Mycoplasma Genitalium: A Comprehensive Guide
Medically reviewed by Andre Stone | MD, University of Pittsburgh School of Medicine on August 25th, 2026.
Published on April 6th, 2026. Updated on August 28th, 2026.
Key Takeaways
Mycoplasma genitalium is a sexually transmitted infection that often causes no symptoms
It can lead to serious complications like pelvic inflammatory disease if left untreated
Many people don't know they have it because symptoms are mild or absent
Testing requires special lab methods that aren't always available
Treatment requires specific antibiotics and is becoming more challenging due to resistance
Overview
Mycoplasma genitalium is a tiny bacteria that causes sexually transmitted infections. It's one of the smallest bacteria that can survive on its own. This infection is more common than many people realize, but it often goes undiagnosed.
The bacteria was first discovered in the 1980s. Since then, doctors have learned it can cause serious problems in both men and women. It spreads mainly through vaginal or anal sexual contact. It spreads mainly through vaginal or anal sexual contact. Whether it can spread through oral sex is unclear.
Many people with mycoplasma genitalium have no symptoms at all. This makes it easy to spread unknowingly to sexual partners. When symptoms do occur, they're often mild and can be mistaken for other infections. Early diagnosis and treatment are important to prevent complications.
The infection can hide in your body for a long time without causing problems. Some people might never know they have it unless they get tested. STI testing can be important depending on your symptoms and risk factors. Routine screening for mycoplasma genitalium in people without symptoms is generally not recommended.
Symptoms & Signs
Most people with mycoplasma genitalium don't have obvious symptoms. When symptoms appear, the timing can vary, and the incubation period is not well defined. The signs can be different in men and women.
Primary Symptoms
Unusual discharge: Clear or cloudy discharge from the penis or vagina
Burning during urination: Pain or stinging when you pee
Pelvic pain: Aching or cramping in the lower belly area
Bleeding between periods: Spotting or bleeding when it's not your normal period time
In men, symptoms might include a thin discharge from the penis or pain during urination. In women, symptoms can include vaginal discharge, pelvic pain, or bleeding between periods. Some people feel pain during or after sexual activity.
When to Seek Care
Get medical help if you notice unusual discharge, pain during urination, or pelvic pain. These symptoms could mean you have an STI that needs treatment. Don't wait if you have persistent fever along with these symptoms.
If symptoms last more than a week, contact your doctor right away. You should also tell your recent sexual partners so they can get tested too. Getting treatment quickly helps prevent the infection from spreading or getting worse.
When to Seek Immediate Care
Contact a healthcare provider right away if you develop severe pelvic pain, high fever, or heavy bleeding between periods.
Causes & Risk Factors
Mycoplasma genitalium spreads through sexual contact with an infected person. The bacteria lives in the genital and urinary tracts. It can pass from one person to another during vaginal, anal, or oral sex.
You can get infected even if your partner has no symptoms. The bacteria can survive in the body for months or years without causing obvious problems. This makes it easy to spread unknowingly.
The infection cannot spread through casual contact like touching or kissing. You also cannot get it from toilet seats, sharing utensils, or swimming pools. You can only get mycoplasma genitalium from sexual contact with an infected person.
Age
Most common in people aged 16-34 years
Genetics
No genetic factors increase risk
Lifestyle
Multiple sexual partners, unprotected sex
Other Conditions
Having other STIs increases infection risk
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Diagnosis
Diagnosis
Medical History & Physical Examination
Your doctor will ask about your sexual history and symptoms. They'll want to know about recent sexual partners and whether you use protection. The doctor will also do a physical exam of your genital area.
During the exam, your doctor will look for signs of infection. They might check for discharge, inflammation, or tenderness. In women, this may include a pelvic exam to check internal organs.
Diagnostic Testing
Urine test: Checks for bacteria DNA in your urine sample
Swab test: Takes a sample from the genital area to test for infection
Testing usually uses a urine sample or a swab to look for the bacteria's genetic material. Blood antibody testing is not used to diagnose this infection in routine care.
