yellow in color - up to 70%, from 10-30% of cases - foamy. Patients note itching and burning in the vulva, dysuric phenomena, which intensify during menopause. 30-50% of patients have no complaints. The main lesion is the vagina, urethra, and vaginal part of the cervix. The skin and mucous membranes of the labia majora, vestibule and vagina are swollen, hyperemic, and covered with discharge. Liquid, purulent, foamy discharge of a greenish-yellow color is characteristic. When examined in the speculum: the cervix is ​​swollen, there are pinpoint hemorrhagic areas with signs of erosion. This symptom is typical of trichomoniasis and is detected in 40% of women during colposcopy.

Complications of trichomoniasis in women are observed in the form of vulvitis, bartholinitis, endocervicitis, rupture of membranes, premature birth and infertility.

Indications for laboratory testing for trichomoniasis in women

Changes in the nature of vaginal discharge compared to the norm, detection of trichomoniasis in a sexual partner, lack of positive changes in the nature of vaginal discharge after empirical treatment, remaining itching of the vulva after empirical treatment with antifungal drugs.

Clinical manifestations of trichomoniasis in men occur as transient and asymptomatic carriage, which is observed in 10-36%. Symptomatic complaints - burning sensation in urethra, scanty gray or whitish-watery discharge is noted. Dysuric phenomena are also observed.

Complications of trichomoniasis in men are diagnosed as epididymitis, prostatitis, vesiculitis, urethral stricture, erectile dysfunction and infertility.

Indications for laboratory testing for trichomoniasis in men

Discharge from the urethra, dysuria, burning and itching in the urethra, irritation in the penile area, reproductive disorders, erectile dysfunction, orchiepididymitis, prostatitis.

Classification of trichomoniasis

Depending on the duration of the disease and the intensity of the body’s reaction to the introduction of the pathogen, the following forms of trichomoniasis are distinguished:

1. fresh, acute, subacute, torpid (asymptomatic);
2. chronic (torpid course and disease duration over 2 months);
3. Trichomonas carriage (in the presence of Trichomonas there are no objective and subjective symptoms of the disease).

Laboratory diagnosis of trichomoniasis

Microscopy of the native and stained specimen is performed. In native preparations, Trichomonas vaginalis is identified by a pear-shaped or oval body shape slightly larger than a leukocyte, a characteristic jerk-like movement and a flagellum. The advantage of studying Trichomonas in stained preparations is the possibility of studying them later long time after taking the material. In stained preparations (methylene blue, Gram) they have an oval, round or pear-shaped shape with well-defined contours and a delicate cellular structure of the cytoplasm.

To identify the finer structure of Trichomonas, more complex staining methods are used (according to Romanovsky-Giemsa, Heidenhain, Leishman). These methods make it possible to identify the causative agent of the disease in 40 to 80% of cases.

Cultural studies using special media can detect up to 95% of cases.

Treatment of trichomoniasis

Metronidazole (Trichopol, Flagyl) is effective. Metronidazole is used 0.25 g 2 times a day for 10 days; per course - 0.5 g or the first 4 days 0.25 g 3 times a day, the remaining 4 days - 0.25 g 2 times a day; per course - 5.5 g. Tipidazole (Fazizhin) is prescribed once in a dose of 2.0 g (four tablets). When trichomoniasis is resistant to metronidazole, orpizol (orpidazole) is effective. For uncomplicated trichomoniasis, it is used 1.5-2.0 g once, for complicated trichomoniasis - 500 mg 2 times a day for 5-10 days.

Metronidazole 2 g orally once.

Alternative scheme

Metronidazole 500 mg twice 2 times a day for 7 days.

In the United States, only oral metronidazole is used to treat trichomoniasis. Randomized trials have shown that the cure rate with recommended metronidazole regimens is approximately 90%-95%, and treatment of sexual partners may increase this cure rate. Treatment of patients and sexual partners results in resolution of symptoms, microbiological cure, and reduction in the likelihood of transmission. Metronidazole gel has been approved for the treatment of bacterial vaginosis, but like other topical antibacterial drugs that do not reach therapeutic levels in the urethra or Bartholin's glands, it is significantly less effective for the treatment of trichomoniasis than oral metronidazole preparations and is therefore not recommended for use . Some other topical antibacterial drugs are used to treat trichomoniasis, but they are probably no more effective than metronidazole gel.

