Does a Positive Mycoplasma Test Indicate an STD?

Mycoplasmas are prokaryotic microorganisms that fall between bacteria and viruses in size. Among the 16 types isolated from humans, 7 are pathogenic. Common infections in the urinary and reproductive tracts include Ureaplasma urealyticum (Uu), Mycoplasma hominis (Mh), and Mycoplasma genitalium (Mg).

These microorganisms are primarily transmitted through sexual contact and can inhabit the vagina, cervix, urethral opening, and urine. Infections can lead to or be associated with diseases like urethritis, cervicitis, pelvic inflammatory disease (PID), chorioamnionitis, and preterm birth.

Are You a Woman Cherished by Mycoplasmas?

Reproductive tract infections have a higher prevalence in young women, especially after sexual maturity and activity. Studies show that the more sexual partners a woman has, the higher the detection rate of mycoplasmas, particularly Uu. However, this does not usually have significant clinical implications.

For pregnant women or those planning pregnancy, a positive Uu test in the lower reproductive tract generally does not require intervention. Testing positive before pregnancy does not imply promiscuity or a sexually transmitted disease (STD) and should not be a cause for undue concern.

Management Principles for Mycoplasma Detection:

1. Asymptomatic Carriers: If both partners show no symptoms of urinary or reproductive tract infections but test positive for Uu, they are considered carriers and do not require treatment.

2. Post-Treatment Carriers: If symptoms disappear post-treatment but Uu remains detectable, it may have converted to a carrier state, and further medication is unnecessary.

3. Symptomatic Males: If a male has Uu urethritis, treat the sexual partner and avoid unprotected sex during treatment.

4. Male Fertility Issues: If a male has abnormal semen quality and there is a desire for childbirth, both partners should undergo treatment.

5. Suspected Infections: Conduct Mycoplasma genitalium testing when suspecting urethritis and cervicitis.

6. PID Treatment: Consider mycoplasma coverage in the antimicrobial spectrum for treating PID.

Diseases Linked to Urogenital Mycoplasma Infections:

1. Urethritis: Mycoplasma is a common pathogen causing urethritis, the most frequent type of urinary tract infection.

2. Cervicitis and PID: Mg is a known cause of cervicitis, endometritis, PID, male reproductive tract diseases, and tubal infertility.

3. Chorioamnionitis and Preterm Birth:** Uu can lead to intra-amniotic infections, necessitating upper reproductive tract sampling for confirmation.

4. Impact on Semen Quality: Uu may affect sperm motility by adhering to sperm or inducing anti-sperm antibodies.

5. Assisted Reproductive Technology: Studies indicate Uu does not significantly impact IVF outcomes, such as fertilization rates, cleavage rates, clinical pregnancy rates, or miscarriage rates. Cervical Uu positivity does not affect IVF-ET pregnancy outcomes.

Mycoplasma Colonization in the Urogenital Tract:

Many people are asymptomatic carriers, especially of Uu, and do not require treatment. True infections present with various symptoms, from vaginal heaviness to frequent urination if the infection spreads to the urethra. Cervical infection can cause increased, cloudy discharge, edema, congestion, or erosion. Urethral involvement may result in redness and discharge but rarely causes tenderness.

Complications:

Common complications include salpingitis, with some patients developing endometritis and PID. If detected during a physical examination, do not panic. The attending doctor will decide on treatment based on symptoms, physical examination findings, laboratory test results, and pregnancy plans. Asymptomatic individuals testing positive for Uu are likely carriers and do not require treatment, allowing them to plan for pregnancy.

Treatment:

Treating mycoplasma infections is not complex. Antibiotics such as tetracyclines, macrolides, and quinolones are commonly used, with tetracyclines being the first choice. Drug sensitivity testing is important to ensure effective treatment and prevent drug-resistant bacteria. Besides, natural medicine Diuretic and Anti-inflammatory Pill and Fuyan Pill can also be a nice option.

In conclusion, a positive mycoplasma test is not necessarily a sign of an STD, and it does not preclude pregnancy planning. Understanding the nature of the infection and appropriate management can help maintain reproductive health and address concerns effectively.