Mycoplasma Genitalium

What is mycoplasma genitalium?

Mycoplasma genitalium is a bacterium that can cause infection of the cervix, urethra (penis), and anus.

It is a sexually transmissible infection and is like chlamydia, but less common.

How do you get it?

You can get mycoplasma genitalium by having anal or vaginal sex without a condom with someone who has the infection.

Some people may not have any symptoms but can still pass on the infection.

What are your symptoms?

There are often no symptoms with mycoplasma genitalium. If symptoms do occur they include:

If you have a vagina:

• Lower abdominal pain or discomfort
• Pain while having sex
• Unusual vaginal bleeding (between periods or after sex)
• Unusual vaginal discharge

If you have a penis:

• Discharge from the penis
• Pain or burning passing urine

If you have an anal infection:

• Discharge and bleeding from the anus
• Pain or burning around the anus

When do you test for mycoplasma genitalium?

Testing for mycoplasma genitalium is only recommended:

If you have symptoms such as those listed above and tests for other sexually transmissible infections are negative

If you have a current sexual partner who has been diagnosed with mycoplasma genitalium

Routine testing is not recommended if you have no symptoms, unless you have had a sexual partner recently diagnosed with a mycoplasma genitalium infection.

How do you test for mycoplasma genitalium?

• If you have a vagina, the test is a vaginal swab (you can collect this yourself or a doctor or nurse can collect for you). Alternatively you can have a swab from the cervix, or a urine sample.
• If you have a penis, the test is a urine sample.
• If you have a rectal infection, the test is a rectal swab.

How do you treat it?

Mycoplasma genitalium is treated with two courses of antibiotics. This cures most infections.

However, it can be difficult to treat. This is because the antibiotics used do not always work (this is called antibiotic resistance). If this is the case, you may need to see a medical specialist and have treatment with different antibiotics. Occasionally the different antibiotics do not work, and a cure may not be achievable.

It is important to avoid any sex without a condom until you and your partner have been treated and have both had a negative follow-up test for mycoplasma genitalium.

Do I need a follow-up test after treatment?

You may not need a follow-up test if you no longer have any symptoms.

If you still have symptoms 2 to 3 weeks after you have finished treatment, or if there is a high risk that you may have been re-infected with mycoplasma genitalium, a follow-up test may be recommended to make sure that there is no infection present. If the infection is still present, you may need to see a medical specialist for further management. 

What happens if I have symptoms and don't get treatment?

If you have a vagina, have symptoms and mycoplasma is left untreated, in about 5 % of cases the infection can extend to the uterus (womb) and fallopian tubes, causing pelvic inflammatory disease (PID). Pelvic inflammatory disease can cause infertility. If infection occurs during pregnancy mycoplasma genitalium can be associated with miscarriage and pre-term delivery.

Should I tell my sexual partners if I am diagnosed with mycoplasma genitalium?

Yes, all sexual partners from the past six months should be contacted, tested, and treated. You can do this yourself or there are websites that can help you to do it anonymously. Your doctor or nurse can help you with this.

How do I avoid getting mycoplasma genitalium?

The best way to prevent mycoplasma genitalium is by using condoms or dams every time you have vaginal or anal sex.

For great tips on using condoms, check out SHFPACT’s condoms factsheet.

References

• Australian STI Management Guidelines for use in Primary Care
• Stay STI Free. Victorian Sexual Health Network.