Mycoplasma Genitalium Guide

Mycoplasma genitalium, often shortened to Mgen, is a sexually transmitted bacterium that can infect the urethra, cervix, and reproductive tract. It is a common cause of urethritis in men and is linked to pelvic inflammatory disease and other issues in women, but it often causes no symptoms at all, which lets it go unnoticed. Because the bacteria are tiny and difficult to grow in the lab, Mgen is usually detected with a nucleic acid amplification test, a molecular test on a swab or urine sample that looks for the bacteria's genetic material. Some strains have become resistant to older antibiotics, so testing and targeted treatment matter. This guide explains symptoms, testing, and treatment for this underrecognized infection.

What Mycoplasma Genitalium Is

Mycoplasma genitalium is a very small bacterium that lives in the cells lining the urogenital tract. It is sexually transmitted and is recognized as an important cause of nongonococcal urethritis in men, as well as of cervicitis and pelvic inflammatory disease in some women.

It behaves differently from many other sexually transmitted bacteria because it has no cell wall, which makes many common antibiotics ineffective against it. This is why accurate testing and the right antibiotic choice matter so much.

Symptoms in Men and Women

In men, Mgen commonly causes urethritis with burning when urinating, discharge from the penis, and sometimes irritation. In women, symptoms may include unusual discharge, pain during sex, bleeding between periods, or pelvic discomfort, though many women have no symptoms.

Many infections, in both sexes, cause no symptoms at all. Because the infection is often silent, it can persist and in some women contribute to pelvic problems, so testing is important when symptoms appear or after a partner is diagnosed.

Testing for Mgen

Mgen is detected with a nucleic acid amplification test, or NAAT, which identifies the bacteria's genetic material in a sample. The sample is usually a first-void urine for men or a vaginal or cervical swab for women. This molecular test is the reliable way to confirm the infection.

Mgen is not grown in routine cultures, and there is no valid blood test for it. Testing is typically done when symptoms of urethritis or cervicitis persist after standard treatment, or when a partner tests positive. Proper collection matters for accuracy.

Treatment and Antibiotic Resistance

Treatment for Mgen usually begins with a course of an antibiotic such as doxycycline followed by azithromycin or moxifloxacin, depending on resistance patterns and test results. Some Mgen strains resist older drugs, so the regimen is chosen carefully and targeted at the confirmed infection.

Because of resistance, the CDC recommends test of cure, a follow-up test after treatment to confirm the infection cleared. Treating sexual partners at the same time prevents reinfection and is a standard part of care.

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