Published on Oct 03, 2023 | 3:51 PM
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First identified in the 1980s, Mycoplasma genitalium, also referred to as M. genitalium or simply Mgen, is a sexually transmitted disease that is growing to be common in the United States. Infecting both genders, regardless of sexual orientation, the STD is often asymptomatic, with most patients reporting feeling no symptoms or those that can be mistaken for other, more common, infections. (1) Doctors stress proper testing and treatment with antibiotics as Mgen has proven to be far more resilient against traditional means of medical care due to symptoms it shares with more common conditions and its natural resistance to many popular antibiotics.
A member of the Mycoplasma genus, like Mycoplasma pneumoniae and Mycoplasma hominis, M. genitalium finds its way into the human body through sexual activity. (2) Transmitted through unprotected sex by both men and women, the infection can infect the penis, cervix, and rectum. It is not confirmed whether the disease can be passed orally or by hand, but the current recommendation is to practice caution in such cases. (1)
Currently, there is no indication that Mgen naturally occurs in the body, infecting the body through unprotected sex. However, the vast majority of cases are often asymptomatic or result in no symptoms. Additionally, the infection lasts inside the body for several months, with some retaining it for over a year and only being aware when symptoms suddenly arise or being prompted to get tested for it specifically. (3)
It is possible for someone to have both Mgen and bacterial vaginosis at the same time, with bacterial vaginosis often contributing to the development of BV in women. (4) However, there is no evidence that the roles are reversed. As discussed in the CallonDoc Guide to Bacterial Vaginosis, BV naturally occurs in the female body due to an imbalance that causes the overgrowth of bacteria. At the time of writing, Mgen is only transmitted into the human body through sexual activity and is not naturally occurring.
In the instance that it causes a noticeable infection, Mgen first gains entry into the body by attaching to the mucous membranes inside the rectum, vagina, penis, and urethra. Inherently lacking a cell wall, the STD more easily invades the cell lining of these membranes at a faster rate than other diseases like it. If symptoms are felt, they occur differently depending on the patient’s gender:
Mycoplasma Genitalium in Women:
Mycoplasma Genitalium in Men:
In addition to symptoms occurring in the genitals, Mgen can play a role in developing infections in the anus. CDC research estimates that 3% of rectal infections in all female patients are due to Mycoplasma genitalium, while up to 26% of men in the LGBTQIA+ community suffer rectal infections caused by Mgen. (6)
The prevalence of M. genitalium cannot be understated, not just in the infections that can be felt but in those that go unnoticed. While most asymptomatic cases cause little to no damage to the body, they have been known to remain for months to years until arising in the form of an infection with symptoms or clearing itself out. (7)
Doctors and scientists have struggled with a number of problems surrounding Mycoplasma genitalium. Due to the recency of its discovery compared to other STDs, its capacity to remain asymptomatic for extended periods, and the lack of established tests to identify it in patients are just some of the many problems surrounding the infection. Fortunately, the United States Food and Drug Administration (FDA) has approved three tests to help detect Mgen alongside improved methods of detection that have improved our understanding of how prevalent the infection has become. (8) In the same year the first test was approved, the CDC added Mgen to the list of top three STDs that prove to be the most concerning to the national populace. (9) All of this is to say that thanks to the added national attention and improved resources, M. genitalium is becoming easier to detect in patients reporting correlating symptoms or are getting tested for conditions that are most known to be included in a co-infection.
When a mycoplasma genitalium test kit is deployed on a potential case, the condition is not necessarily difficult to diagnose. Each of the three uses the DNA gathered from either a swab or urine sample and amplifies the results to be viewed in a lab. In the instance that it is tested for, the results tend to be conclusive when the virus is present. With all of that said, the relatively low detection rate of Mgen is not necessarily due to the capability of tests used, but because the STD is still new to some medical providers. Call-On-Doc has been treating and testing for Mycoplasma since its foundation in 2017.
