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A doctor’s guide to MG – the new STI you need to know about

Mycoplasma Genitalium (MG), a new sexually transmitted infection has been dubbed the next superbug.  Marie Pan talks to the experts

You’ve heard of chlamydia and gonorrhoea but have you heard of the new guy on the sexual health block, mycoplasma, which affects the genitals, rectum and even the respiratory tract including the throat.

Few of us have heard of MG and it’s not routinely tested for, which means can go unnoticed and untreated for years, causing infertility (especially as it often comes with no symptoms).

This week, The British Association of Sexual Health and HIV launched new guidelines for testing and treating for MG.

Their concern is high about MG because though it can be treated right now, it is becoming antibiotic resistant. For this reason, MG has been dubbed ‘the next superbug’.

Indeed, MG is now more common than gonorrhoea, affecting up to two per cent of the UK population, and is even outstripping chlamydia in some high risk groups.

Despite this, recently developed tests to diagnose the disease are still not available in all sexual health clinics, BASHH said as it issued new guidelines for its treatment.

Healthista spoke to the experts to get medical take on what you need to know about this new STI.

What exactly is Mycoplasma Genitalium or MG?

‘Mycoplasma genitalium, or MG. are tiny bacteria that can be transmitted through sex, says Karin O’Sullivan, clinical consultant at sexual health charity FPA.

‘It’s thought that MG. bacteria are present in around 1-2% of the population at any one time, but not everyone will develop an infection or have any symptoms.

‘If you do get symptoms, they can be similar to other sexually transmitted infections like chlamydia and gonorrhoea,’ she said.

Symptoms of MG

In women, symptoms include:

Pain when peeing

Pelvic pain

Bleeding after sex or between periods.

In men, symptoms include:

Pain when peeing

a discharge from the penis

Irritation or pain in the penis

‘Although mycoplasma genitalium bacteria have been known about since the 1980s, it’s only more recently we’ve confirmed that they’re sexually transmitted,’ says Dr O’Sullivan.

‘Mycoplasma is a really common cause of non-specific urethritis in men,’ says Dr Preethi Daniel, a GP specialising in sexual health at London Doctors Clinic.

‘This is irritation of the urethra, the pipe that carries your urine out. Non-specific implies there is no gonorrhoea. This can mean discomfort in the penis, pain when passing urine, discharge and even testicular pain’.

In women she explains, there are studies that show mycoplasma can cause bleeding after sex, inflammation of the cervix and pelvic inflammatory disease.

‘There is also a link between mycoplasma and premature births and spontaneous abortions,’ says Dr Daniel.

‘These symptoms are all much the same as what people might experience with chlamydia and gonorrhoea, so it can be mistaken for either,’ she says..

‘The majority of people however will not have any symptoms at all much like chlamydia’, says Dr Daniel. The new guidelines say people who have a partner with mycoplasma but do not have symptoms should also be treated.

How is MG trasmitted?

It’s transmitted through vaginal and anal sex.

Younger age and multiple sexual partners are some of the risk factors and it’s slightly more prevalent in women than men. And yes, condoms do protect from it.

Though a 2015 study found no cases of MG in people who had only had oral sex, it’s better to be safe than sorry.

How do you get tested?

‘A test for MG. isn’t usually included as part of a routine STI screening, which helps explain why not many people have heard of it,’ says Dr O’Sullivan.  ‘But we hope this will change now the new guidelines have been released’.

‘Testing is recommended in anyone experiencing symptoms and current partners of anyone infected with mycoplasma,’ says Dr Daniel. ‘It is not necessary to get tested if you are not having symptoms (unlike in chlamydia).

‘The most useful test is the first pass of urine in men and a vaginal swab in women,’ Dr Daniel explains. ‘There is still not enough information on the incubation period so it is unclear when we should test for mycoplasma. It is widely accepted however, that sensitive tests will pick up early infection’.

‘If you don’t have any symptoms, you might be able to order a free STI testing kit from your local sexual health service,’ says Dr O’Sullvan. ‘However, if you have any symptoms you should always visit a service (such as a sexual health clinic or your GP) in person.

‘Many people with STIs don’t have any signs or symptoms at all, so don’t assume you’ll always be able to tell whether someone has an STI,’ she warns.

‘To reduce your risk, it’s far better to practice safer sex and use condoms, especially as they’re the only type of contraception that can help prevent you getting or passing on STIs. You can find out more on FPA’s Sexwise website.’

Can MG be treated?

‘MG has been associated with other problems, such as pelvic inflammatory disease in women and persistent inflammation of the urethra (the tube that carries pee out of the body) in men and the new guidelines recommend that people with symptoms are tested so that they can be treated with antibiotics if necessary,’ says Dr O’Sullivan.

Though MG is resistant to some types of antibiotics, we do still have treatments that work and will clear up the infection, although it’s always better to avoid the infection in the first place by using condoms to protect yourself, advices Dr O’Sullivan.

If you do need treatment, you’ll need to avoid having sex until you’ve finished the treatment to help prevent re-infection and you’ll need to go back for a test to check the MG has gone, she says.

‘Make sure to get tested regularly as detection of mycoplasma is associated with other conditions such as chlamydia,’ says Dr Daniel. ‘It goes without saying that barrier protection is the best way to protect yourself from sexually transmitted diseases. So, always practice safe sex.’

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