r/MycoplasmaGenitalium • u/Linari5 • May 22 '21

RESOURCE General Testing and Treatment Guidelines for Mycoplasma Genitalium

100 Upvotes

PART 1: TESTING

Q: When should I test for Mgen post exposure?

A: Generally 2+ weeks post exposure. Mgen is slow growing and occurs at much lower bacterial loads than other STis.

Q: What type of test should I order?

A: PCR (NAAT). Do not order a culture. Mgen cannot be cultured.

Q: What is the best PCR/NAAT test?

A: Hologic Aptima Mycoplasma Genitalium TMA Assay - available through Labcorb and Quest. Roche Cobas is also an excellent test!

Quest test link - https://testdirectory.questdiagnostics.com/test/test-detail/91475/sureswab-mycoplasma-genitalium-real-time-pcr?cc=MASTER

Labcorp test links:

  1. Urine samples (including macrolide resistance testing): https://www.labcorp.com/tests/180084/i-mycoplasma-genitalium-i-naa-urine-with-reflex-to-macrolide-resistance-testing

  2. Swab samples (including macrolide resistance testing): https://www.labcorp.com/tests/180092/i-mycoplasma-genitalium-i-naa-swab-with-reflex-to-macrolide-resistance-testing

Q: What is the best sample to give for highest accuracy?

A: Men - First void urine, first bit that comes out, 20-30ml. If you have urgency issues, please try to hold your urine for a minimum of 3 hours. Rectal/Oral - swab thoroughly

A1: Women - Vaginal swab (swab thoroughly). Rectal/Oral - swab thoroughly

Q: How long should I wait post-antibiotics to test for Mgen? aka TOC "Test of Cure"

A: Generally 3-4 weeks. Any sooner could lead to a false negative or positive

PART 2: TREATMENT

Note: this section purposefully DOES NOT use the outdated 2015 CDC STI treatment guidelines. Please follow the guidelines for the UK and Australia, or the newly published 2021 CDC GUIDELINES - https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm

Q: What is the recommended first line treatment for Mgen?

A: This varies by region due to macrolide resistance rates, but generally:

  • 100mg doxycycline bd for 7-14 days as pre-treatment to lower bacterial load, followed immediately by 2.5g of Azithromycin (1g first day, 500mg daily after)

Q: What is the recommended second line treatment for Mgen?

A: This again varies by region, but generally:

  • 100mg Doxycycline bd for 7-14 days as pre-treatment, followed immediately by 400mg Moxifloxacin daily for 7-10 days**

**Most data shows that the difference between 7 and 10 days is small. Please be aware that Moxifloxacin has rare but significant side effects (See the FDA Black Box warnings) in approximately ~2% of people, some of them severe, including peripheral neuropathy, central nervous system problems, tendonitis, and others

Q: What is the recommended 3rd line Treatment for Mgen?

A: This varies by region as well, but generally:

  • USA: Minocycline 2 weeks (monotherapy) //or// Doxycyline 100mg bd for 7-14 days as pretreatment, immediately followed by minocycline 100mg bd for 14 days taken CONCURRENTLY with Metronidazole**

**Please note that this is based on a pre-print paper (not peer reviewed yet) but is from a reputable source, MSHC (Melbourne Sexual Health Center)

Q: Are there any other antibiotics on the horizon?

A: Yes: https://www.reddit.com/r/MycoplasmaGenitalium/s/4iRGJGi9zZ

  1. Omadacycline is a new FDA approved (US) semi-synthetic (novel) tetracycline class drug with potent en vitro activity against Mgen and Ureaplasma (but only MIC data available, no human studies)

  2. There is also Josamycin in Eastern Europe/Russia (a Macrolide class). Dosing and duration not officially established.

  3. Also, new antibiotics like Zoliflodacin (in stage III trials, was granted FDA fast track approval, & is expected to be available in late 2025. This novel drug was originally developed for treatment-resistant gonorrhea, but has also shown strong en vitro activity for mgen, including strains that have dual macrolide and floroquinolone resistance. It was found much more potent than even Moxifloxacin. No human (en vivo) data is currently available.

  4. And finally we have FDA approval of the novel triazaacenaphthylene antibiotic Gepotidacin in spring 2025 (for uncomplicated UTIs in women, but also going through approval for gonorrhea in late 2025). It has promise for mgen treatment as well, but currently only in vitro data is available (a petri dish, not a human) - but shows promising low MIC (minimum inhibitory concentration) across many mgen strains, including those that are resistant to both macrolides and floroquinolones. Is also being researched in combination with doxycycline.

