Mycoplasma Genitalium (MG)

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Mycoplasma genitalium (MG) is a curable STI caused by bacteria that affects the cervix, urethra and rectum. Transmission can occur if you have unprotected penetrative sex with someone who already has the infection. It is often asymptomatic but can cause health problems such as pelvic inflammatory disease, endometriosis, and serious pregnancy complications. 

Signs and Symptoms

Mycoplasma genitalium (MG) is often asymptomatic. If symptoms do occur, it will usually be within 2 – 60 days of exposure. 

Vagina/Vulva

MG can present no symptoms at all. If signs or symptoms are present, there may be:

  • Bleeding between menstrual cycles
  • Bleeding after penetrative sex
  • Pelvic pain
  • Pain during penetrative sex
  • Yellow/green discharge

Penis

MG can present no symptoms at all. If signs or symptoms are present, there may be:

  • Irritation, burning or stinging when peeing
  • Watery discharge
  • Irritation around the urethral opening

Anus/Rectum

MG can present with no symptoms at all. If signs or symptoms are present, there may be:

  • Inflammation inside the rectum and anus

Transmission

Mycoplasma genitalium is mainly transmitted by genital-to-genital contact and/or genital-to-anal contact. MG can be transmitted via: 

  • Unprotected vaginal or anal sex
  • Unprotected blow jobs (transmission through oral sex is uncommon)

MG can be spread even when the person with MG has no symptoms.

Prevention

  • Use condoms for penetrative anal/vaginal sex
  • Use condoms for blow jobs 
  • Hold the base of the condom when withdrawing, so semen doesn’t spill out

It is recommended that you always change condoms when going from anal to vaginal or oral sex.

Testing 

Here’s some information about testing for MG. You can view a list of sex worker-friendly sexual health clinics at our Where To Test page.

Testing method

  • If you have a vagina, the test is usually a vaginal or cervical swab which is more accurate than urine, but urine can be used if it is the only acceptable option.
  • If you have a penis, the test is usually a urine sample.
  • If you have an anal infection, the test is an anal swab.

When to test

  • If you have symptoms but test negative for chlamydia, gonorrhoea and herpes.
  • MG is not included in routine STI testing, so you may need to request a test from your doctor or nurse. 
  • Testing is recommended for HIV-positive people with symptoms.
  • It is not recommended to test asymptomatic people unless they know they’ve had sexual contact with someone with MG. 

Other info

  • Sexual health clinic testing is often bulk billed, even if you don’t have Medicare, so the test will most likely be free. 
  • If you see a GP, you may pay a fee or be bulk billed. 

Treatment

Mycoplasma genitalium is curable with antibiotics. Here’s what you need to know about treating it.   

Treatment method/s

  • Mycoplasma genitalium is usually treated with two different types of antibiotics, one after the other. This is usually an 8 – 14 day course of tablets. Both courses of antibiotics need to be taken to cure MG.
  • Sometimes Mycoplasma genitalium is resistant to certain antibiotics, so you may need a different or longer course of antibiotics.
  • If you have symptoms or have had sexual contact with someone who has been diagnosed with mycoplasma genitalium, you may be offered treatment before your test results come back. Often it is best to wait for your test result to come back.

Costs and other information 

  • Treatment cost will depend on which antibiotic you are prescribed.
  • Sexual health clinic treatments are often bulk billed, even if you don’t have Medicare, so the treatment may be free. 
  • If you see a GP, you may pay a fee or be bulk billed. 
  • Mycoplasma genitalium is cured by effective treatment, but you do not develop any immunity. It is possible to get another Mycoplasma genitalium infection.

Because you may have had an asymptomatic infection you got months before, you may want also to avoid sexual contact with partners from the last 6 months until 7 days after they have also been tested and treated. 

How might this impact my work? 

Practical considerations

  • After treatment, avoid sexual contact for 7 days, and avoid unprotected sex until after your follow-up test comes back negative (showing that your treatment was successful). 
  • If you cannot afford to take this time off work, consistent condom use can protect you from MG transmission while receiving treatment. 
  • Some antibiotics can reduce the effectiveness of oral contraception (‘the pill’). 
  • If you often get thrush when you take antibiotics, you may want to take probiotics during and after your treatment to help prevent this.
  • You should inform any recent doubles partners if you test positive for MG. 

Legal and reporting considerations

  • Some states and territories may have laws that criminalise sex working or having sexual contact while you have a BBV or STI. Check out our BBV, STI and the Law resource or contact your local sex worker peer organisation for more information. 
  • Contact tracing of previous sexual partners (also known as ‘partner notification’) is a consideration for some BBV and STI, and should be done with consideration of the unique transmission risk and privacy needs of sex workers. Your local sex worker peer organisation can advise on any partner notification process to ensure that it is appropriate for your circumstances.

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