Follow-up

Follow-up is not necessary for men and women whose symptoms disappear after treatment or who were initially asymptomatic.

Infections caused by strains of T. vaginalis with reduced sensitivity to metronidazole may occur. However, most of these microorganisms were eliminated after using higher doses of the drug. If the treatment regimen is violated, the patient should be re-treated according to the following regimen: metronidazole 500 mg 2 times a day for 7 days. If treatment is again ineffective, the patient must be given metronidazole 2 g once a day for 3-5 days.

Patients in whom infection is culture-confirmed and treatment regimens recommended in this guideline have failed and reinfection has been ruled out should be consulted with an expert; CDC consultation available. When evaluating such cases, it is necessary to determine the sensitivity of T. vaginalis to metronidazole.

NB! The FDA has approved Flagyl 375™ twice daily for 7 days for the treatment of trichomoniasis based on pharmacokinetic similarity to metronidazole 250 mg three times daily for 7 days. However, there are no clinical data to support the clinical similarity of these two regimens.

To treat trichomoniasis in men, medications and their dosage regimen are prescribed by a doctor, based on individual characteristics body. Trichomonas is a pathogen that belongs to the flagellate family, which determines the specificity of the lesion male body.

You cannot treat trichomoniasis yourself at home. Otherwise, the infection becomes chronic, which can lead to various complications. Medicines for the disease in question are varied. But they must be used correctly according to the scheme proposed by the doctor. Tablets, injections and capsules are taken according to different medical algorithms.

Therapy for trichomoniasis includes taking symptomatic medications and performing various physical procedures. At the same time, the immune system is strengthened with the help of immunomodulatory agents. Optimal therapy is based on the use of short and long regimens. Combined treatment is indicated for complicated trichomoniasis in men. The basis of therapy is the intake antibacterial drugs(Trichopol, Klion, Flagyl).

The optimal oral agent is Metronidazole. It is quickly absorbed, but can accumulate in tissues. A short scheme for using Metronidazole:

• duration of therapy - 6 days;
• total dosage - 3.65 grams;
• the first day of treatment - 3 times 0.5 grams;
• Every day the dose is reduced by 1 tablet.

Long-term treatment with Metronidazole:

• duration - 10 days;
• daily twice-daily oral administration of the drug, 0.25 grams.

Specialists can prescribe an alternative therapy regimen based on Tinidazole and other similar agents (Fazizhin). These medications are taken once, 4 tablets. Sometimes clindamycin-based medications are included in the treatment regimen. They are taken 2 times every day. The above schemes are used at an early stage of the disease.

In case of advanced infection, a combination treatment is prescribed, which is based on several drugs, including Metronidazole or its analogues. Advanced trichomoniasis is treated with intramuscular injections of Solcotrichovac, which are administered 3 times daily for 2 weeks.

Medicines of different effects

1. Klion (Flagyl, Trichopolum) - prescribed to eliminate urogenital Trichomonas. Medicines quickly accumulate in the blood, thus ensuring the effective dosage.
2. Tinidazole (Fazizhin) - has a mechanism of action characteristic of Trichopolum. To eliminate the infection, take 4 tablets once. Not prescribed for pathologies of the central nervous system.
3. Solcotrichovac - 0.5 ml is injected into the muscle once a day.
4. Clindamycin - taken 2 times a day.

To increase the effectiveness of system-wide therapy, prescribe local remedies. In men, the disease is more difficult to treat with local means than in women. Due to the inability to use vaginal suppositories, the dosage of oral medications is increased.

Local medications include:

• Ginalgin;
• Ornidazole;
• Atrican.

You can use a 0.5% solution of silver nitrate or 1% collargol. Therapy is based on medications with pronounced systemic effects. The general principles of treatment of trichomoniasis include:

1. To protect the liver, before therapy, hepatoprotectors (Essentiale-Forte) are taken, 2 tablets of Cycloferon once or three tablets of Immunal three times a day. The drugs are taken simultaneously with etiological agents. Men are prescribed rectal suppositories Viferon-3.
2. If trichomoniasis is accompanied by candidiasis, then the candida fungus is treated before taking anti-trichomoniasis drugs.
3. Mandatory rehabilitation of both partners.