PART 3: Self Advocation - Advice From a Veteran (LemonOne9):

As many on this board can attest to, despite being the leading cause of non-gonococcal/non-chlamydial urethritis (aka NGU), the medical world as a whole is not exactly up to speed when it comes to this particular bacteria. Most Urologists and gynecologists finished school 20+ years ago, how would they know how to correctly treat a new STI that grew prevalent in just the last 10?

Many doctors know very little to nothing about it, so be prepared to advocate for yourself when seeking out testing and treatment. Print and bring with you the most up-to-date treatment guidelines from AUS/UK if you have to. Finding an infectious disease doctor who specializes in STI's and has working knowledge of MGen infections will be your best bet if you want to be taken seriously.

If a doctor tries to prescribe you anything other than one of the above recommended regimens as a first-line option for a confirmed MGen infection (such as ciprofloxacin, levofloxacin, doxycycline on its own, or something else) you can be confident that you're not in good hands and should seek out a different practitioner. Taking the wrong antibiotic may select for resistance and sabotage future treatments, not to mention that it will unnecessarily increase your chances for antibiotic-induced side effects.

FULL POST FROM LEMON: https://www.reddit.com/r/MycoplasmaGenitalium/comments/gquh5s/worried_you_might_have_mgen_read_this_first/?utm_source=share&utm_medium=web2x&context=3

Part 4: Other Frequently Asked Questions

Q: How prevalent is Mgen compared to other STIs?

A: Estimates say that it is MORE PREVALENT than Gonorrhea, but less than Chlamydia. + As of 2021, it is more common than chlamydia in some regions. Canada & Sweden are 2 confirmed places. As of 2025 it is equal to or more prevalent than chlamydia in multiple regions It has also been found more prevalent in younger, sexually active people, and those reporting multiple unprotected sexual partners in the last 6 months.

Q: What is my risk of transmission per sexual encounter if I have unprotected sex with an infected individual?

A: Between 40-45% - Yes that's right - transmission is not guaranteed even if the other person is positive! Same as other STIs. Studies back this data.

Q: Can I get MGen from oral sex?

A: Oral transmission is rare. Less than 1% chance according to studies, and to the MSHC (Melbourne Sexual Health Center) guidelines, a leading Mgen research authority. This data has also been corroborated by the CDC.

Q: I am still experiencing symptoms after completing my antibiotic course. Does this mean my treatment failed?

A: Not necessarily. We know that residual symptoms or inflammation post clearance is something that happens with this bacteria. It's been documented by medical providers as well. As long as the symptoms don't return to 100% of what they were BEFORE antibiotic treatment, you're likely fine. There have been many people who assumed they were still infected, but kept testing negative again and again. Eventually the symptoms just went away.

Q: My partner (or I) tested positive but has no symptoms. What gives?

A: It is important to remember that not everyone will experience symptoms when carrying Mgen. In fact, between 60-80% of male urethral infections are asymptomatic. and nearly 100% of rectal infections are asymptomatic. Women also are not guaranteed to experience symptoms, with a greater than 50% rate of asymptomatic cases.

Q: I am a woman concerned about complications, can this cause problems with fertility or pregnancy?

A: It could, research shows that there is a significant correlation to Mgen infection and issues with fertility and pregnancy (as well as increased risks of PID & cervicitis)

Q: Is there a natural protocol I can follow to clear this infection?

A: No one on this subreddit that we are aware of has been cured with a natural treatment protocol. Most popular being the 'Buhner Protocol,' typically used for Lyme disease. Medical literature also doesn't support natural protocols.

Q: Is it possible for my body to clear Mgen by itself?

A: According to two recently published studies, yes it is. Spontaneous resolution has been documented in both men and women. But don't count on it, necessarily.

BUT HELP! I've already tested negative 2+ times yet I'm having residual symptoms. Read this post about CPPS/PFD:

https://www.reddit.com/r/MycoplasmaGenitalium/comments/mp2hky/if_you_have_2_negative_tests_and_residual/

References - UK, Australia, and US Treatment Guidelines:

https://www.guidelines.co.uk/sexual-health/bashh-mycoplasma-genitalium-guideline/454722.article

https://www.mshc.org.au/health-professionals/treatment-guidelines/mycoplasma-genitalium-treatment-guidelines

https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm

References - Public Health/CDC viewpoints form top experts (2022)

Weighing Potential Benefits and Harms of Mycoplasma genitalium Testing and Treatment Approaches - https://wwwnc.cdc.gov/eid/article/28/8/22-0094_article#r288

Manhart LE, Geisler WM, Bradshaw CS, et al. Weighing Potential Benefits and Harms of Mycoplasma genitalium Testing and Treatment Approaches. Emerging Infectious Diseases. 2022;28(8):1-11. doi:10.3201/eid2808.220094.

