Mycoplasma Genitalium: What To Know About This STI

Written on August 12, 2023 by Lori Mulligan, MPH. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What Is Mycoplasma Genitalium?
• How Is Mgen Spread?
• How Do You Know If You Have Mgen?
• What Happens If Mgen Goes Untreated?
• How Can You Prevent a Mgen Infection?
• How Is Mgen Diagnosed?
• How Do You Treat Mgen?
• How Soon After Treatment Will You Feel Better?
• How Can Everlywell Help?
• Related Content

The CDC called Mycoplasma genitalium (Mgen) an “emerging issue” in 2015, but don’t feel bad if you know little or nothing about it. The following will help educate you on this little-discussed sexually transmitted infection (STI). According to the CDC, Mgen is responsible for causing approximately 15% to 30% of persistent or recurrent urethritis cases in men in the United States and 10% to 30% of cervicitis cases in women.

What Is Mycoplasma Genitalium?

Mgen is a bacterial sexually transmitted infection (STI) that can cause infection among people of any gender. Mgen can infect the cervix (opening to the uterus), inside the penis (the urethra), or the rectum.

How Is Mgen Spread?

You can get Mgen by having vaginal or anal sex without a condom with someone who has the infection. Researchers are still determining whether sex partners can spread Mgen through oral sex.

A person with Mgen can pass the infection to someone even when they have no signs or symptoms.

How Do You Know If You Have Mgen?

People with Mgen often have no symptoms.

Someone with symptoms may notice:

• Vaginal discharge
• A burning sensation when peeing
• Discharge from the penis

See your healthcare provider if you notice any of these symptoms.

You should also see a provider if your partner has an STI or symptoms of one. Symptoms of an STI can include:

• An unusual sore
• Smelly discharge
• Burning when peeing
• Pain or bleeding after sex
• Bleeding between periods

What Happens If Mgen Goes Untreated?

Left untreated, Mgen may cause serious and permanent health problems in women, including pelvic inflammatory disease (PID). Some of the complications of PID are[1]:

• Formation of scar tissue that blocks fallopian tubes
• Ectopic pregnancy (pregnancy outside the uterus)
• Infertility (not being able to get pregnant)
• Long-term pelvic/abdominal pain

For women who are already pregnant, Mgen may be associated with preterm (early) delivery or pregnancy loss. More definitive studies of the natural history of Mgen infection in women are required before we can determine that serious reproductive health outcomes occur, in whom they occur, and how often. This final issue — how often Mgen leads to adverse sequelae — is critical, because future decisions about the importance of screening for the infection will need to be based on cost-effectiveness analyses, and the results of these analyses will depend on the magnitude of the health risks associated with the infection.[2]

We do not know if men develop long-term health problems from Mgen.

Infection in men is usually asymptomatic, and most men will likely resolve infection without developing disease.[3]

How Can You Prevent a Mgen Infection?

Limit your sex partners. Sex with one partner who has sex only with you can reduce your risk of getting a sexually transmitted infection (STI).

Talk with your partner or partners about STIs before you have sex. Find out if they are at risk for an STI. Remember that it’s possible to have an STI and not know it.

Avoid having sex if you (or any partners) have symptoms of an infection or if you are being treated for an STI.

Use a condom every time you have sex. Condoms are the only form of birth control that also helps prevent STIs.

Don’t share sex toys. But if you do share them, use a condom and clean the sex toys between each use.[4]

How Is Mgen Diagnosed?

Despite the bit of mystery surrounding Mgen, the infection can cause serious issues, particularly for women, if left untreated, as discussed above. Thankfully, a relatively new test may help healthcare providers diagnose it more accurately.

In 2019, the FDA authorized the marketing of a new test — Hologic’s Aptima Mycoplasma genitalium Assay — to help with the diagnosis of Mgen. The test can be performed using a vaginal, endocervical, or urethral swab, as well as a urine sample.

In cases where Mgen is detected, providers can consider forgoing the use of antibiotics that are known to be ineffective against the infection and choose a treatment more likely to be appropriate. Having accurate and reliable tests to identify the specific bacteria that is causing an infection can assist providers in choosing the right treatment for the right infection, which can reduce the overuse of antibiotics and help in the fight against antimicrobial resistance.[5]

How Do You Treat Mgen?

