This is general health information only and is not a substitute for advice from your GP or healthcare professional.
1. What is Mycoplasma genitalium?
Mycoplasma genitalium (M. genitalium) is a sexually transmitted bacterial infection that can infect the cervix, urethra, vagina, rectum, and, less commonly, the throat. It can occur without symptoms, particularly in women.
2. How is Mycoplasma genitalium transmitted?
M. genitalium is mainly transmitted through sexual contact, including vaginal and anal sex. Transmission through oral sex is less well established. Using condoms consistently can reduce the risk of transmission.
3. What are the symptoms of Mycoplasma genitalium?
Many people have no symptoms. When symptoms occur, they may include burning or pain when urinating, vaginal or penile discharge, pelvic pain, pain during sex, or bleeding after sex or between periods. In men, urethritis is a common presentation.
4. How is Mycoplasma genitalium diagnosed?
M. genitalium is diagnosed using a molecular test, usually a nucleic acid amplification test (NAAT) performed on a urine sample or genital swab. Resistance testing is important where available because M. genitalium has developed resistance to several commonly used antibiotics.
5. Is Mycoplasma genitalium the same as chlamydia or gonorrhoea?
No. M. genitalium is a different bacterial STI from chlamydia and gonorrhoea. The symptoms can be similar, however, so specific testing is required to identify the infection.
6. How is Mycoplasma genitalium treated?
Treatment depends on antibiotic resistance and previous treatment. Resistance-guided therapy is preferred where available, and treatment commonly involves a staged antibiotic approach rather than a single dose of antibiotics. Azithromycin should not be used as a single-dose treatment because of the high risk of treatment failure and resistance.
7. Why is antibiotic resistance a problem with Mycoplasma genitalium?
M. genitalium has developed high levels of resistance to macrolide antibiotics such as azithromycin, and resistance to fluoroquinolones is also increasing. Using the wrong antibiotic can result in treatment failure and further resistance, which is why treatment should be guided by appropriate testing and current clinical guidelines.
8. Should sexual partners be tested or treated?
Current management of sexual partners depends on symptoms, local guidelines, and availability of testing. Partners may require assessment and testing, particularly when there is a confirmed infection. Patients should follow their clinician’s advice about sexual activity and partner management during treatment.
9. Can Mycoplasma genitalium cause complications?
Yes. In women, untreated infection has been associated with pelvic inflammatory disease, which can increase the risk of chronic pelvic pain, infertility, and ectopic pregnancy. In men, persistent infection can cause urethritis. The long-term significance of asymptomatic infection is less certain.
10. When should I see a doctor?
You should seek medical advice if you have symptoms of an STI, have a sexual partner diagnosed with M. genitalium, or have persistent urethritis or cervicitis despite treatment for other infections. Follow-up testing may be recommended after treatment because treatment failure due to antibiotic resistance can occur.