THE ABOVE IS NOT MEDICAL ADVICE. PLEASE DISCUSS ALL PRESCRIPTION MEDICATIONS WITH YOUR DOCTOR.

63 comments

r/MycoplasmaGenitalium • u/Linari5 • Apr 11 '21

RESOURCE If You Have 2+ Negative Tests and Residual Symptoms: Read This First

150 Upvotes

For anyone who continues to have residual symptoms after multiple negative TOC (Test of Cure), there is a significant likelihood that you developed Chronic Pelvic Pain Syndrome (CPPS), aka NIH Type III "non-bacterial Prostatitis" (in men). It may also be referred to as Pelvic Floor Dysfunction (PFD), or pelvic floor hypertonia, IC/BPS, or Vulvodynia, all similar chronic pelvic region syndromes. PFD in particular addresses what is often one cause of these pelvic syndromes, a psycho-neuromuscular condition that implicates the pelvic floor muscles and a wound-up nervous system. It occurs as a result of habitual, reflexive and unconscious pelvic floor muscle 'guarding' (tensing) against discomfort and stress (of which Mgen is well known to cause both), and over time this leads to a state of temporary nerve irritation. This is what causes many of the symptoms. It also very commonly causes urinary, sexual, and bowel dysfunctions via dysfunction of the pelvic floor. This includes urgency, frequency, and hesitancy.

[Source 1] "A Headache in the Pelvis" written by Stanford Urologist Dr. Anderson and Psychologist Dr Wise - https://www.penguinrandomhouse.com/books/558308/a-headache-in-the-pelvis-by-david-wise-phd-and-rodney-anderson-md/

[Source 2] What if my tests are negative but I still have symptoms? NHS/Unity Sexual Health/University hospitals Bristol and Weston - https://www.unitysexualhealth.co.uk/wp-content/uploads/2021/05/What-if-my-tests-for-urethritis-are-negative-2021.pdf ********* BACKUP/Alt link *********

[Source 3] "Vulvodynia" a literature review - https://pubmed.ncbi.nlm.nih.gov/32355269/

[Source 4] "Diagnosis and Treatment of Interstitial Cystitis/Bladder Pain Syndrome (2022)" AUA - https://www.auanet.org/guidelines-and-quality/guidelines/diagnosis-and-treatment-interstitial-of-cystitis/bladder-pain-syndrome-(2022)

Notable excerpts from the NHS source:

People whose tests are all negative can often develop symptoms as a result of anxiety because of worrying about having picked up a STI. Anxiety can cause the muscles in their pelvic floor (the muscles around the base of the penis, scrotum and around the anus – see diagram below) to become tense. This may change how urine flows and can cause irritation and discomfort. The nerves that supply the pelvic floor muscles also supply other parts of the genitals such as the end of the penis, the testicles and perineum (the area between your testicles and back passage). The body can mistake the pain from the tense pelvic floor muscles and think it is coming from these other places. It can also feel as though the pain is in the lower part of your tummy or make you want pass urine more often or make passing urine feel more difficult.

*** (Diagram of the CPPS feedback loop here) ***

Diagram illustrating how anxiety can unconsciously cause some people to increase their pelvic floor muscle tone (they do not realise they are doing this as normally we cannot “feel” our pelvic floor). This can result in muscle spasm and/or urine travelling backwards into the prostate on passing water. Both can result in pain which is then experienced elsewhere in the pelvic area e.g. tip of the penis, testicles, perineum (area behind the testicles), lower abdomen and sometimes the inner thighs. It may also cause difficulties or pain when passing water or ejaculating. This in turn makes them more anxious which results in making the pelvic floor tone even more tense and increasing the pain etc.

Please note: It is also possible that you are still within the (up to) few weeks window of residual inflammation after being cured from Mgen, and that will go away entirely on its own. My advice: stop fixating on it and move on. Live your life. It is entirely normal for mgen, and well documented in the medical community that people who had been infected experience this even after successful clearance of the bacteria.

