Mycoplasma genitalium

• Mycoplasma genitalium (Mg) is a sexually transmissible infection from which many people have no symptoms.
• Mg is easy to test for in a urine sample or swab from the vagina, cervix, or anus.
• If not treated successfully with antibiotics, the infection can remain in the body for a long time.

Mycoplasma are bacteria that can infect different parts of the body. The bacteria are very small and have no cell walls which makes antibiotic treatment complicated. There are about 200 types of mycoplasma bacteria, with most being harmless. If they do cause problems, the part of the body being damaged depends on the type of mycoplasma bacteria causing the infection (e.g. lungs, skin, urinary tract, genitals). The sexually transmissible infection (STI) Mycoplasma genitalium (Mg) commonly affects the urethra, cervix, anus, and very rarely, the throat. It may spread to the uterus and fallopian tubes, or testicles, which can cause infertility and problems during pregnancy if not treated.

Signs and symptoms

Many people with Mg have no symptoms. The symptoms listed below don't necessarily mean you have Mg, but can be associated with Mg or other common STIs like chlamydia. If you have any symptoms, get a check-up with a health professional as soon as possible.

Vagina

• a change in vaginal discharge
• pain when passing urine
• bleeding or spotting between periods or after having sex
• pain during or after sex
• pain in the lower abdomen.

Penis

You may notice:

• a discharge from the penis
• pain when passing urine.

Anus

• You may experience pain or irritation inside the anus and/or anal bleeding.

Testing

Testing for Mg is not routinely offered as part of a sexual health check but may be considered if there is recurrent non-gonococcal urethritis, pelvic inflammatory disease, bleeding after sex, or your sexual partner has Mg. Testing for Mg is easy using a urine sample and/or swabs from the vagina, cervix, or anus sent to the laboratory for testing. Swabs can often be self-collected while you are at the clinic or pathology collection centre.

If you test positive for Mg, your ongoing sexual partners should be tested and may need treatment. Sample conversations and services that assist with telling partners in a confidential and anonymous way (if desired) are available online:

• Let Them Know
• Drama Down Under
• Better to know

Treatment

Because of the structure of the Mg bacterium and increases in antibiotic resistance, it can be complex to treat. There is a need to balance the side effects of repeated antibiotic treatment and harm caused by Mg. The goal of treatment is to get rid of symptoms and the infection, but this may not be achievable in all cases. Highly antibiotic resistant Mg infections are increasing in Australia, and it can be challenging and expensive to access effective treatment. Your treating doctor may seek specialist antibiotic resistance testing and advice if your Mg infection persists after treatment.

To give Mg treatment the best chance of success:

• take medication as advised by your treating doctor or other healthcare professional
• avoid sexual contact (not even sex with a condom) for 14–21 days after you and your partners have completed treatment and been tested again to make sure the antibiotics worked to cure the infection
• avoid sexual contact with untested partners as Mg may remain in the body for a long time, has no symptoms for many people, and you could be re-infected.

Transmission

You can get an STI such as Mg by having sex without a condom.

If you're having sex without a condom, the risk of getting an STI is higher:

• if you have casual partners
• the more casual partners you have
• if you have partners who have had sex in some countries outside Australia (especially if they haven't used a condom in the past)
• if you have partners who have injected drugs
• for men who have anal sex with other men.

Prevention

Practise safe sex, talk to your partners about sexual health, and make sure you get enthusiastic consent. Condoms are the best way to prevent STIs and using them with a water-based lubricant will be more pleasurable and reduce the risk of the condom breaking.

The only way to know that you do not have an infection is to get a sexual health check. If you have sex with new or different partners and do not use condoms, you'll need to have more frequent sexual health checks.

Health outcome

Without treatment, Mg can develop into pelvic inflammatory disease and can lead to infertility. Having Mg during pregnancy may lead to miscarriage or pre-term delivery and it is important to have antenatal checks which include STI tests. Knowledge about Mg is still evolving and there may be other long-term consequences.

Other resources

Related content

• Safe Sex
• Contact tracing

Help and assistance

Get qualified health advice 24/7 for the cost of a local call 13 HEALTH (13 43 25 84).

This factsheet provides general information and is not intended to replace the need to see a health professional or have a sexual health check. For more information on Mg or sexual health please talk to a healthcare provider. A doctor, nurse or health worker can assist with:

• providing appropriate tests, treatment and information about how to prevent STIs
• helping people to ensure that their sexual partners get tested and treated.