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A guide to – Mycoplasma genitalium

Mycoplasma genitalium – the basics
Mycoplasma genitalium (Mgen) is a curable sexually transmitted infection (STI). It is a type of bacterium or germ that can infect the water passage (urethritis), the neck of the womb (cervicitis), the womb and fallopian tubes (pelvic inflammatory disease).  Less commonly it can be found in the rectum (back passage). However, most people who carry the infection do not experience any problems, and many get rid of MGen infection without any treatment. 

Testing is available at some (but not all) 	specialised sexual health or genitourinary medicine (GUM) clinics. Testing all GUM clinic attenders for this infection is not recommended as most people who have Mgen do not develop any problems and will naturally clear the infection without any treatment. For a few people with symptoms, testing for Mgen may be required. These symptoms are burning when passing urine or discharge from the penis, or pelvic pain (lower tummy) or bleeding after sex in women/transmen. The clinic doctor or nurse will decide if you need to be tested based on your symptoms.

If you have been diagnosed positive for Mgen because of your symptoms you should attend promptly for treatment and we recommend that you should have tests for other STIs.

How common is Mgen?
Around 10-15% of people with discharge from the penis and/or pain passing urine, and around 5-10% of people with pelvic pain who are tested at the clinic will have Mgen.

How do you catch Mgen?
Mgen is passed on through penetrative vaginal or anal sex without a condom with someone who has the infection. It cannot be caught by kissing, hugging, sharing baths or towels, using swimming pools or from toilet seats. 

What would I notice if I had Mgen?
As Mgen is only one infection of several which may give you the following symptoms, your doctor or nurse will advise you if you need testing:
•	Pain in the lower abdomen (tummy), particularly during sex, in women/transmen
•	Vaginal bleeding after sex 
•	Pain or burning in the penis when passing urine
•	Discharge from the penis

How do I get tested for Mgen? 
Vaginal samples
A swab is taken from inside the vagina. This swab can be taken by the doctor, by a nurse or by you if you prefer. 

Penile samples
A swab may be taken from the tip of the penis by the doctor or nurse if a discharge is present. You will also be asked to give a urine sample.
Most people do not need rectal swabs. The clinician will advise you if this is necessary.

How is Mgen treated?
Mgen is treated with antibiotics and you will get these from a sexual health clinic. Treatment is always free.

Important information about your treatment 
There are strains (types) of Mgen which are resistant to some antibiotics and need further treatment with different antibiotics. This can be identified by attending for a test of cure (repeating your test) five weeks after the initial treatment. It is very important that you have this test, even if you are feeling better, to ensure that the infection has been successfully treated.

What about my partner?
Mgen is sexually transmitted so it is important that your current partner(s) is/are tested for this infection too – this means anyone you are having sex with at the moment and you may have sex with again. If they also carry the infection, there is a risk you will be re-infected if they are not treated. We can help you tell your partner(s) if this is difficult.

What happens if my Mgen is left untreated?
Rarely, Mgen may spread from the neck of the womb (cervix) to the womb (uterus). This is called pelvic inflammatory disease (see the BASHH leaflet ‘pelvic inflammatory disease’). Infection of the womb can cause longer term problems with fertility and pain. 

Mgen can spread from the urethra to the testicles causing pain and swelling of the testicles. This is uncommon, and known as epididymo-orchitis (see the BASHH leaflet ‘Epididymo-orchitis’). We do not know yet if this may cause long term problems with fertility. 

How long should I wait after treatment before I can have sex again?
We advise you not to have any type of sex (with or without condoms) until both you and your partner have both finished your treatment, and your symptoms have gone.  

Can I catch Mgen again?
Yes, you can. To prevent this, make sure your current partner(s) have been treated. Protect yourself with new partners by using a condom.

Mgen in pregnancy
Mgen can be caught by pregnant women. Your doctor or nurse will discuss treatment options with you. 

This leaflet was produced by the Clinical Effectiveness Group of the British Association for Sexual Health and HIV (BASHH). The information in the leaflet is based on the ‘UK National Guideline for the management of Mycoplasma genitalium infection’ published by BASHH in 2018.

Revision date: 2021