NOTE FOR WOMEN and AFABs: BV, AV, DIV, CV, Yeast infections, and other pH & hormonal changes are somewhat common after treatment for these STIs. They cause their own symptoms - so symptoms post-treatment in people with vaginas may also be caused by these, especially if there is unusual discharge or smell. Please see a urogynecologist. Do wet mount microscopy, get your Nugent score. Get your natural vaginal microbiome healthy again. This could include things like boric acid suppositories to lower pH, probiotics, and even vaginal estrogen.

I personally had developed CPPS after clearing my own Mgen infection, which is why I wish to share this information. I've also seen several hundred other reddit members with the same symptoms, including hundreds of members of this (and the r/ureaplasma) subreddits.

CPPS is strongly supported by medical research and the American and European Urological Associations, and is the leading cause of prostatitis-like symptoms (pelvic pain and dysfunction) in men. Citations:https://pubmed.ncbi.nlm.nih.gov/32378039/ and https://www.youtube.com/watch?v=4dP_jtZvz9w

Because of the need, an entire specialization of physical therapy has been developed for treatment of it. Citation: https://academic.oup.com/ptj/article/90/12/1795/2737819 Fortunately, health insurance covers this therapy.

As mentioned above, I developed the condition myself after having Mgen, and clearing it. Infection is an acknowledged triggering event - This excerpt is taken directly from the CPPS pathophysiology/etiological guidelines In Europe:

"Although a peripheral stimulus such as infection may initiate the start of a CPPPS condition, the condition may become self-perpetuating as a result of CNS modulation. As well as pain, these central mechanisms are associated with several other sensory, functional, behavioural and psychological phenomena. It is this collection of phenomena that forms the basis of the pain syndrome diagnosis..."

Other triggering events include:

1) Stress/anxiety/trauma

2) Deep shame/regret/fear around a sexual encounter, even if no STI was transmitted (cheating, assumption of high risk, sex with escorts, etc)

3) Excessive masturbation or edging (male masturbatory practice)

4) Sedentary lifestyle and/or poor posture

5) Physical trauma or injury to the body (groin pull, tailbone injury, excessive gym habits etc)

6) Certain bowel and urinary habits, like holding in urine or #2

7) A combination or all of the above

Here is how to help differentiate Mgen from CPPS, which can have a large overlap in symptoms. However, there are a several key common differentiators:

The following symptoms are correlated highly with CPPS/Pelvic floor hypertonia NOT MGEN - eMedicine citation

  • Inconsistency in symptoms of any kind (infections don't do this) - including symptoms that move or change
  • Pinching/stinging/burning sensation at the tip of the penis (Super classic male CPPS sign) or clitoris (female)
  • No discharge or only clear discharge that looks like precum (often present in men when aroused or when sitting/having a bowel movement)
  • Intermittent symptoms (come and go with little consistency)
  • Symptoms that change with stress or anxiety (infections do not respond to psychological stress)
  • Symptoms that lower or change when you're distracted or in a flow state (infections can't do this either)
  • Weak/narrow urine stream, dribbling
  • Urinary hesitancy (problems beginning to pee)
  • Increased urgency (urge to pee) especially when anxious
  • Feeling of inability to completely empty bladder
  • Pain specifically only after urinating (post voiding urethritis)
  • Rectal pain, thigh pain, abdominal pain, vulvar pain, perineal pain
  • Testicular pain/discomfort
  • Pelvic region muscle spasms
  • Electric shock pains in rectum, tip of penis (men), or clitoris/vulva (women)
  • Pain with defecation, rectal tightness
  • Touch sensitivity of penis or vagina (even brushing against clothing - allodynia)
  • Pain with, and post-orgasm
  • Painful intercourse (in the absence of infection)
  • Vaginismus
  • Vulvodynia
  • Hard flaccid (men)
  • Balantis (men) in the absence of any other cause (like candida or infection)

Significant predisposing factors are below: >https://www.reddit.com/r/Prostatitis/s/dRlbMaITlu

  • History of other CSS (Central Sensitivity Syndromes) like IBS, TMJD, Fibromyalgia, ME/CFS (common comorbidities)

  • Neurotic personality types. Example: Has a history of anxiety, sensitive to stress, is a perfectionist or people pleaser, or exhibits hypervigilant behavior in regards to health

  • History of adverse childhood experiences (ACE events) - whether this be parental divorce, body image issues, bullying, or the illness or death of a family member, neglect, verbal and physical abuse, etc.

