Mycoplasma Genitalium
A sexually transmitted bacterial infection
Quick Facts
- Type: Sexually transmitted infection (STI)
- Cause: Mycoplasma genitalium bacterium
- Often: No symptoms
- Treatment: Specific antibiotics, guided by resistance
Overview
Mycoplasma genitalium is a tiny bacterium that is spread through sexual contact and can infect the genital and urinary tracts. It is increasingly recognized as a cause of sexually transmitted infections, although many people who carry it have no symptoms at all and may not know they are infected.
When it does cause problems, it can lead to inflammation of the urethra in men and of the cervix or reproductive organs in women. Because it shares symptoms with more familiar infections like chlamydia and gonorrhea, it can be missed without specific testing. Mycoplasma genitalium has also become harder to treat as it develops resistance to some antibiotics, so accurate diagnosis and guided treatment are important.
Because the infection is often silent, it can quietly persist and spread between partners for a long time before it is recognized. It is also one reason that symptoms of urethritis or cervicitis sometimes do not clear after treatment aimed at chlamydia or gonorrhea. In those situations, testing specifically for Mycoplasma genitalium can reveal the true cause and guide more effective treatment.
Symptoms
Many infections cause no symptoms. When symptoms do occur, they differ between men and women.
- In men: Discharge from the penis, burning during urination, and irritation or discomfort at the tip of the penis (urethritis).
- In women: Unusual vaginal discharge, burning with urination, bleeding between periods or after sex, and pelvic or lower abdominal pain.
- Discomfort or pain during sex in either sex
Because it is often silent, the infection can be passed to partners and can persist until detected by testing.
Causes
The infection is caused by the bacterium Mycoplasma genitalium, which is passed from person to person through sexual activity.
- Sexual transmission: It spreads through vaginal, anal, and possibly oral sexual contact with an infected partner.
- Contact with infected fluids and tissues: The bacterium attaches to the lining of the genital and urinary tracts.
It is not spread through casual contact such as sharing toilets, towels, or swimming pools. A person can be infected without symptoms and unknowingly transmit it to partners.
Risk Factors
- New or multiple sexual partners
- Sex without condoms
- A partner with the infection or another STI
- A history of other sexually transmitted infections
- Symptoms of urethritis or cervicitis that do not improve after treatment for other infections
Diagnosis
Mycoplasma genitalium requires a specific test because it is not detected by standard chlamydia and gonorrhea screening.
- Nucleic acid amplification test (NAAT): A sensitive test performed on a urine sample or a swab from the genital area that detects the bacterium's genetic material.
- Resistance testing: Some tests also check for genetic markers of antibiotic resistance, which helps guide treatment.
Testing is often considered when symptoms of urethritis or cervicitis persist despite treatment for chlamydia and gonorrhea.
Treatment
Treatment uses specific antibiotics, and the choice is influenced by growing antibiotic resistance.
- Antibiotics: Treatment typically involves a combination or sequence of antibiotics, sometimes guided by resistance testing, because the bacterium has become resistant to certain drugs.
- Follow-up testing: A repeat test may be done after treatment to confirm the infection has cleared.
- Partner treatment: Recent sexual partners should be tested and treated to prevent reinfection and further spread.
- Avoiding sex during treatment: Refraining from sexual activity until treatment is complete and the infection is cleared helps prevent transmission.
It is important to take antibiotics exactly as prescribed, since incomplete treatment can contribute to resistance.
Prevention
- Use condoms consistently and correctly during sexual activity
- Limit the number of sexual partners
- Get tested for STIs if you or a partner have symptoms or new partners
- Ensure partners are treated before resuming sex after an infection
- Have open conversations with partners about STI testing
When to See a Doctor
See a doctor if you have genital discharge, burning with urination, unusual bleeding, or pelvic pain, or if symptoms persist after being treated for another infection. Women with severe lower abdominal pain, fever, or pain during sex should seek prompt care, as untreated infection can spread to the reproductive organs (pelvic inflammatory disease) and affect fertility. Testing is also wise after unprotected sex with a new partner, even without symptoms.
Frequently Asked Questions
What is Mycoplasma genitalium?
It is a bacterium spread through sexual contact that can infect the genital and urinary tracts. It can cause urethritis in men and cervical or pelvic inflammation in women, though many people have no symptoms and do not know they are infected.
How do you get tested for it?
A specific nucleic acid amplification test (NAAT) on a urine sample or genital swab is needed, because standard chlamydia and gonorrhea screening does not detect it. Testing is often done when urethritis or cervicitis persists after treatment for other infections.
Is Mycoplasma genitalium hard to treat?
It can be, because the bacterium has developed resistance to some antibiotics. Treatment usually involves specific antibiotics, sometimes guided by resistance testing, and a follow-up test may be done to confirm the infection has cleared.
Can it cause complications?
Yes. If untreated, it can lead to ongoing urethritis in men and can spread to the reproductive organs in women, causing pelvic inflammatory disease, which may affect fertility. Treating the infection and partners helps prevent these problems.
How can I prevent it?
Using condoms consistently, limiting the number of partners, getting tested when you have symptoms or new partners, and making sure partners are treated all reduce the risk of getting or spreading the infection.
References
- Centers for Disease Control and Prevention (CDC). Mycoplasma genitalium.
- MedlinePlus, U.S. National Library of Medicine. Sexually transmitted infections.
- World Health Organization (WHO). Sexually transmitted infections.
- British Association for Sexual Health and HIV (BASHH). Mycoplasma genitalium.