Among the Mycoplasma species, M. genitalium and M. hominis are primarily transmitted through sexual contact.

They can spread via vaginal, anal, or oral sex, with unprotected intercourse posing a particularly high risk. M. hominis can also exist as a normal resident in the genital or urinary tract, and may cause symptoms under certain conditions such as immune suppression.

Many people are asymptomatic carriers, which increases the risk of unknowingly transmitting the infection to partners.

Awareness and prevention are therefore essential.

Mycoplasma infections often present without symptoms, but when symptoms do occur, they differ between sexes. In M. genitalium infections, men may experience mild urethritis or discomfort during urination, while women may develop cervicitis or pelvic inflammatory disease (PID).

These infections can contribute to infertility and should not be overlooked. M. hominis is more likely to cause issues during periods of immune suppression and has been associated with vaginitis, intrauterine infections, and complications such as premature birth or miscarriage during pregnancy.

In men, M. hominis may be linked to urinary tract infections and possibly prostatitis.

Both pathogens can cause symptoms similar to chlamydia or gonorrhea, making misdiagnosis a risk.

Standard culture methods are often ineffective for detecting Mycoplasma species, so nucleic acid amplification tests such as PCR are the main diagnostic tools. Samples are typically taken from urine, vaginal secretions, or cervical swabs for genetic identification.

However, because M. hominis can exist as a normal commensal, results must be interpreted in the context of symptoms. M. genitalium is usually tested when symptoms persist despite negative results for chlamydia.

It is not always included in standard STI panels, so testing often requires a physician’s specific request.

The test may not be covered by insurance, and diagnostic accuracy can vary depending on the laboratory.

Mycoplasma infections are treated with antibiotics. M. genitalium is typically treated with macrolides such as azithromycin, although resistance is increasingly common, requiring alternative antibiotics such as minocycline or moxifloxacin.

A follow-up test (TOC: Test of Cure) is recommended to confirm the infection has cleared and prevent reinfection.
M. hominis, on the other hand, is generally resistant to macrolides and is better treated with tetracycline-class antibiotics such as doxycycline.

Due to rising antibiotic resistance, careful selection of medications is necessary. Self-medication is strongly discouraged; treatment should always be based on a physician’s instructions.

If one partner is treated, the other should be tested and treated as necessary to prevent recurrence.

Using condoms correctly is the most effective method for preventing mycoplasma infections.

This applies to vaginal, anal, and oral sex, especially with new or multiple partners. Because many cases are asymptomatic, regular STI screening is recommended even if no symptoms are present. In particular, if a person tests negative for chlamydia and gonorrhea but still has symptoms, mycoplasma testing should be considered.

Education about STIs and open communication with sexual partners are key to prevention. Pregnant women should be especially cautious, as early diagnosis and treatment may be important for fetal health.