How Do I Get Tested for Mycoplasma Genitalium?

Mycoplasma bacteria, illustration
Mycoplasma bacteria, computer illustration. Mycoplasmas are the smallest cellular organisms known (diameter 0.3-0.9 microns). They resemble bacteria in some respects (some authorities regard them as primitive bacteria), but they differ in that they lack a true cell wall and hence display a variety of forms. They may be spherical, branched or unbranched filaments. Some species are pathogens of humans and animals (cattle, sheep) living on the moist mucosal membranes. In humans Mycoplasma hominis may infect the genital tract; Mycoplasma pneumoniae causes a pneumonia-like disease of the lungs. KATERYNA KON/SCIENCE PHOTO LIBRARY / Getty Images

Mycoplasma genitalium, known as MG, is now recognized to be an extremely common STD. However, even if you have signs of a sexually transmitted infection, very few doctors are going to test you for Mycoplasma genitalium right off the bat. Mycoplasma genitalium testing is not a screening that is on most doctors' lists. Instead, the presence of mycoplasma is simply assumed in certain circumstances.

For example, if you have symptoms of urethritis or cervicitis, but don't have either gonorrhea or chlamydia, your doctor may just presumptively treat you for Mycoplasma.That's because MG is the most common cause of cervicitis and urethritis symptoms other than those two diseases. In addition, antibiotic treatment for MG is relatively safe, if not always effective. Therefore, there's thought to be little reason to put off treatment to wait for mycoplasma testing. (This is true despite the fact that there is some evidence of antibiotic-resistant mycoplasma.) 

Sometimes, however, more comprehensive testing is done when you have symptoms that suggest you have some form of bacterial urethritis. In these cases, your healthcare provider will take a urine sample and/or one or more swab samples from your penis or vagina. Those samples will be sent to a laboratory. There, tests will be run to determine what infection is causing your discomfort. Among those tests will probably be a NAAT test for Mycoplasma. NAAT stands for nucleic-acid amplification testing. These tests can be used to identify even small amounts of DNA or RNA from an STD pathogen. 

It requires very specific tests to find Mycoplasma. For example, if your doctor doesn't test your urine for bacterial DNA, it is unlikely that she will detect a Mycoplasma infection. Why are NAAT tests for mycoplasma needed? Because it is almost impossible to grow the bacterium from swabs outside of a research laboratory. (I can say from personal experience that it's also almost impossible to do so inside of a research laboratory.) However, even with urine testing, the doctor has to look for Mycoplasma. That doesn't always happen.

Even if she thinks Mycoplasma is causing your symptoms, your provider may also do additional tests to rule out other sexually transmitted infections. For example, she might look for syphilis or other conditions that frequently occur simultaneously with urethritis/cervicitis. That is done because people who have one STI are generally at risk for more. Co-infections are not uncommon when people are having risky sex. You might also need repeated testing for Mycoplasma, since sometimes treatment doesn't work. Running a second NAAT test for mycoplasma can show whether or not the antibiotics that were used were able to effectively eliminate the infection or if you need to be treated again. 

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