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Mycoplasma genitalium (Mgen) a sexually transmitted infection (STI) similar to Chlamydia and Gonorrhea. The associated symptoms can include unusual discharge, painful urination, and abdominal pain. However, notexhibiting any symptoms is also common with this disorder.
Usually, Mycoplasma genitalium is spread through unprotected vaginal or anal sexual intercourse but is rarely transmitted via oral sex.
To test for Mgen, a urine sample or vaginal swab is used, and if necessary, an oral or analswab. The obtained samples are analysed through PCR technology to check for the infection.
If you are diagnosed with the disease, treatment with oral antibiotics is available. Generally, treating Mycoplasma genitalium is crucial to prevent severe complications that may occur if untreated.
By Able Health I Medically reviewed by Dr. Alireza Estedlal
Page last reviewed: February 2024 I Next review due: February 2026
Most Mycoplasma genitalium (Mgen) cases are asymptomatic. But when symptoms do occur, they are often nonspecific and can be mistaken for other STIs like chlamydia and gonorrhoea.
Mgen symptoms usually don’t show up right away because the condition has an incubation phase of 4 to 8 weeks. Therefore, it might take up to one or more months between exposure and manifestation of the symptoms.
Symptoms of Mycoplasma genitalium often vary among natal males and females. Men who are symptomatic might experience pain when urinating (dysuria) or urethral discharge. In women, symptoms can include unusual vaginal discharge, pelvic pain, nausea, vomiting, fever, and possibly bleeding after intercourse.
Furthermore, Mgen can be associated with an odd smell, just like in other types of STIs. Some individuals with the infection perceive a fishy odour, especially after sexual intercourse.
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Mycoplasma genitalium is a bacterium infecting the human reproductive organs, such as the penis, vagina, and sometimes rectum.
Mgen is generally a common form of STI. An approximation of up to 1% of the population in developed states have the infection, and the occurrence can go up to 4% in developing nations. While anybody can be infected with Mgen, it is more widespread among sex workers as well as natal males engaging in sexual activities with other natal males.
The Mgen bacterium is mostly transmitted through unprotected intercourse, including both vaginal and anal sexual activities.
Some individuals may have been infected with Mgen for many years but aren’t aware of it since they don’t exhibit any symptoms. While the infection may disappear on its own in those who are asymptomatic, others can still spread the bacterium during the period of infection.
Mycoplasma genitalium can lead to several complications in both men and women. They include:
There isn’t a single approved blood test to diagnose Mycoplasma genitalium. However, the standard diagnostic procedure is a nucleic acid amplification test (NAAT). This test uses samples of urine and swabs from the urethra, cervix, penis opening, or vagina and provides results within 24 to 48 hours.
If a NAAT isn’t accessible, the doctor might diagnose Mgen depending on persistent or recurring urethritis or cervicitis. Research indicates that Mgen is the primary cause of 40 percent of all cases in men and up to 30 percent in women.
Syndromic treatment involves treating all STI cases with a particular symptom profile in the same way without knowing the exact cause. Physicians may diagnose and treat Mycoplasma genitalium depending on the symptoms only. However, this approach isn’t always accurate since some people have a completely different kind of infection requiring a distinct treatment. If the condition is detected immediately, then the appropriate treatments could be administered sooner.
Therefore, NAAT is the recommended method for diagnosing suspected Mgen cases. This test allows doctors to make precise treatment choices according to the test results instead of relying on assumptions.
Doctors usually prescribe antibiotics for over a 10-day course to treat Mycoplasma genitalium. The choice of antibiotics can vary as the bacterium may develop resistance to certain treatments. Also, the treatment plan may differ for people who are pregnant, breastfeeding or have allergies. It’s advisable to avoid any kind of sexual activity, even using a condom while receiving treatment.
During the past years, Mgen was treated with a single 1-gram dosage of azithromycin. However, Mgen might develop resistance to first-line antibiotics, including azithromycin and moxifloxacin. This implies that the bacteria has undergone mutation and the drugs are now ineffective.
Presently, the Mgen strain from an infected person is examined to check if it has mutated to resist azithromycin. Based on the results, the treatment can include two 7-day courses of various antibiotics.
If Mgen hasn’t undergone mutation, the doctors can recommend doxycycline of 100 milligrams (mg) taken twice daily for seven days. This will be followed by azithromycin of the initial 1-gram dosage, and finally 500 mg every day for three days.
On the other hand, if Mgen has undergone mutation, 100 mg of doxycycline should be taken twice daily for 7 days. After that, 400 mg of moxifloxacin is taken once per day for 7 days.
Using condoms is often the best approach to preventing Mgen, although there is still a possibility of infection despite wearing one. If diagnosed with Mgen, it is essential to avoid sexual activity for at least 7days after starting treatment. This prevents the spread of the disease to others.
If you’ve engaged in unprotected sex with a partner whose sexual history is unknown to you, then it’s advisable to make an appointment at a clinic for a check-up. While you might not have Mgen, it’s best to be cautious as you may have been infected with another infection. Currently, Mgen testing is recommended only in specific circumstances, which can be discussed during your visit.
The majority of individuals with Mgen do not show any symptoms. Other STIs, like chlamydia, can also be asymptomatic but are extremely contagious. It’s thus a good idea to make an appointment for a check-up.
While condoms minimise the risk of contracting Mgen, they don’t entirely prevent it. So, if your partner has been diagnosed with Mgen, it is advisable that both of you undergo treatment and avoid sexual activity until you have completed treatment.
You can resume sexual activity after completing the 10-day treatment. Some people prefer waiting till the recommended test of cure, which is done five weeks following treatment, to ensure the infection is fully cleared.
Mgen isn’t believed to affect the unborn baby. But in rare cases, it has been associated with miscarriage and early labour. If you are expectant and test positive for Mgen, discussing the situation with your provider or obstetrician on what to do is recommended.
Mgen can contribute to pelvic inflammatory disease (PID), a condition that lowers fertility. So, if you experience PID symptoms, it is important to make an appointment or go to the clinic for immediate assessment.