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Mycoplasma genitalium treatment and tests

The information provided herein does not constitute an expert or medical advice, nor intended to replace such advice.

Sexual Health

Mycoplasma genitalium is a very small bacteria — in fact, it’s the smallest free-living organism that is capable of self-replication — that can cause a sexually transmitted disease (STD). Despite the fact that many people with Mycoplasma genitalium remain completely asymptomatic and clear the infection on their own, this STD has also been linked to different long-term health complications in some cases.

Let’s talk about Mycoplasma genitalium treatment and tests at STDWatch.com.

Mycoplasma genitalium tests and diagnosis

Mycoplasma genitalium, also known as M. genitalium or Mgen, is notorious for growing extremely slowly. This can make it difficult to diagnose, since its incubation period can vary a lot from one person to the next, and it takes a long time to show up in a culture test.

Mycoplasma genitalium can take up to 6 months to show up on a bacterial culture, which is an extremely long period to have to wait for an STD test result. However, a more modern technique called nucleic acid amplification test (NAAT) has become available to diagnose Mgen. According to a study published by the Indian Journal of Medical Research, these tests are based on PCR technology and they have a high sensitivity for Mgen.

Fortunately, these tests have become available as at-home STD tests. After ordering an at-home STD test, you’ll receive a (discreetly packaged) testing kit that will include everything you need to take a sample, plus detailed instructions. It’s important to follow these instructions closely, since the quality of your sample can affect the results of the test.

According to a study published by the Journal of Skin and Sexually Transmitted Diseases, first-void urine is considered to be the most sensitive type of sample to detect Mgen in men, and is preferred over urethral swabs. In women, the most sensitive samples come from vulvovaginal swabs, followed by endocervical swabs.

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Currently, it’s not recommended that asymptomatic individuals get routinely screened for Mgen. However, there are some instances in which your doctor could recommend testing for M. genitalium even if you don’t have any symptoms. This bacteria can cause different reproductive health problems, including:

  • Recurrent non-gonococcal urethritis
  • Recurrent cervicitis
  • Pelvic inflammatory disease (PID)

If you experience any of these conditions and the exact cause hasn’t been determined yet, a Mgen test could be ordered by your healthcare provider. In some cases, they could also order antibiotic resistance tests to determine which medications the bacteria is sensitive or resistant to. Drug-resistant Mycoplasma genitalium is quite common, and it’s important to choose the right treatment so you can get rid of this infection effectively. 

Mycoplasma genitalium treatment

According to the treatment guidelines published by the CDC, resistance testing should be used to guide Mgen treatment whenever possible. Depending on the results of resistance testing, different approaches can be used to treat M. genitalium.

When Mgen is determined to be sensitive to a type of antibiotics called macrolides, the treatment will consist of:

  • Doxycycline 100 mg, taken twice a day for 7 days; followed by,
  • An initial dose of azithromycin of 1g, and then,
  • Azithromycin 500 mg, taken once daily for 3 more days

When Mgen is resistant to macrolides or resistance testing isn’t available, the treatment will be as follows:

  • Doxycycline 100 mg, taken twice a day for 7 days; followed by,
  • Moxifloxacin 400 mg, taken once daily for 7 days

Once you start your treatment, you will need to abstain from sex until your symptoms resolve completely, or for at least 14 days after starting treatment. Your partner should also be tested for M. genitalium so they can receive treatment and prevent reinfection.

It’s also very important to make sure to follow the entire course of antibiotics as prescribed. You shouldn’t stop taking your antibiotics early, even if you’re already feeling better before the end of your treatment — this can lead to recurrences or antibiotic-resistant bacterial strains.

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Why is Mycoplasma genitalium hard to treat?

Mgen has certain characteristics that can protect it from antibiotics. For example, it doesn’t have a cell wall. Since some antibiotics work by inhibiting the formation of a bacterium’s cell wall, these medications are ineffective against M. genitalium.

Additionally, many cases of Mycoplasma genitalium are first incorrectly diagnosed as chlamydia and treated as such. This can help the bacteria to “learn” how to protect itself against the antibiotics that are commonly used to treat chlamydia, and develop antibiotic resistance against them. According to a review published by the journal Microbiology, the difficulty in diagnosing Mgen infections has encouraged non-specific treatment, which also increases the risk of antibiotic resistance.

Because of these concerns, it’s very important to make sure you get a correct diagnosis and the right type of antibiotic for your treatment if you get Mycoplasma genitalium. The appearance of antibiotic-resistant strains of this bacterium could become a public health concern in the future, and we should avoid taking unnecessary or incomplete courses of antibiotics to prevent this from happening.

Despite the fact that Mycoplasma genitalium can be difficult to diagnose and treat, modern science has allowed us to develop tests and treatments that can be used against this disease. If you ever experience symptoms of Mgen, it’s advised that you take a test to make sure you can receive the proper treatment as soon as possible.

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Dr. Andrea Pinto Lopez

Dr. Andrea Pinto Lopez

Mar 25, 2022

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