Simply due to how new the STD is and how unusually fast it infects any sexually active population, many doctors will still assume the presence of a more common sexually transmitted disease. In such instances, the more common conditions are tested for and then ruled out until a test for Mgen is considered necessary. That is especially the case when the patient is suffering from conditions like cervicitis or urethritis. (10)
Mycoplasma is an STD that can be transferred from person to person but does not necessarily cause additional STDs by itself. However, it can lead to other conditions in the reproductive tract, such as:
In terms of symptoms, several sexually transmitted infections (STIs) can share similarities with Mycoplasma genitalium (Mgen). Common STIs that can have similar symptoms to Mgen include:
Chlamydia: Chlamydia trachomatis is a bacterial STI that often presents with symptoms such as genital discharge, pain or discomfort during urination, and abdominal pain. Chlamydia can infect the genital and urogenital tract, leading to these symptoms, which can resemble those of Mgen infection. For more information about Chlamydia, read the CallonDoc Guide to Chlamydia.
Gonorrhea: Neisseria gonorrhoeae is another bacterial STI that can infect the genital and urogenital tract. Symptoms of gonorrhea can include genital discharge, painful urination, and abdominal discomfort. These symptoms may overlap with those of Mgen infection. For more information on Gonorrhea, read the CallonDoc Guide to Gonorrhea.
Trichomoniasis: Trichomonas vaginalis is a protozoan parasite that infects the genital tract. Symptoms of trichomoniasis in women can include vaginal discharge, itching, and discomfort, which can resemble some of the symptoms of Mgen infection. For more information on trichomoniasis, read the CallonDoc Guide to Trichomoniasis.
M. genitalium is a complex challenge for healthcare providers due to its genetic makeup and its natural resistance to traditional means of treatment. In addition to most cases being asymptomatic, many are still assumed to be more common STDs like chlamydia, gonorrhea, or trichomoniasis. Some providers who are new to treating mycoplasma might introduce antibiotics that prove ineffective and cause antibiotic resistance. This is especially important to know and be considered when getting treated.
It is thereby important to stress the importance of STD testing when you believe you ultimately have one. At the time of writing, the most effective Mycoplasma genitalium treatment options are doxycycline or azithromycin. (12)
At the time of writing, the CDC favors doxycycline, azithromycin, and moxifloxacin in specific regimens when discussing mycoplasma genitalium treatment. More specifically, if the condition is sensitive to macrolide, doxycycline should be used first before it should be followed up by azithromycin. If the condition is resistant to macrolide, the doxycycline regimen should be followed up by moxifloxacin. In either case, the exact amount and for how long would be left up to your healthcare provider. (13) Call-On-Doc follows the guidance of the CDC and treats mycoplasma according to the government agency’s guidelines.
On top of Mgen lacking a cell wall and therefore being naturally immune to antibiotics that target cell walls, the condition has developed antibiotic resistance to many of the most commonly used STD antibiotics. In many cases, patients must get an additional round of Mycoplasma genitalium treatment due to many strains building immunity against azithromycin. In such instances where a patient develops an antibiotic resistant strain of Mgen, the CDC has developed a treatment failure registry for the healthcare and scientific community to keep track of for the purpose of creating a cure for such a problem.
When undergoing Mycoplasma genitalium treatment, there are steps you can take to enhance the effectiveness of the treatment and minimize the risk of reinfection or complications:
Knowing if Mycoplasma genitalium (Mgen) is cured typically involves a combination of factors. The primary method is through follow-up testing, also known as a “test of cure,” usually a few weeks after completing the prescribed antibiotic treatment. Healthcare providers may use nucleic acid amplification tests (NAATs) or other molecular techniques to detect the presence of Mgen DNA in genital samples. A negative test result suggests successful clearance of the bacterium. However, it's essential to follow your healthcare provider's recommendations regarding the timing of follow-up testing, as Mgen may require longer treatment durations in some cases. Additionally, the resolution of any symptoms or discomfort associated with the infection can be an indicator of successful treatment. Open communication with your healthcare provider is crucial to ensure proper follow-up and to address any concerns or persistent symptoms effectively.
When looking to get a mycoplasma genitalium test, treatment, or get retested after treatment, choose Call-On-Doc to get the best care possible for your and your partner’s infection. Call-On-Doc is known for its discreet, same-day treatment without appointments or expensive visits. Get started now and pick-up your treatment in just a few hours.
English graduate and Call-On-Doc’s medical resource guide, Wayne C. Hahne is an experienced and passionate medical education content expert. Through diligent research, provider interviews and utilizing the industry's leading resources for wellness information, it is Mr. Hahne’s personal mission to educate the general public on medical conditions with in-depth and easy-to-understand written guides.
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