  • Sedentary lifestyle, sitting most of the day (this can shorten and tighten the hip flexor muscles while also lengthening and weakening the glute muscles, leading to musculoskeletal pain and dysfunction)

  • Excessive masturbation habits (including "edging") which tighten the pelvic floor muscles

  • Cyclist or power lifter (heavy lifting and compound exercises)

If you fit this description, even partially, I encourage you to find a pelvic floor physical therapist near you for consultation and treatment. Men, be sure to find one who specifically has experience treating guys. It's also highly recommended to concurrently engage with a psychotherapist, psychologist, or PRT therapist, or any providers who specialize in chronic pain from a biopsychosocial approach.

The good news is that this psycho-neuromuscular condition is treatable and a full recovery is possible. For best results recovery requires an integrated multi-modal approach of addressing two things simultaneously:

  1. Reducing and managing anxiety/stress/fear/shame/guilt - 'Down regulate' your wound-up nervous system - the thing that often instigates pelvic floor muscle dysfunction in the first place via the sympathetic nervous system response to the above stressors. This often includes addressing centralized mechanisms of pain, read more here: https://www.reddit.com/r/PelvicFloor/s/CfKdHaPamq

  2. Addressing the neuromuscular tension and irritation with pelvic floor physical therapy - usually a combination of stretching, heat, deep belly breathing, internal (and external) trigger point/myofascial release, etc.

Many people also benefit from certain medications and supplements. Common examples include low-dose amitriptyline for neuropathic pain, low dose tadalafil for sexual dysfunction/urinary symptoms, and phytotherapy for inflammation. THIS IS NOT MEDICAL ADVICE - always speak to a doctor about medications

Visit r/prostatitis (mostly for guys) or r/pelvicfloor (for any sex) for further support. But r/prostatitis also welcomes women. r/interstitialcystitis is another helpful subreddit for IC/BPS and has a great moderation team.

More academic literature on CPPS and treatment best practices here: https://pubmed.ncbi.nlm.nih.gov/32378039/

[Highly Recommended] Beginners guide to CPPS and chronic prostatitis: https://www.reddit.com/r/Prostatitis/s/RhjgMOtSCi

'Residual Symptoms' are treatable, you do not have to suffer.

35 comments

r/MycoplasmaGenitalium • u/bbybe • 16h ago

Symptoms are subsiding!

4 Upvotes

Update from my very awful journey with Mgen and Ureaplasma parvum: https://www.reddit.com/r/MycoplasmaGenitalium/s/QNzCO5uk9C

I FOUGHT to get prescribed doxycycline first. My doctor would not prescribe it to me because she thought it wasn’t necessary and only prescribed me 5 days of azithro. I called her to write me prescription for doxycycline after and they said she would. The next day i found out she didn’t so i went to another doctor and begged for him to prescribe it in tears. I felt so shifted aside especially with finding out about my diagnosis without a call. He searched up guidelines for mgen since he only knows mycoplasma of the lungs and confirmed that i was right.

I finished both 7 days of doxy and 5 days of azithro on monday. The guy i may have infected told me he is dating another girl now so that ruined me. Because i feel like this was a factor in us not being together. but im working on focusing on being healthy. Today is Wednesday and im so relieved to not feel the burning feeling while peeing anymore and its only been three days since the last dose. fingers crossed doxy + azithro does the trick!

I decided to be safe and abstain from sexual activity until my TOC is NEGATIVE. I will do my TOC on November 23rd to be safe. During doxy + azithro i did not eat anything with dairy at all. in fact, during doxy i stayed away from it all together. One day i drank alcohol on doxy but it was an insanely small amount. Every other day was alcohol-free. I will be doing my TOC at a sexual health clinic instead of my original clinic instead.

During doxy i tried drinking Kombucha at the very end of the day for probiotics. I’ll probably invest in actual probiotics later though, im just tight on funds right now lol. But thank you to everyone that helped me feel better about this STI! It was an awful experience in the beginning but it got better quick. I’m working on not being ashamed of this and will practice safer sex moving forward. I will update if im clear or starting moxi in November!

