Ureaplasma and You
If you have never in your life heard of either Ureaplasma and Mycoplasma, you aren’t alone! These are sexually transmitted bacterial infections of the vagina, bladder, urethra and pelvis in women (and men) that can cause SO many symptoms.
Many of my patients come in with symptoms of a UTI, but traditional urine cultures are negative. Sometimes antibiotics feel like they work, but symptoms inevitably come back.
Some patients have pelvic pain, pain with sex, or pressure in the bladder.
Others feel burning in the urethra or urinary urgency without pain.
Men often have NO symptoms…
Since these infections can show up in different ways, they can be hard to diagnose, especially since the only test for Ureaplasma and Mycoplasma are PCR tests (like the COVID nasal swabs). These look for the DNA of the bacteria instead of culturing them on a dish. This means we usually do not have the ability to see which antibiotics work for them best. Commercial labs did not even look for these bacteria until 2019 even though they were identified originally in the 1980s and found in men with urethral pain.
In my practice I see more Ureaplasma than Mycoplasma, but both show up. Urine samples are not as good as vaginal swabs in finding the infections so I usually do a vaginal swab. Ureaplasma Parvum seems to cause the most pain with infections and this pain seems to linger longer than with other subtypes (sometimes months).
Treatment of these infections is similar to other bacterial infections- antibiotics! They have to be oral pills, not vaginal medications because the bacteria live inside of cells. The CDC recommendations are a little behind the time on best treatment strategies but Canada and the Europeans do a better job testing and treating these bacteria. Doxycycline, Azithromycin, and/or Moxifloxicin work the best, but since I cannot see what antibiotics will work before I treat patients on the culture results, I make an educated guess.
The most unusual thing about these bacteria that feel like bladder infections is that your partner (male or female) likely have this bacteria too, so they need to be treated as well. If they do not get treated, you will catch the infection back when you have unprotected sex! Thankfully, in California expedited partner treatment can be used to treat both people at the same time without a doctor visit for your partner. I also do a test of cure to make sure the bacteria is gone since some people will need to be treated
There is some evidence that women are more likely to have other infections like bacterial vaginosis (BV) if they have ureaplasma. There is also limited evidence that these infections may cause preterm birth, amniotic infections, or pelvic inflammatory disease, but these are very small and early studies, so I don’t put as much weight on them at this time.
More resources below:
If you need a community to discuss with, highly recommend the Ureaplasma subreddit:
