Mycoplasma Genitalium Symptoms in Men and Women
Mycoplasma genitalium symptoms are usually absent: according to the CDC, most people who have it notice nothing at all. When symptoms do show up, the most common are discharge from the penis or vagina and burning when you pee. Women may also notice bleeding between periods or after sex.
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Mycoplasma genitalium symptoms
Mgen symptoms look a lot like chlamydia: discharge, burning when peeing and, in women, unusual bleeding. Many people have no symptoms at all.
Because the signs overlap with other STDs, symptoms alone can't tell you which infection you have. Only a test can.
| Men | Women | |
|---|---|---|
| Discharge | From the penis, often cloudy or pus-like | From the vagina |
| Burning or pain when peeing | Yes | Yes (can feel like a UTI) |
| Bleeding | — | Between periods, or during or after sex |
| Other | — | Pelvic pain, peeing more often (mainly with PID, a pelvic infection) |
| No symptoms at all | Common | Common |
Mgen symptoms in men
Mycoplasma genitalium symptoms in men center on the urethra (the tube urine passes through). According to a 2011 review, Mgen causes 15% to 30% of nongonococcal urethritis, meaning inflammation of the urethra not caused by gonorrhea. Men with Mgen are more likely than men with other causes to have discharge, and it tends to be cloudy or pus-like.
Mgen is also a common reason urethritis keeps coming back. The same review found it may be present in up to 40% of people whose symptoms didn't clear after doxycycline or azithromycin.
To rule out chlamydia and gonorrhea the same day: rapid chlamydia and gonorrhea test, results in 30 minutes
Mgen symptoms in women
In women, Mgen can infect the cervix and the urethra. Studies of infected women report vaginal discharge, painful urination and bleeding between periods. Women whose infection has led to PID (pelvic inflammatory disease, an infection of the uterus and fallopian tubes) also report bleeding during or after sex, pelvic pain and peeing more often.
It can feel like a UTI. A 2021 study found Mgen in up to 22% of women with painful urination, and the usual UTI antibiotics work poorly against it. If a "UTI" keeps coming back after treatment, Mgen may be the cause.
If you also have BV symptoms: 30-minute rapid BV test
What color is Mgen discharge?
There's no signature color. In men, Mgen discharge is more often cloudy or pus-like than discharge from other causes of urethritis.
For women, no reliable study describes a typical color. Color alone can't reliably tell Mgen apart from chlamydia, gonorrhea or BV.
How long can you have Mycoplasma genitalium without knowing?
You can have Mgen for months, sometimes more than a year, without knowing. In studies of women published through 2019, infections typically lasted 1 to 3 months, but up to 16% still had it after 12 months. In a 2019 study of men, it stayed in the body up to 11 months after their symptoms went away.
How soon do symptoms start? No US health authority has set an incubation period (the time between catching it and noticing symptoms). The UK's NHS estimates 1 to 3 weeks after sex when symptoms appear, and says some people don't notice anything for months.
That's how a partner can have Mgen without knowing it. Studies through 2019 found that 30% to 50% of the partners of someone with Mgen also test positive.
What is Mycoplasma genitalium (Mgen)?
Mycoplasma genitalium is a sexually transmitted bacterium that infects the urethra, the cervix and the rectum. It's very small and has no cell wall, which is why penicillin and the ceftriaxone shot used for gonorrhea don't work on it. Because Mycoplasma genitalium symptoms are often mild or absent, doctors often miss it, and the first FDA-cleared test only arrived in January 2019.
A national US survey in 2017–2018 found Mgen in 1.7% of people aged 14 to 59, about 3 million people, and in 3.9% of people in their 20s. At US STD clinics in 2020, 16.6% of patients tested positive.
How do you get Mgen?
You get Mgen through vaginal or anal sex without a condom with someone who has it. According to the CDC, researchers still don't know whether oral sex spreads it. A person without symptoms can still pass it on.
The CDC says using condoms every time, and staying in a mutually monogamous relationship with a partner who doesn't have Mgen, lower your risk.
Mycoplasma genitalium testing: urine or swab?
A NAAT (nucleic acid amplification test) finds Mgen's genetic material in a urine sample or a swab. There is no rapid test and no blood test for Mgen.
It's not part of a standard STD panel, so your doctor has to order it by name. For women, a vaginal swab catches more infections than urine.
| Sample | How often the test finds Mgen when it's there |
|---|---|
| Urethral swab (men, TMA test) | 98% |
| Male urine | 91–100% |
| Vaginal swab | 92–99% |
| Cervical swab | 82–83% |
| Female urine | 78–86% |
Source: National STD Curriculum, University of Washington, 2026
Who should get tested? The CDC recommends testing for men whose urethritis keeps coming back and women whose cervicitis (inflammation of the cervix) keeps coming back, and says to consider it for women with PID. Partners of someone who tested positive should get tested too.
The CDC does not recommend screening people without symptoms. If you want to know anyway, we'll test you.
Timing matters, too: when to test after an exposure
How to read your result: NAA, TMA and PCR
"NAA," "NAAT," "TMA" and "PCR" on a lab report all name the same kind of test: one that detects Mgen's genetic material. TMA and PCR are two ways of doing it.
"Detected" or "positive" means the lab found Mgen in your sample. The result doesn't show how long you've had it.
Tested positive after treatment? A test taken too soon can pick up genetic material from dead bacteria. See when to retest, below.
Mycoplasma genitalium treatment
Treatment is two antibiotics in a row: doxycycline twice a day for 7 days, then moxifloxacin once a day for 7 days. The CDC recommends this regimen when resistance testing (a lab check of which antibiotics will work) isn't available, as in most US clinics. In a 2020 study of this approach, it cured 92% of infections.
Why not a single dose of azithromycin? US studies published 2019–2021 found 44% to 64% of Mgen resistant to it. Resistance to moxifloxacin is lower but growing: about 10% of samples from the Americas collected 2011–2017 carried a gene change linked to treatment failure.
Side effects to know about. Moxifloxacin is a fluoroquinolone antibiotic. Since 2008, the FDA has required a boxed warning (its strongest warning) on these drugs for tendon inflammation and tendon rupture.
In 2018, the FDA added a warning about roughly twice the risk of tears or ruptures in the aorta, the body's main artery. Tell your doctor if you have an aortic aneurysm (a bulge in the aorta), high blood pressure, Marfan or Ehlers-Danlos syndrome (inherited conditions), or if you're older.
Does Mgen go away on its own?
Sometimes, but you can't count on it. In a 2022 study of men, some cleared Mgen without treatment over 18 months. Others carry it much longer and can pass it on the whole time.
Treatment clears it in most people.
How long does Mycoplasma genitalium last after treatment?
Treatment takes 14 days. If your symptoms continue more than a few days after the last pill, the CDC advises going back to your provider.
When can you have sex again?
Wait until you've finished both antibiotics, your symptoms are gone, and any ongoing partner has been tested or treated. You can get Mgen again even after treatment.
Do you need a retest after treatment?
Usually not. If your symptoms clear after doxycycline and moxifloxacin, the CDC does not recommend a test of cure (a follow-up test to confirm it's gone). Retest only if symptoms continue or come back, and no sooner than 21 days after the last pill, so leftover genetic material doesn't cause a false positive.
What happens if Mgen isn't treated?
In women, untreated Mgen is linked to cervicitis and PID, which can scar the fallopian tubes. A 2015 review found women with Mgen are about 2 to 2.5 times as likely to have PID, though experts still debate how directly Mgen causes it. In men, long-term effects aren't known.
Women. Studies from 2009–2010 found Mgen in 10% to 29% of women with cervicitis, and a 2024 review found it in about 1 in 10 women diagnosed with PID. Some studies link it to infertility from blocked tubes; others don't.
Men. According to the CDC, it isn't known whether men develop long-term problems from Mgen. No solid data link it to testicle inflammation or male infertility.
