Mycoplasma genitalium

Mycoplasma genitalium (MG) is a bacterial infection. It can infect the genital tracts (vagina, penis and rectum (bum)). MG is often asymptomatic, meaning many people don't know they have it. It is a relatively common infection but is less well known than chlamydia or gonorrhoea. Many people who have MG do not have symptoms, which means it additionally often goes undiagnosed.

MG is spread through sexual contact. It is transmitted through genital fluids rather than skin-to-skin contact. Condoms and dental dams can reduce the risk of transmission.

Most people who have MG don't notice any symptoms, so they don't know they have the infection - this is why testing is really important!

In people with a vagina:

• Pain when peeing
• Unusual discharge or fluid leaking from the vagina
• Pelvic (low tummy) pain, especially during sex
• Unusual bleeding between periods, or after sex
• Discharge or bleeding from the anus if there has been anal sex.

In people with a penis:

• Soreness, unusual discharge, or itching in the opening at the end of the penis (urethra - where the pee comes out)
• Pain when peeing
• Discharge or bleeding from the anus if there has been anal sex
• Painful or swollen testicles.

Mycoplasma genitalium is treatable, but because MG can be resistant to some antibiotics, correct testing and treatment is important.

Testing is done using a swab or urine test, depending on your symptoms and anatomy.

Testing is usually recommended if:

• You have ongoing genital or urinary symptoms
• Symptoms persist after treatment for another STI
• You are a sexual partner of someone diagnosed with MG.

Routine screening in people without symptoms is not currently recommended.

Mycoplasma genitalium requires specific antibiotics, and treatment may involve more than one step.

Because antibiotic resistance is common, treatment often includes:

• An initial antibiotic to reduce the bacterial load
• Followed by a second antibiotic chosen based on resistance patterns.

It is important to:

• Take all medication exactly as prescribed
• Avoid sex until treatment is completed and advised by your clinician
• Attend follow-up or test-of-cure if recommended.

Do not re-treat yourself with leftover antibiotics, as this can worsen resistance.

You will require a retest at 4 weeks after you have finished treatment.

• Use condoms correctly every time you have sex
• Get tested if you have symptoms or ongoing genital discomfort
• Avoid sexual contact until treatment is completed if diagnosed
• Ensure partners are tested and treated if required.

If you are diagnosed with Mycoplasma genitalium, recent sexual partners should be informed and advised to have a full sexual health check - including testing specifically for MG, even if they do not have symptoms. The testing is recommended to be done around 2 weeks after the last episode of unprotected sex.

Partner treatment is only recommended if they test positive for Mycoplasma genitalium.

Your healthcare provider or sexual health clinic can help you with partner notification if needed.

You should avoid sex, or use condoms consistently and correctly, until you and your partner(s) have completed treatment and are testing negative.