A little-known infection that affects millions of people worldwide can have a significant impact on your life, yet it often goes unnoticed. Mycoplasma genitalium is a sexually transmitted infection that is becoming increasingly common.
This infection can impact both men and women and infects the cervix, urethra, penis, or rectum. Mycoplasma genitalium often has no symptoms, but it can cause serious long-term health effects.
This article explores Mycoplasma genitalium, its symptoms, causes, treatments, and preventive measures, empowering you with vital health knowledge.
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What is Mycoplasma Genitalium?
Mycoplasma genitalium is one of over 100 species of Mycoplasma. This group of bacteria can cause infections in many parts of the body. One species of Mycoplasma, Mycoplasma pneumoniae, is responsible for atypical (or walking) pneumonia.
Overview of Mycoplasma Genitalium
Mycoplasma genitalium specifically infects the genital tract, causing cervicitis, urethritis, and pelvic inflammatory disease. Mycoplasma genitalium infections often don’t have symptoms, which means that they can cause significant harm and spread between partners without the infected person knowing that they are infected. This makes it a significant public health risk.
Prevalence and Global Impact
Mycoplasma genitalium was identified in 1980 and is one of the smallest free-living cells. It has been growing in prevalence as a sexually transmitted infection, overtaking gonorrhea in prevalence in the 2010s, though still behind chlamydia.
In addition to the rates of infection trending upward, there is also increasing concern about Mycoplasma genitalium becoming more resistant to some of the antibiotics traditionally used to treat it.
Symptoms and Diagnosis
Many people with Mycoplasma genitalium don’t have symptoms, which makes it more difficult to detect. However, some Mycoplasma genitalium infections do have symptoms.
Common Symptoms
Nearly 93% of Mycoplasma genitalium infections are asymptomatic. This has allowed the infection to spread more easily. Silent spreaders can be present in many populations. A 2022 study showed that nearly 20% of men who have sex with men were found to be coinfected with Mycoplasma genitalium, most of them asymptomatic.
Some people with Mycoplasma genitalium infections are symptomatic. Symptoms of infection may include:
- Pain with urination
- Discharge from the penis or vagina
- Pelvic pain in women
If you or your partner has been diagnosed with a sexually transmitted infection (STI) or has symptoms of one, you should see a healthcare provider and get tested. Mycoplasma genitalium is often not included on a standard STI panel. If you are concerned about this infection, you may want to ask your healthcare provider about it specifically.
Mycoplasma genitalium may be associated with long-term complications including:
- Scarring of the fallopian tubes
- Ectopic pregnancy
- Infertility (possibly)
- Chronic abdominal and pelvic pain
- Possibly preterm delivery or pregnancy loss if infection occurs in pregnancy
The presence of long-term complications of Mycoplasma genitalium in men is unknown.
Diagnostic Challenges
As STIs go, Mycoplasma genitalium isn’t so much new as it is increasingly recognized. Diagnosing Mycoplasma genitalium used to be more difficult because there wasn’t adequate testing available. It is also easier to miss since the infection is frequently asymptomatic.
Testing for Mycoplasma genitalium is usually done using nucleic acid testing. In 2020, there were only two tests approved by the Food and Drug Administration (FDA) for detecting Mycoplasma genitalium.
Fortunately, this is improving, and now multiple tests are available. It is possible for Mycoplasma genitalium to be detected on cultures, but it requires a special laboratory to detect and this may take months.
Causes and Transmission
Mycoplasma genitalium is a bacterial infection spread through sexual contact.
Causes of Mycoplasma Genitalium
Mycoplasma genitalium infections are slow-growing, but they are quite hardy. These small bacteria have protective mechanisms to resist the body’s defenses against infection.
Risk factors for developing an infection include:
- More than one partner in your lifetime
- Your partner having other sexual partners
- Low-socioeconomic status
- Unprotected intercourse
- Previous history of STI
- Chlamydial infection
- Becoming sexually active at a younger age
Because Mycoplasma genitalium infections are often asymptomatic, many infections go undetected, which may lead to underestimates of infection rates as well as a lack of information about the risk factors associated with it.
How it Spreads
Mycoplasma genitalium is spread through sexual intercourse. Either anal or vaginal intercourse without a condom can spread the infection. It is unknown whether the infection can be spread through oral intercourse. The infection can be spread whether or not the person knows that they are infected.
Treatment Options
Mycoplasma genitalium can be difficult to treat due to increasing antibiotic resistance.
Medical Treatments
Antibiotics are the first line of treatment for Mycoplasma genitalium. In patients with pelvic inflammatory disease (PID), traditional treatment regimens are not effective. Moxifloxacin 400mg daily for two weeks is recommended to treat Mycoplasma genitalium infections.
Treatment partners should be tested and treated if positive. Since it can take some time to get results back to rule out Mycoplasma genitalium, if PID is suspected, the traditional treatment of doxycycline 100mg twice daily for 14 days should be started while waiting for results.
Azithromycin used to be the treatment of choice for Mycoplasma genitalium and is still included in many guidelines. However, the bacterium is becoming increasingly resistant to this antibiotic, so it is often not effective.
Managing Antibiotic Resistance
If the strain of Mycoplasma genitalium is resistant to moxifloxacin, the recommended treatment regimen is doxycycline 100mg twice daily for 7 days, followed by moxifloxacin 400mg daily for 7 days. The best way to avoid antibiotic resistance is to make sure that you are taking all of your antibiotics, as not completing antibiotics can lead to more antibiotic resistance.
Newer antibiotics are being studied to treat Mycoplasma genitalium due to the growing resistance to traditional antibiotics such as the macrolide and quinolone classes. These new antibiotics are showing some promise in treating these stubborn infections in the future.
Prevention and Public Awareness
Because this infection is so difficult to treat, public awareness and prevention are important to help decrease its spread.
Preventing Mycoplasma Genitalium
The best way to prevent Mycoplasma genitalium is to be in a monogamous relationship with a partner who doesn’t have the bacteria and to use condoms consistently every time you have vaginal or anal intercourse.
Routine testing for Mycoplasma genitalium is not recommended in people without symptoms. Testing is recommended for people who have recurrent urethritis, cervicitis, or proctitis. Testing may also be recommended for people who have a partner known to be infected with the bacteria.
Raising Awareness
Public health campaigns are trying to raise awareness of Mycoplasma genitalium infections. Increasing education in clinics and potentially schools can help close the knowledge gaps with this infection.
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Key Takeaways
Mycoplasma genitalium is a common, frequently asymptomatic infection
- Mycoplasma genitalium can be detected using nucleic acid-based testing
- Mycoplasma genitalium is becoming increasingly resistant to antibiotics
- Consistent condom use and being in a monogamous relationship are the best ways to prevent the spread of this infection
Mycoplasma genitalium is difficult to treat and may be the cause of recurrent or chronic genital infections.
Being proactive about your health management and using safer sex practices can help prevent the spread of this infection. Raising awareness of this infection may also help decrease infection rates by encouraging safer sex practices. Take control of your health today: Speak with your healthcare provider about screenings and prevention strategies.
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