Mycoplasma genitalium

Overview

Mycoplasma genitalium (often called M. gen) spreads through sex. In men, it's a common cause of urethritis (an irritated urethra) that keeps coming back. In women, it can cause cervicitis and may play a role in pelvic inflammatory disease.

Many people have no symptoms. Testing isn't recommended for people without symptoms. It's harder to treat than some STIs because it has become resistant to common antibiotics.

Symptoms

Many people have no symptoms.

• Discharge from the penis
• Burning when urinating

Less common

• Unusual vaginal discharge
• Bleeding after sex or between periods
• Pelvic or lower belly pain
• Pain during sex

How it usually goes

• Days to weeks: Symptoms may start, if any.
• After treatment: Symptoms that don't clear are a reason to test for M. gen.
• About 2 weeks of pills: Both antibiotics are finished.

When to get medical care

Causes

M. gen is caused by the bacterium Mycoplasma genitalium. It spreads through sexual contact.

Does it spread or run in families?

• Yes, it can spread from person to person.
• How it spreads: sex.
• Condoms lower the risk. Sex partners should be tested and treated too.

Who is more likely to get it

• More than one partner
• Not using condoms
• Symptoms that came back after STI treatment

Possible complications

• Urethritis: Irritated urethra that keeps coming back
• Cervicitis: Inflamed cervix
• Pelvic inflammatory disease: May play a role

Diagnosis

Testing is usually done when symptoms come back or don't go away after treatment.

Questions you may be asked

• Discharge, burning, or pelvic pain
• Past treatment for an STI
• Recent partners

The exam

They may check your genitals and, for women, do a pelvic exam.

Tests

Tests include:

• Urine test or swab: A lab test looks for the bacteria's genetic material.
• Resistance test: If available, shows which antibiotic will work.
• Other STI tests: For chlamydia, gonorrhea, and trichomoniasis, which cause similar symptoms.

Treatment

Treatment is usually 7 days of doxycycline, then a second antibiotic chosen to beat resistance.

Self-care

• Take every dose of both medicines
• Don't have sex until you finish treatment and symptoms are gone
• Ask about testing your partners so you don't get it again
• Come back if symptoms don't go away

Medicines

These need a prescription.

Usual STI treatments don't always cure M. gen, so testing matters when symptoms keep coming back.

If the infection doesn't clear, other antibiotics may be tried. A follow-up test is sometimes done about 3 weeks after treatment.

How it compares

Prevention

You can lower your risk:

• Use condoms correctly every time
• Limit your number of partners
• Get checked if symptoms come back after treatment

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a sexual health clinic, an OB-GYN, or a urologist; your local health department can test for free or low cost.

Back to school, work, or sports

• You can go to school and work as usual.
• Don't have sex until you and your partners finish treatment and your doctor says it's OK.

Children, pregnancy, and older adults

• Women: May cause cervicitis; testing may be considered with pelvic inflammatory disease.
• Pregnancy: Some of these antibiotics aren't used in pregnancy. Ask which is safe.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

M. gen can usually be cured with the two-step treatment, but resistance is growing. Follow-up matters if symptoms don't clear.

Getting ready for your visit

Bring a list of past STI treatments.

What to bring

• What you were treated with before and when
• Symptoms and when they started
• Recent partners

Questions to ask

• Should I be tested for M. gen?
• Is a resistance test available?
• Do my partners need treatment?
• When should I come back if it doesn't clear?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Mycoplasma genitalium