Mycoplasma genitalium (Mgen) is a bacterial organism that primarily infects the urogenital tract, often causing sexually transmitted infections (STIs). Identified relatively recently compared to other STIs, Mgen is gaining medical attention for its role in conditions such as urethritis, cervicitis, and pelvic inflammatory disease (PID). Mgen presents a significant challenge due to its ability to evade the immune system and its growing resistance to antibiotics, complicating effective treatment.

Transmission and Risk Factors

Mgen is spread mainly through sexual contact, including vaginal, anal, and oral intercourse. The bacteria can infect the urethra, cervix, and rectum, causing various symptoms. However, many people remain asymptomatic carriers, unknowingly passing the infection to others. Mgen is most common among sexually active individuals, particularly those with multiple sexual partners or who do not consistently use condoms or other barrier methods. As asymptomatic cases are frequent, regular testing is critical, especially for those at higher risk of STIs.

Symptoms of Mycoplasma genitalium Infection

Symptoms of Mgen infection differ between men and women:

In Men:

Urethritis is a primary symptom, often causing painful urination, a burning sensation, and a watery penile discharge. Some cases may also involve epididymitis (swelling of the epididymis), resulting in testicular pain and discomfort.

In Women:

While many women do not experience symptoms, some may develop cervicitis, which can cause unusual vaginal discharge, pain during intercourse, and bleeding post-sex. If untreated, Mgen can lead to PID, a severe condition affecting the uterus, fallopian tubes, and ovaries. PID can cause chronic pelvic pain and even infertility.

Diagnosis of Mycoplasma genitalium

Diagnosing Mgen infections is challenging due to frequent asymptomatic cases and overlapping symptoms with other STIs, like chlamydia and gonorrhea. Nucleic acid amplification tests (NAATs) are the most reliable diagnostic tools for detecting Mgen’s genetic material. These tests are not standard in routine STI screenings, so specific testing may be required if Mgen infection is suspected.

Complications of Untreated Mgen Infections

Untreated Mgen infections can result in serious health complications for both men and women:

In Men:

Persistent urethritis can lead to chronic discomfort. In rare cases, the infection may extend to the prostate or epididymis, causing swelling and tenderness.

In Women:

Untreated Mgen can lead to pelvic inflammatory disease (PID), which can permanently damage the fallopian tubes, leading to infertility and increasing the risk of ectopic pregnancies.

Treatment and Management of Mycoplasma genitalium with Doxycycline

Treatment for Mgen typically involves antibiotics, although antibiotic resistance makes this challenging. Doxycycline is commonly used in managing Mgen infections, primarily to reduce the bacterial load, even if it does not fully eradicate the infection.

Doxycycline Dosage: 100 mg taken twice daily for seven days.

This treatment can help manage symptoms and reduce the bacterial presence, though additional follow-up testing may be necessary to ensure complete eradication. Partner treatment is also recommended to avoid reinfection and continued transmission. Those undergoing treatment are advised to abstain from sexual contact until the full course of antibiotics is completed.

Prevention of Mycoplasma genitalium Infections

Preventing Mgen infections involves practicing safe sex methods, like consistent condom use and reducing the number of sexual partners. Regular STI screenings, especially for those with high-risk behaviors, help detect Mgen infections early, even in the absence of symptoms. Open communication with partners about sexual health and previous STI testing further reduces transmission risks.

Outlook and Prognosis

With appropriate treatment, Mgen infections can be managed effectively. However, due to increasing antibiotic resistance, treatment is often complicated, and some cases may require multiple rounds of antibiotics. Left untreated, Mgen poses significant health risks, particularly for women, who may face complications affecting their reproductive health. Regular follow-up is critical to ensure complete resolution of the infection and to mitigate long-term health impacts.