Mycoplasma genitalium (MG) is a common, yet often overlooked, bacterial infection transmitted through sexual contact. This organism infects the cells lining the urethra, cervix, and rectum, and is a recognized cause of non-gonococcal urethritis and cervicitis. Because a significant number of infections are asymptomatic, testing is the only reliable way to confirm diagnosis. Untreated MG can lead to serious reproductive health complications, including Pelvic Inflammatory Disease (PID) in women, which may result in chronic pelvic pain and tubal factor infertility.
Understanding the Need for Testing
Testing for Mycoplasma genitalium is guided by risk factors and the presence of non-specific symptoms. Because the infection is often asymptomatic, particularly in men, it is called a “stealth” pathogen that persists silently. Testing is highly recommended if you have a new sexual partner, engage in unprotected sex, or if a partner has recently been diagnosed with MG or a related condition like persistent urethritis or cervicitis.
The symptoms that do appear are frequently confused with other common sexually transmitted infections (STIs) like chlamydia or gonorrhea. In women, this may include abnormal vaginal discharge, pain during sex, or bleeding between menstrual periods. Men might notice a watery discharge from the penis or a burning sensation during urination. Seeking a test is particularly important if you have these symptoms and previous tests for other STIs returned negative, as MG may be the underlying cause.
Primary Testing Locations and Access Points
Public health facilities, such as local health department clinics and organizations like Planned Parenthood, offer accessible and often low-cost testing options. These clinics frequently provide services on a sliding fee scale, making them an excellent resource for individuals who are uninsured or seeking anonymous testing.
Private healthcare providers, including a primary care physician, gynecologist, or urgent care center, offer the convenience of integrating MG testing into your existing medical care. Testing through these channels ensures results are added to your comprehensive medical record, and follow-up care is readily available. However, coverage for MG testing can vary significantly depending on your insurance policy.
Telemedicine and at-home testing kits provide a discreet, convenient alternative for those who prefer to collect a sample privately. These kits typically involve a self-collected vaginal swab or a urine sample that is mailed to a certified laboratory for analysis. It is crucial to ensure the testing provider is reputable and includes a medical consultation to discuss positive results and treatment.
How the Testing Process Works
Diagnosis of Mycoplasma genitalium relies on highly sensitive laboratory techniques, as the bacteria cannot be reliably grown in a standard culture. The standard diagnostic method is the Nucleic Acid Amplification Test (NAAT), which detects the organism’s unique genetic material. This is the same type of testing used for chlamydia and gonorrhea.
The required sample type varies by gender and the site of potential infection. For men, a first-catch urine sample is typically sufficient for testing the urethra. For women, a self-collected vaginal swab is generally preferred, as studies show it can be more accurate than a female urine sample. Rectal or pharyngeal swabs may also be collected if exposure occurred at these sites. Once the sample reaches the lab, the turnaround time for results is usually quick, often ranging from 24 to 48 hours.
Treatment and Follow-up
A positive Mycoplasma genitalium diagnosis requires a specific antibiotic regimen, which has become more complex due to increasing antibiotic resistance. Historically, single-dose Azithromycin was the primary treatment, but high rates of macrolide resistance have made this regimen largely ineffective.
Current guidelines recommend a two-step approach to maximize the chance of successful treatment. This preferred treatment involves an initial seven-day course of Doxycycline, which helps reduce the overall bacterial load, followed by a second, more potent antibiotic. The second drug is either a high-dose Azithromycin regimen or Moxifloxacin, often guided by resistance testing. A “Test of Cure” (TOC) is mandated 21 days after the final dose of antibiotics to confirm eradication. Partner notification is also necessary to prevent reinfection and the further spread of resistant strains.