Mycoplasma genitalium (Mgen) is a bacterial infection transmitted through sexual contact. It is increasingly recognized as a cause of various genitourinary issues. Many wonder if this infection resolves on its own without medical intervention. This article explores the nature of Mgen and explains why treatment is necessary for its resolution.
What is Mycoplasma Genitalium?
Mycoplasma genitalium is a small bacterium, distinct from other common sexually transmitted infections. It primarily spreads through unprotected vaginal, anal, or oral sexual contact. The bacterium attaches to cells in the genital and urinary tracts, leading to inflammation and potential infection.
In men, Mgen can cause symptoms such as urethral discharge (a fluid coming from the penis) and dysuria (painful urination). Some men may also experience itching or discomfort inside the urethra. For women, common indicators include unusual vaginal discharge, pelvic pain, and discomfort during or after sexual intercourse.
The infection can also lead to bleeding after sex or between menstrual periods in women. However, a significant number of individuals, both male and female, may carry Mgen without experiencing any noticeable symptoms. This asymptomatic nature allows the infection to spread unknowingly and potentially persist if not detected through specific testing.
The Persistence of Mgen Infection
A common misconception is that Mgen might naturally clear from the body over time. However, Mycoplasma genitalium infections typically do not resolve spontaneously without medical treatment. The human immune system often struggles to effectively eliminate this bacterium on its own.
Mgen has evolved mechanisms to evade the body’s natural defense responses, allowing it to persist within the genitourinary tract. This ability to avoid immune detection means the infection can become chronic if left untreated. Without intervention, the bacterium continues to reside and multiply within the host.
The persistent nature of Mgen is a concern because it can lead to long-term health issues. Unlike some infections where the body might eventually suppress the pathogen, Mgen usually requires specific antimicrobial therapy to be eradicated.
How Mgen is Diagnosed and Treated
Accurate diagnosis of Mycoplasma genitalium relies on specific laboratory tests, as it cannot be detected by standard bacterial cultures. The most widely used method is a Nucleic Acid Amplification Test (NAAT), which identifies the bacterium’s genetic material. These tests are performed on urine samples or swabs collected from the urethra, cervix, or rectum, depending on the site of potential infection.
Once diagnosed, Mgen is treated with antibiotics, although rising rates of antibiotic resistance present challenges to effective treatment. Initial treatment often involves an extended course of azithromycin. If azithromycin resistance is identified or suspected, a fluoroquinolone antibiotic like moxifloxacin may be prescribed.
It is important to complete the entire course of antibiotics as directed, even if symptoms improve, to help ensure the infection is fully cleared. Follow-up testing after treatment is often recommended to confirm eradication and detect resistant strains. All sexual partners of an infected individual should also be informed, tested, and treated simultaneously to prevent reinfection and further transmission.
Risks of Leaving Mgen Untreated
Leaving a Mycoplasma genitalium infection untreated can lead to a range of serious health complications for both men and women. In men, persistent Mgen can cause non-gonococcal urethritis, characterized by ongoing inflammation of the urethra. It may also contribute to epididymitis, an inflammation of the coiled tube at the back of the testicle, causing pain and swelling.
For women, untreated Mgen has the potential to spread from the lower genital tract to the upper reproductive organs. This can result in cervicitis (inflammation of the cervix) and pelvic inflammatory disease (PID), a serious infection of the uterus, fallopian tubes, or ovaries. PID can lead to chronic pelvic pain, infertility due to scarring of the fallopian tubes, and an increased risk of ectopic pregnancy, where a fertilized egg implants outside the uterus.
Mgen infection during pregnancy has been associated with adverse outcomes, including an increased risk of preterm birth. In some cases, Mgen can also be linked to reactive arthritis, a type of inflammatory arthritis that affects joints, eyes, and the urinary tract.