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M. genitalium is usually found when someone has urethritis or cervicitis, which is ongoing or repeated inflammation of the urethra or cervix. It has also been associated with pelvic inflammatory disease (PID). M. genitalium can cause other conditions (e.g. proctitis, epididymitis) but there is less data and certainty around these.
How the infection is passed
M. genitalium is mainly passed during genital-to-genital or penis/external genitals-to-anal sexual contact where there is an exchange of body fluids. This includes touching the genitals with fingers or sharing sex toys.
It cannot be passed through saliva (i.e. kissing or sharing food/drink), and because the bacteria does not survive outside of the body it cannot be passed through activities like swimming or using toilet seats.
It is common to not notice any symptoms. If you do get symptoms, they are similar to other STIs and can include:
- smelly or unusual discharge (fluid) from the genitals or anus
- abnormal or irregular bleeding from the vagina/internal genitals (especially after sex)
- difficulty or pain (discomfort, stinging or burning) during urination (peeing)
- pain in the lower abdomen, testicles, or rectum (anal passage)
- pain during sex
- discomfort of the urethra or irritation of the penis/external genitals
Tests and Diagnosis
Testing for M. genitalium is not recommended during routine STI screening and is not recommended for those without symptoms.
Most people infected with M. genitalium do not develop symptoms or complications. If you have a positive test result and do not have symptoms, treatment is generally not recommended. This is because overuse of antibiotics can lead to antibiotic resistance, which is thought to out-weigh the unknown risks to not treating.
Treatment is usually only offered if you have a condition associated with infection (i.e. urethritis, cervicitis or pelvic inflammatory disease), or if treatment for other STIs like gonorrhoea and chlamydia has not worked and symptoms continue.
A health care provider can help determine whether sexual partners should be notified or treated to prevent re-infection.
Current sexual partners will generally be treated with the same antibiotic as the person with a confirmed infection.