There has recently been some media coverage on a little known organism called Mycoplasma genitalium as an emerging cause of STIs in women and men. We are still learning about this condition, and there is much research happening around Australia regarding its relevance and treatment.
In women, M.genitalium is known to be associated with inflammatory conditions of the cervix (cervicitis) and upper genital tract (pelvic inflammatory disease or PID). If untreated, PID can lead to complications including infertility, miscarriage and preterm delivery. The exact role of M.genitalium in these complications is not yet clear.
As a result of the development and availability of diagnostic tests for M.genitalium, health professionals can now test women with symptoms that suggest a possibility of cervicitis or PID. Symptoms may include bleeding after intercourse, vaginal discharge or pelvic pain. Testing can occur at the same time as testing for chlamydia and gonorrhoea
In men, M.genitalium is strongly associated with urethritis, which is an inflammatory condition of the urethra, the tube that extends from the bladder to the exterior carrying urine as well as semen. Sometimes urethritis is complicated by infections at other sites such as the testicles or prostate. Men with symptoms such as painful urination or a discharge from the penis diagnosed with urethritis, which is not caused by either chlamydia or gonorrhoea, will also be tested for M.genitalium.
Unlike chlamydia, for which screening is offered to people who are at risk but don’t have any symptoms, health professionals do not screen for M.genitalium.
Treatment for people diagnosed with M.genitalium currently includes an antibiotic which is also used to treat chlamydia. However, it appears that M.genitalium is increasingly resistant to this antibiotic, which means that treatment can fail. Other secondary antibiotics are available, although these are relatively expensive and are usually prescribed by specialist sexual health clinics. People who test positive for M.genitalium will be advised to return to their health professional about three weeks after their initial antibiotic treatment to make sure no further antibiotics are needed.
Australian experts, together with colleagues across the world, are working hard to ensure that we manage M.genitalium and antibiotic use appropriately given its tendency to develop resistance. A recently approved test which can detect whether M.genitalium is sensitive to particular antibiotics may soon become widely available in Australia, which will help keep it controlled.
Talk to a health professional or make an appointment at our Northbridge clinic if you would like to know more about Mycoplasma genitalium.