The recommended treatment for all cases of Mgen is a two-step therapy with doxycycline, followed by an additional agent (either moxifloxacin or azithromycin). Although cure rates with doxycycline monotherapy are low, using doxycycline as the initial agent may lower Mgen organism load and facilitate organism clearance.[6]

While many antibiotics are ineffective at destroying mycoplasma bacteria, the macrolide class of antibiotics effectively eliminates the bacteria from your body when taken as directed. These include:

• Erythromycin
• Clarithromycin
• Azithromycin
• Doxycycline

You can take over-the-counter (OTC) medications to relieve your symptoms if you’re congested or have a cough.

Some cases of mycoplasma infections can resolve on their own, so treatment isn’t always necessary, especially if you have very mild symptoms. If you think you have an infection, talk to your provider to learn about your best treatment options.

To curb antimicrobial resistance, the only patients in whom testing for Mgen is clearly indicated are those with symptoms (urethritis, cervicitis, pelvic inflammatory disease), and current partners of index patients infected with Mgen (even if asymptomatic), to prevent potential reinfection.[7]

How Soon After Treatment Will You Feel Better?

After you begin antibiotics, your symptoms will often decrease after two to three days, but it may take weeks to completely resolve respiratory infections. Contact your healthcare provider if you still feel sick or have symptoms after you’ve completed your antibiotics.[8]

How Can Everlywell Help?

Virtual Visits

Everlywell offers STI consults in 2 hours or less and on-demand STI appointments when and where you need them. If you think you may have been exposed to Mgen or another sexually transmitted infection or disease, connect with a clinician quickly and easily through Everlywell.

Make Right-for-You Medical Decisions

STIs typically cause mild symptoms, but it is also possible to have an STI and feel no symptoms at all. Many STIs can be treated with medication, and early detection is key.

Speak Privately to a Healthcare Provider

Your Virtual Care Visit will include a discreet 20- to 30-minute video call with a licensed board-certified nurse practitioner, where you can discuss your sexual health concerns and get questions answered.

Discuss a Care Plan for Your STD or STI Symptoms

During your appointment, your clinician will provide personalized recommendations and next steps based on your symptoms and exposure history. This may include additional testing or prescription medication, if applicable.

STI Kits: Getting Tested Is Invaluable

As mentioned above, some STIs have no noticeable symptoms. The best way to know for sure if you have an STI is to get tested regularly if you’re sexually active. Everlywell offers at-home STI kits for men and women.

STI kits screen for six types of infections: chlamydia, syphilis, HIV, gonorrhea, hepatitis C, and trichomoniasis. While Mgen is not one of them, it can help narrow the range of possible diseases if you take this before seeking treatment for Mgen. Kits are available for men and women.

Related Content

Augmentin® For STDs: What You Need to Know

Can STDs Go Away Without Treatment?

Managing HIV In Pregnancy: What You Need To Know

References

1. Mgen: Basic fact sheet. Centers for Disease Control and Prevention. Last reviewed November 16, 2022. https://www.cdc.gov/std/mgen/stdfact-Mgen.htm. Accessed on August 1, 2023.
2. Manhart LE, Broad JM, Golden MR. Mycoplasma genitalium: Should We Treat and How? Clin Infect Dis. 2011 Dec 15; 53(Suppl 3): S129–S142. doi: 10.1093/cid/cir702. https://doi.org/10.1093%2Fcid%2Fcir702.
3. Horner PJ, Martin DH. Mycoplasma genitalium infection in men. The Journal of Infectious Diseases, Volume 216, Issue suppl_2, 15 July 2017, S396–S405. https://doi.org/10.1093/infdis/jix145.
4. Mgen: Condition basics. Kaiser Permanente. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.mycoplasma-genitalium.aco3468. Last reviewed May 9, 2023. Accessed on August 1, 2023.
5. FDA permits marketing of first test to aid in the diagnosis of a sexually-transmitted infection known as Mycoplasma genitalium. Food and Drug Administation. https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-first-test-aid-diagnosis-sexually-transmitted-infection-known-mycoplasma. June 23, 2019. Accessed on August 1, 2023.
6. Mgen: Detailed fact sheet. Centers for Disease Control and Prevention. https://www.cdc.gov/std/mgen/stdfact-Mgen-detailed.htm. Last reviewed on December 5, 2022. Accessed on August 1, 2023.
7. Bradshaw CS, Horner PJ,Jensen JS, White PJ. Syndromic management of STIs and the threat of untreatable Mycoplasma genitalium. The Lancet. DOI: https://doi.org/10.1016/S1473-3099(18)30080-X.
8. Mycoplasma. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/23545-mycoplasma. Last reviewed on August 27, 2022. Accessed on August 1, 2023.