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Sexual health

Mycoplasma genitalium

Mycoplasma genitalium (often called M. gen) is a sexually transmitted bacterium that is not always part of a routine Australian sexual health check. It is usually silent, and more common than many people realise. Untreated, it can swell and scar both fallopian tubes (hydrosalpinx) and affect fertility. If you have persistent pelvic pain and other tests keep coming back clear, it is worth asking your GP to test for it.

Common symptoms

  • Often no symptoms at all
  • Persistent cervicitis (an inflamed cervix noted on examination)
  • Bleeding after sex or between periods
  • Discharge changes that do not settle
  • Pelvic pain, including as a cause of PID
  • Burning when weeing or ongoing urethral symptoms

Useful to track

  • Whether symptoms persisted after previous STI treatment
  • Bleeding after sex — dates and pattern
  • Previous test dates and exactly which infections were named on the result
  • Antibiotics already taken, and whether symptoms changed

Tests and conversations that may be relevant

  • A specific NAAT test — it is not detected by chlamydia or gonorrhoea tests
  • Australian guidance generally reserves testing for people with symptoms, contacts of a known case, or PID, rather than everyone
  • Macrolide resistance testing is often done at the same time, because resistance is common and changes treatment
  • Testing asymptomatic people is not routinely recommended, partly to avoid unnecessary antibiotics

When to see a GP or specialist

  • Symptoms that persisted after treatment for chlamydia or another infection
  • Persistent pelvic pain with clear results so far — ask whether M. gen has been ruled out
  • Persistent bleeding after sex or ongoing cervicitis
  • PID, or a partner diagnosed with M. gen

Urgent warning signs

  • Pelvic pain with fever or feeling very unwell

In Australia, call 000 or healthdirect on 1800 022 222.

Questions to take to a clinician

  • Was Mycoplasma genitalium included in my last test, or not?
  • Given my symptoms, do the guidelines support testing me for it?
  • If it is found, will resistance testing guide the antibiotic choice?
  • Do my partners need testing?
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Related

Pelvic inflammatory disease (PID)Thrush (yeast infection)Bacterial vaginosis (BV)Chlamydia

eophi shares general information reviewed against Australian guidance. It never diagnoses. If something feels urgent, call 000 or healthdirect on 1800 022 222.