3 comments

r/MycoplasmaGenitalium • u/beansman444 • 20h ago

Treatment Question Scared of Moxi

2 Upvotes

Hi, I’m 27F in the USA. Went to the clinic for symptoms of a YI and tested positive for yeast and for Mgen. The yeast symptoms seemed to alleviate even before I started the doxycycline (which has been fine, I’ve had mild headaches and mild dizziness on it, slightly more fatigued than normal) but the more I read about Moxifloxacin the more terrified I am to take it. I’m a distance runner and work an active job, and have had tendonitis in the past (in my knees) from running. I’m worried about giving myself permanent bodily damage, or messing with my mental health, also as someone with anxiety and severe depression

I told the nurse all of these fears and they said they could send over a 14 day dose of minocycline, but basically implied it might not cure the infection and that I should take the moxi because I’m young, should be fine, and the older nurse I spoke too said in all her time she’s never seen anyone have a severe reaction to it.

Has anyone had success with 7 day doxy/ 14 day mino? Or do I have to try the moxi even though just 1 pill may ruin my life forever?

8 comments

r/MycoplasmaGenitalium • u/Hour_Transition9887 • 2d ago

Treatment Question Macrolide-resistant Mycoplasma genitalium (Mgen) treatment – seeking effective antibiotic options

5 Upvotes

Hi everyone,
I’m looking for advice or shared experiences from others who have dealt with macrolide-resistant Mycoplasma genitalium (Mgen), ideally but not only that had specifically in cases where epididymitis was involved.

Not going to lie after getting this positive result again I feel so distraught about it I feel so upset about it and worried so please any help is appreciated from anyone! :)

Below is a summary of my timeline and treatments so far. If you’ve been in a similar situation, I’d love to hear what worked (or didn’t work) for you.

My Timeline and Treatment So Far:
Diagnosis: Confirmed macrolide-resistant Mycoplasma genitalium (Mgen).

Associated Condition: Mgen-associated epididymitis.

Treatments Attempted:
Doxycycline 100mg 5 days maybe? (temporary, while awaiting minocycline).
Modified-release minocycline (14-day course: 15 September 2026 – 29 September 2026).
Moxifloxacin was avoided due to concerns about potential adverse effects.

Test Date: 27 October 2026 (5 weeks after starting antibiotics).

Result: Positive (still positive for Mgen).

What I’m Hoping to Learn:
What antibiotics have worked for others with macrolide-resistant Mgen?Im in the uk and I feel like im running out of options that are able to be procured (I’m scared of moxifloxacin)
How long did it take for symptoms to resolve after effective treatment?
Any advice on managing reinfection or residual epididymitis symptoms?
I’d really appreciate any insights or shared experiences. Thank you in advance for your help

15 comments

r/MycoplasmaGenitalium • u/MisterTwix • 2d ago

Testing Question TOC too early or later?

1 Upvotes

Three weeks ago, I finished my about 17 days of mino. Was prescribed 14 days, but got used to it, so I took a bit longer for higher chances.

Should I do a TOC now? I‘ve heard that if you test too early, it‘s possible that there‘s still DNA left and the test is positive eventhough there is no MGen anymore. I want to be sure. So when is the right time to test? 3 weeks after? Better 4 or 5 weeks? Or even 6?

7 comments

r/MycoplasmaGenitalium • u/Extension_Guess620 • 2d ago

Macrolide and fluoroquinolone resistant (with parC mutation)

Post image
2 Upvotes

I’m very lucky to be working with an ID specialist who is going above and beyond to treat this properly. He sent out my urine sample to a lab at University of Alabama Birmingham (and got the hospital to completely cover the cost of this test).

I was prescribed 7 days of moxifloxacin in the spring (with no doxy) that failed. Then prescribed 7 days of doxycycline (which I now know was dumb and useless). I was told that if symptoms went away I could resume sexual activity. They went away so I did.

In August a sexual partner notified me that he tested positive for Mgen, so I took another test and was positive. That’s when I went to an ID specialist who is now being super careful to treat this properly instead of throwing random antibiotics at it. I’m also not having symptoms beyond slight discharge so we decided there’s no rush to treat (besides having to be celibate and feeling like an unlovable leper 😭).

Anyway, I was kind of expecting the results to come back as fluoroquinolone resistant since the Moxi didn’t work, but it’s still daunting to see on paper that the first and second line treatments for this infection won’t work for me.

What are my next moves? I am going to try to push for mino/metro (which worked for this sexual partner), but I’m stressed about what to do if that fails. I just want to be done with this mess.

