Urinary Symptoms of boyfriend: Trichomoniasis or Chlamydia?

Dear Ask The Doctor: Hello, my boyfriend is experiencing redness at the tip of his penis, frequent urges to urinate, and consistent dull pain that subsides after urinating. He had consulted his family doctor who thought he could have trichomoniasis, and was given Flagyl, which he took a 2000mg dose at once. It's been 48 hours since taking the medication and these symptoms have not gone away. I have also taken the Flagyl, and my symptoms have disappeared. However, neither of us was actually tested for Trichonomiasis. I was tested for Chlamydia over a month ago, and the results were negative. My boyfriend has been recently tested, but has not yet received the results. Any thoughts on what the redness and pain he is experiencing is? Is it Trichonomiasis, Chlamydia, or something else? Could it be possible that Flagyl is not effective for him, if it is Trich.?

Dear Jan:

According with the description of your boyfriend’s symptoms, most likely he is experiencing a Trichomonas infection, which is a sexually transmitted, caused by the Trichomona vaginalis. It is one of the most common sexually transmitted diseases in the United States. Trichomoniasis in women may be asymptomatic or may cause various symptoms, including a thick yellow-green vaginal secretion and vulvar irritation, in men, trichomoniasis could be asymptomatic or present with itchiness and redness of the penis. It is very important to rule out other sexual transmitted diseases, because frequently Trichomoniasis coexist with, Chlamydia infection, gonorrhea or syphilis.

The standard treatment for Trichomona vaginalis infection is Metronidazol (“Flagyl”) which has been very effective over all these years. Drug resistance is rare, however if it appears the alternative is nitroimidazole drugs(“Tinidazole”, “Ornidazole”). If treatment fails maybe it will be required a higher dose of metronidazole (“Flagyl”) or the use of a different drug as the mentioned above.