Male trichomoniasis is not treated with concomitant inflammation of the urogenital tract. In this case, the patient must comply with the following rules:

• rinse the genitals daily with water;
• completely empty the bladder;
• use individual personal hygiene products;
• shave hair;
• Take a hygienic shower daily.

Review of medications

Medicines for male trichomoniasis are taken according to regimens that help minimize adverse reactions from treatment. Many drugs belong to the group of DNA-tropic drugs that die when the deoxyribonucleic acid of microbes is destroyed.

Secnidazole, Nimorazole are medications that have a selective effect on infection. After getting inside the microbe, the drugs are destroyed under the influence of enzymes to a toxic metabolite. The following adverse reactions may occur during therapy with imidazoles:

• leukopenia;
• skin rash;
• skin redness;
• noise in the head;
• fear;
• allergy;
• dyspepsia;
• neurotoxicosis.

Since the list of adverse reactions is extensive, doctors do not recommend treatment at home. Microbes develop resistance to drugs. This mechanism is typical for short-term or low-dose treatment. Chronic infection is difficult to eliminate.

If the patient has developed resistance to nitroimidazoles, then Furamag, Mebendazole, Butoconazole, Galavit, Nifuratel are prescribed. Timely detection of infection guarantees complete elimination of trichomoniasis.

The main group of medications for trichomoniasis are nitromidazoles. Metronidazole is considered the most effective medicine for the disease. Its analogues include:

• Trichopolum;
• Klion.

If a mild form of the disease is detected, a one-time dose of metronidazole is indicated. Taking into account the patient’s condition, the doctor may suggest a weekly treatment regimen for Trichomonas with Metronidazole. In this case, the drug is taken twice a day. The medication is quickly absorbed by the blood, creating a significant concentration of the active component in the places where the infection is localized.

But against the background of such therapy, the patient experiences heaviness in the stomach, dizziness, vomiting and belching. During treatment it is forbidden to drink alcoholic beverages. Otherwise, adverse reactions will intensify. This will result in a disulfiram reaction.

New generation medicines

In addition to Metronidazole, other, more effective drugs can be used in the treatment of trichomoniasis. modern means. They are effective and less toxic to the male body. IN this group includes Tinidazole - tablets available in a dosage of 0.5 g. They are prescribed 4 tablets for a single dose or for a long course.

Mild infections are treated with Ornidazole, which is taken for 5-10 days. It has less effect on the body and does not contribute to the manifestation of significant adverse reactions. At the same time, the shade of urine does not change, but oral cavity does not dry out.

The main reason for the ineffectiveness of therapy is the presence of other microbes in the body (B-hemolytic streptococcus, which reduces the effectiveness of Metronidazole and its analogues). In this case, before starting repeated antiprotozoal therapy, in order to eliminate the coccal flora, empirical antibacterial therapy is carried out with Amoxiclav three times a day or Erythromycin.

One full course of antiprotozoal therapy with Metronidazole or its analogues most often completely destroys Trichomonas. If such treatment is ineffective, the dosage of the drug is increased or Tinidazole is used.

Local therapy

If the disease is acute or a protracted chronic illness, a combination of general therapy with local sanitation is indicated.

Less commonly, the patient is prescribed antiprotozoal and antimicrobial agents:

• McMiror;
• Neo-Penotran;
• Ginalgin.

In severe cases, when the disease does not respond to standard treatment, the Solcotrichovac vaccine is additionally prescribed. It promotes the production of specific antibodies against Trichomonas. With this therapy, the development of negative microbes is inhibited, but the number of organisms of normal flora increases.

The antibody titer increases gradually over 14 days after injection. The patient's condition should improve within 14-20 days. The vaccine must be injected deep into the muscle 3 times a day with an interval of 2 weeks.

Repeated revaccination is indicated after a year (1 dose). If there are indications, it is carried out after 2 years. To complement the complex therapy for mild forms of infection, the use of immunocorrective agents is indicated. Doctors advise using herbal preparations (Eleutherococcus tincture, Leuzea extract).

The most dangerous complications trichomoniasis in men - prostatitis, vesiculitis, epididymitis. Therefore, the disease requires immediate treatment. It is better to do this during the period of Trichomonas carriage or with minor clinical manifestations infections. This will prevent the development of infection and complications.

Comments

Megan92 () 2 weeks ago

Daria () 2 weeks ago

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Megan92 () 13 days ago

Daria () 12 days ago

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