Special labs that use advanced testing methods are needed to find mycoplasma genitalium. Not all regular doctor's offices have the equipment to run these tests. Your doctor may send your sample to a specialized laboratory for accurate results.
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Treatment Options
The goal of treatment is to clear the infection and prevent complications. Mycoplasma genitalium requires specific antibiotics because it doesn't respond to many common treatments.
Conservative Treatments
Azithromycin may be used after doxycycline when testing shows the infection is likely to respond to it. Treatment should follow current guidelines because resistance is common.
Doxycycline is commonly used as the first step of treatment, followed by another antibiotic chosen according to resistance results and current guidelines.
Recent sexual partners may be offered testing and treated if the result is positive. If testing is not possible, a healthcare professional may offer the same treatment given to the diagnosed person.
Advanced Treatments
Moxifloxacin: Used for resistant infections that don't respond to other antibiotics
Treatment often uses two antibiotics in sequence rather than at the same time. The exact regimen should follow current guidelines and, when available, resistance-test results.
It's important to take all your antibiotics exactly as prescribed by your doctor. Never stop taking them early, even if you feel better. Finishing all your medicine helps make sure the infection is completely gone.
Some strains of mycoplasma genitalium are becoming resistant to antibiotics. This means certain antibiotics don't work as well as they used to. Your doctor will choose the best antibiotic based on current treatment guidelines.
Living with the Condition
Daily Management Strategies
Avoid sexual contact until you and your partner complete treatment. Take all prescribed antibiotics even if you feel better. Drink plenty of water to help your body fight the infection. Keep track of symptoms to report back to your doctor.
Getting enough rest helps your immune system fight the infection. You should sleep 7-9 hours each night during treatment. Try to reduce stress, which can weaken your immune system and slow recovery.
Exercise & Movement
Regular exercise can help boost your immune system during treatment. Avoid activities that put pressure on your pelvic area if you have pain. Upper limb exercises are safe and won't affect your recovery.
Light walking or stretching can help you feel better without causing pain. Listen to your body and take breaks if something causes discomfort. Once you finish treatment and feel better, you can return to normal activities.
Prevention
Use condoms consistently during all types of sexual activity
Get tested regularly for STIs, especially if you have multiple partners
Have open conversations with sexual partners about STI testing
Limit your number of sexual partners to reduce infection risk
Talk honestly with your sexual partners about getting tested for STIs. Many people don't realize they have mycoplasma genitalium because they have no symptoms. Protecting your partners means getting tested and sharing test results with them.
Regular STI testing is especially important if you're sexually active with new partners. Ask a healthcare professional which STI tests are appropriate for you based on your symptoms, partners, and other risk factors. Routine screening for mycoplasma genitalium in people without symptoms is generally not recommended. Early treatment prevents serious complications and stops the spread to others.
Frequently Asked Questions
Mycoplasma genitalium can sometimes clear without treatment, but it may persist and can be associated with complications. If you test positive, ask a healthcare professional whether treatment is recommended. The infection can persist for months or years if left untreated. It can also lead to serious complications like pelvic inflammatory disease.
Most people start feeling better within a few days of starting antibiotics. Treatment length depends on the regimen and clinical situation. Recommended treatment often uses antibiotics in sequence, so follow the full schedule prescribed by your healthcare professional. It's important to finish all your medicine even if you feel better.
Yes, you can get infected again after being cured. Having the infection once doesn't make you immune to future infections. This is why it's important for all sexual partners to get tested and treated.
While many people have mild or no symptoms, untreated infections can cause serious problems. In women, the infection is associated with pelvic inflammatory disease and may be linked to infertility, although some long-term effects are still being studied. Discussing these possible complications with a healthcare professional can help you understand the importance of appropriate testing and treatment.
Tests for mycoplasma genitalium are generally accurate when done properly. However, not all labs can perform these specialized tests. Your doctor may need to send samples to a special laboratory for testing.
Still have questions?
Consult with a healthcare professional for personalized advice.