Sexual Health STDs Symptoms Diagnosis and Treatment of Mycoplasma Genitalium Common bacteria linked to sexually transmitted infections By Elizabeth Boskey, PhD Elizabeth Boskey, PhD Facebook LinkedIn Twitter Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. Learn about our editorial process Updated on October 28, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Anju Goel, MD, MPH Medically reviewed by Anju Goel, MD, MPH LinkedIn Anju Goel, MD, is board-certified in internal medicine. She has over 10 years of experience in the California public health system addressing communicable disease, health policy, and disaster preparedness. Learn about our Medical Expert Board Print Mycoplasma genitalium (Mgen) is a type of bacteria that is sexually transmitted. It can cause vaginal itching, burning with urination, and bleeding of the skin around the vagina in women, and urethral discharge or burning with urination in men. Mgen is the cause of several types of infections, including forms of bacterial vaginosis (BV) and non-gonococcal urethritis (NGU). It has also been associated with pelvic inflammatory disease (PID) and implicated in other infections once attributed to other bacteria. Jess Wiberg / Getty Images Mycoplasma Genitalium Symptoms By and large, most cases of Mgen don't cause symptoms. If symptoms appear, they are primarily nonspecific and easily mistaken for other sexually transmitted infections (STIs) such as chlamydia and gonorrhea. Mycoplasma genitalium symptoms also differ significantly in women and men. Mgen Symptoms in Women Vaginal itching Burning with urination Pain during intercourse Bleeding between periods or after sex With BV, a fishy odor after sex and changes in vaginal discharge Mgen Symptoms in Men Urethral discharge Burning with urination Mgen is the next most common cause of NGU in men behind chlamydia. Symptoms of Common STDs Diagnosis There is no approved blood test for diagnosing Mgen. A nucleic acid amplification test (NAAT) is the standard test for a diagnosis. A NAAT uses urine and swab samples from the urethra, opening of the penis, part of the cervix, or vagina, and produces results in 24 to 48 hours. If a NAAT is unavailable at a certain clinic, a healthcare provider might go ahead and diagnose Mycoplasma genitalium simply based on the fact that urethritis or cervicitis is persistent or recurrent. Studies show that 40% of such cases in men and up to 30% in women are caused by Mgen. Role in Guiding Treatment Syndromic treatment is when all STI cases that fit a certain profile of symptoms are treated the same without knowing their actual cause. Healthcare providers who diagnose Mycoplasma genitalium based on symptoms alone and treat it accordingly may be right, but not always. That means that some people may have an entirely different infection that warrants an entirely different treatment. Had the infection been confidently identified from the start, they could have started on the correct medication sooner. NAAT is, therefore, the recommended testing method to diagnose a suspected case of Mgen. Your doctor can make specific treatment choices based on the results rather than trying something out based on an educated assumption. Treatment Mycoplasma genitalium is typically treated with antibiotics. In the past, the most common form of treatment was a single 1-gram (g) dose of azithromycin. But evidence has shown increased resistance to azithromycin in populations where it's used broadly. That means that the bacteria has mutated, so that this drug is no longer effective. Today, Mgen from a patient is tested to see whether or not the bacteria has mutated into a variant that is resistant to azithromycin. Results of that testing dictate the recommended treatment: Mgen has not mutated: 100 milligrams (mg) of doxycycline two times a day for seven days, followed by an initial 1 gram dose of azithromycin, then 500 milligrams of azithromycin daily for the next three daysMgen has mutated: 100 milligrams of doxycycline two times a day for seven days, followed by 400 milligrams of moxifloxacin once daily for seven days How Healthcare Providers Choose the Right Antibiotic Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Keane FE, Thomas BJ, Whitaker L, Renton A, Taylor-Robinson D. An association between non-gonococcal urethritis and bacterial vaginosis and the implications for patients and their sexual partners. Genitourin Med. 1997;73(5):373-377. Horner PJ, Martin DH. Mycoplasma genitalium Infection in Men. J Infect Dis. 2017;216(suppl_2):S396-S405. doi:10.1093/infdis/jix145 Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines. Bradshaw CS, Jensen JS, Tabrizi SN, et al. Azithromycin failure in Mycoplasma genitalium urethritis. Emerging Infect Dis. 2006;12(7):1149-1152. doi:10.3201/eid1207.051558 Additional Reading Otieno FO, Ndivo R, Oswago S, et al. Evaluation of syndromic management of sexually transmitted infections within the Kisumu Incidence Cohort Study. Int J STD AIDS. 2014;25(12):851-859. doi:10.1177/0956462414523260 Tosh AK, Van Der Pol B, Fortenberry JD, et al. Mycoplasma genitalium among adolescent women and their partners. J Adolesc Health. 2007;40(5):412-417. doi:10.1016/j.jadohealth.2006.12.005 Unemo M, Nicholas RA. Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea. Future Microbiol. 2012;7(12):1401-1422. doi:10.2217/fmb.12.117