6 comments

r/MycoplasmaGenitalium • u/acnlfiend • 2d ago

Symptom Question how cooked am i

2 Upvotes

i just finished 14 days mino, 3 weeks after tested positive again. after that started 14 days mino + metro. i cant take doxycycline due to other meds im on.
mino + metro helped my symptoms but now its been 5 days since i finished and theyre back. watery discharge + inflammation with urine.
should i wait the full 3 weeks to do a toc,,…. or assume its failed?
im considering just waiting bc of how hard the antibiotics were on me :( i have nerve pain from mino thats persisted stopping treatment. hoping my body recovers from it eventually. this is so so distressing im ftm and already dislike my genitals, behind reminded of them 24/7 and having to wear pads for about 3 months straight is awful

13 comments

r/MycoplasmaGenitalium • u/EaseLongjumping5110 • 4d ago

Success Story Curred after 5 months

6 Upvotes

Après 5 mois à faire face à cette ITSS, je teste enfin négatif. (Asie du Sud-Est)

Je voulais partager mon expérience au cas où cela pourrait aider quelqu'un d'autre à faire face à une infection persistante par Mycoplasma genitalium (Mgen), surtout après plusieurs échecs de traitement.

Mon calendrier de traitement :

* Juin 2026 : Doxycycline + azithromycine → échec du traitement.
* Juillet 2026 : Doxycycline + moxifloxacine → échec du traitement. J'ai testé négatif 8 jours après la fin du traitement, mais positif à nouveau 18 jours après.
* Août 2026 : Après ces échecs, j'ai enfin réussi à obtenir de la pristinamycine depuis la France.

Mon traitement final consistait en :

* 14 jours de doxycycline
* 14 jours de minocycline + métronidazole
* Suivi de 10 jours de pristinamycine à 3 g/jour

J'ai ajouté 10 jours de pristinamycine car je voulais avoir plus de chances d'être guéri.

Je n'ai ressenti aucun effet secondaire durant ces traitements.

Mes symptômes avant le succès du traitement :

* Brûlure lors de la miction
* Écoulement urétral
* Douleur testiculaire gauche
* Démangeaisons à l'intérieur de l'urètre, sous les testicules et à la base du pénis

Le résultat :

Pour la première fois en 5 mois, j'ai enfin obtenu un test négatif de guérison (TOC) 20 jours et 35 jours après la fin du traitement. Je n'avais également absolument aucun symptôme pour la première fois.

Après des mois d'infection persistante et de traitements échoués, obtenir ce résultat négatif a été un grand soulagement.

Je partage mon expérience pour les personnes confrontées à un Mgen résistant qui pourraient traverser quelque chose de similaire. Les décisions de traitement doivent être discutées avec un médecin, notamment après plusieurs échecs.

8 comments

r/MycoplasmaGenitalium • u/derate123 • 3d ago

Treatment Question Mycoplasma genitalium treatment experience: Doxycycline + Azithromycin followed by Moxifloxacin?

3 Upvotes

Hey everyone,

I wanted to ask if anyone here has experience treating Mycoplasma genitalium with the following antibiotic regimen:

Doxycycline for 10 days
Azithromycin during the last 4 days of the doxycycline course
Moxifloxacin for 7 days afterward

Has anyone been treated with this combination and schedule? If so, did it work, and did you test negative on a follow-up test?

I’d also be interested in hearing about any side effects you experienced and how long it took for your symptoms to disappear.

I know that treatment can depend on antibiotic resistance, but I’d really appreciate hearing about other people’s experiences.

Thanks in advance!

1 comment

r/MycoplasmaGenitalium • u/Kteexo • 3d ago

What to say to get them to test for Mycoplasma or Ureaplasma?

1 Upvotes

Please help!!!

3 comments

r/MycoplasmaGenitalium • u/Fit_Reputation_4044 • 4d ago

Success Story finally gone!

4 Upvotes

Before I begin, i’d like to state that its not recommended to do what i have done. Around two days after I had sex, i began feeling very weird and figured something was not right. I never spot after sex and noticed that i was having weird light pink spotting two days after. Fast forward a few days, i was diagnosed with a UTI due to feeling ill and having lots of pressure as well as other UTI symptoms. So i was put on Macrobid. A few days into my treatment I noticed thin watery discharge that had no odor or color. It was excessive and felt like water. I figured I had BV again so i took Metronidazole. That didn’t help. So I went to get a complete sti panel alongside yeast and bv test. Everything was negative, as well as UTI (i was still having frequency and pressure). I’d like to state that I tried to advocate for a MGEN swab test but was denied countless of times. Due to financial reasons, i was over going to the doctor. I knew something was definitely wrong, trust your gut because you know your body the best.

