Hi friends, Giana here. I am so glad you are taking time to explore this topic because today we are diving into two lesser-known bacteria that can have a big impact on your vaginal and reproductive health: ureaplasma and mycoplasma. These organisms often go unnoticed, but they can quietly contribute to persistent BV, UTIs, pelvic discomfort, and even fertility challenges.
What Are They?
Ureaplasma and Mycoplasma genitalium belong to a group called mollicutes, which are bacteria that lack a cell wall. This structural difference makes them resistant to many standard antibiotics. They are commonly found in the genital and urinary tracts and can exist without causing symptoms for many people.
How Common Are They?
Ureaplasma is surprisingly prevalent, found in up to 40 to 80 percent of women and 50 percent of men. Mycoplasma genitalium affects roughly 1 to 4 percent of sexually active individuals and has been detected in up to 30 percent of women with cervicitis or pelvic inflammatory disease (PID).
Symptoms and Complications
|
Symptom Type |
Ureaplasma |
Mycoplasma genitalium |
|
Unusual discharge |
Yes |
Yes |
|
Burning or pain with urination |
Yes |
Yes |
|
Pelvic or lower abdominal pain |
Sometimes |
Often in PID |
|
Post-coital bleeding, cervicitis |
Rare |
Common |
|
Fertility and pregnancy complications |
Possible |
Documented risk |
Both can contribute to chronic vaginal infections and symptoms that often get misdiagnosed or mistreated.
Testing and Diagnosis
The gold standard for diagnosis is a nucleic acid amplification test (NAAT) using vaginal or cervical swabs, or a first-catch urine sample. For Mycoplasma genitalium, it is helpful to also test for antibiotic resistance before beginning treatment.
Treatment Options
Because these organisms lack a cell wall, antibiotics must be carefully chosen.
For Ureaplasma:
-
First-line options include macrolides (like azithromycin) or doxycycline. Fluoroquinolones may be used if necessary.
For Mycoplasma genitalium:
-
Often treated with doxycycline followed by moxifloxacin, or azithromycin if there is no resistance. A test of cure is recommended about three weeks after completing treatment.
Why Recurrence Happens
These bacteria can form biofilms, which are protective layers that make them harder to eradicate. This is why a holistic, phased approach is so important:
-
Break down biofilms with targeted enzymes or compounds
-
Use the right antibiotics to eliminate the bacteria
-
Rebuild the vaginal microbiome using probiotics and nutrition
Prevention and Self-Care
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Use barrier methods like condoms
-
Clean sex toys thoroughly between uses
-
Pause sexual activity for 7 to 21 days post-treatment, depending on medication
-
Support the microbiome with probiotics, a balanced diet, hydration, and stress reduction
When to See a Provider
You may want to request testing if you are experiencing:
-
Persistent or unusual discharge
-
Burning with urination
-
Pelvic or post-coital pain
-
Recurrent BV or UTIs
-
Fertility concerns or pregnancy risks
Final Thoughts
Although they are often overlooked, ureaplasma and mycoplasma can be significant contributors to chronic vaginal symptoms. With early detection, targeted treatment, and microbiome support, healing is absolutely possible.
If this topic resonates with you, be sure to check out my recent G-Chats episode where I go deeper into the science, share real patient stories, and talk about protocols that work.
Let me know if you would like the printable protocol, my recommended product list, or a support guide in your inbox. I am always here to help you advocate for your body and your wellness.
With love and clarity,
Giana Jarrah
Biomedical Engineer and Co-Founder, With Meraki Co