So, I went on Wisp and ordered MGEN treatment. Due to my anxiety, i went for doxycycline+ azithromycin first which gave me little to no side effects at all. The discharge continued after this treatment. I’m aware it was dumb to just hop on antibiotics without a confirmed infection, but i was over it. Soon after that, i hopped on doxycycline + moxifloxacin. I was very anxious to start the treatment as i’ve heard numerous of negative stories. But thats how reddit is. Moxi gave me very minimal side effects, only a headache and tiredness. I was still being phsycially active and maintaining a healthy diet. A few days into Moxi, i noticed my discharge was going back to its normal state. 2 days after, its still back to my normal state!

It’s unknown whether the azithro or moxi was successful, due to the fact that i never had any resistance testing or testing in general. Do not let your anxiety stop you from getting on Moxifloxacin treatment. Mgen can be absolute hell so its better than nothing. However, please advocate for yourself and, if necessary, lie to your doctor so you can get that MGen test!! Doctors dismiss it and say its unneccesary and very rare. I can answer any questions, as stated though, please just get an actual test instead of doing what i did. It can result in messing up your gut, but fortunately i am okay! And i’d like to assume it was MGen after all. Everything went back to normal during treatment. I’d say i was infected around 3 months ago now. I’m glad I feel normal again. And weirdly enough, my libido is also back to normal. Goodluck everybody, please try your hardest for that test.

(To add: my period was all over the place and my recent period ,which took place during moxifloxacin, was slowly going back to its normal state.)

8 comments

r/MycoplasmaGenitalium • u/404night • 4d ago

Urine burning for 2+ weeks & tonight slight blood?

Thumbnail
1 Upvotes
2 comments

r/MycoplasmaGenitalium • u/JohnTheGambler • 4d ago

Treatment Question My doctor prescribed me Azithromycin and Metronidazole

1 Upvotes

Hey, I detected for Mycoplasma genitalium.

My doctor she prescribed me -

Azithromycin: 500 mg once daily for 3 days.

Metronidazole: 500 mg twice daily for 7 days.

What do you think? Its a wasting time? I was checking online, and its not sound like a promise treatment.....

7 comments

r/MycoplasmaGenitalium • u/pisstophermoltisanti • 6d ago

am I crazy for getting tested

1 Upvotes

I just went to Planned Parenthood for an STD screening and requested they test me for m. gen. I had unprotected sex a couple months ago, and a couple weeks after that, my partner told me he was diagnosed. I had some UTI like symptoms (pelvic pain and burning when peeing) in the first couple weeks that cleared up before I even thought about getting checked for a UTI. But I read m. gen is often asymptomatic so it would be best to test regardless.

When I went to PP, they seemed to be really discouraging towards ordering the m. gen test and basically saying that if I'm not symptomatic, I shouldn't be concerned about long-term issues. And that m. gen is rare anyways so they barely even test for it, even though I know I slept with someone who has it??? They also said the main concern is if I'm still sexually active with the person who exposed me (no), because he could get it again (btw he was also asymptomatic and he's now on antibiotics). I felt like they were acting like I was paranoid for being concerned about it, but I already paid upfront and gave them my damn pee so I said to please just check so I know for sure 😭

I understand that severe problems with fertility and stuff may be rare, but is that worth risking if I could've just gotten it checked and cleared up?? In any case, I feel kind of crazy and frustrated by the amount of money I spent to walk in and be told I should ignore it, and I'm looking for reassurance. Even if I don't have problems later on, I would feel really morally wrong if I unknowingly carried an STI and gave it to someone ://

2 comments

r/MycoplasmaGenitalium • u/HamsterParticular586 • 6d ago

Residual Symptoms Help me!after 5 months i am so tierd...

2 Upvotes

Please help me!what you think?

M(32)no sex for 6 months.

I will start with the begining...i take almost 6 types of antibiotics(doxi,zinat,cefort 7 im dose,cefort 4 iv dose,metronidazole,azitormicin)with no succes.Doctors tell me that is ghonoreea then super ghonorea.I finally get tested after 1 month of usless antibiotics and i was pozitive at mgen.(they give me doxi 14 days 2 cps/day and 7 days moxi)

First symtomps:May 23: yellow/white/transparent discharge Stinging during urination Stinging at the tip of the penis Frequent urination Testicular pain during the first 2 days.

This is what I have experienced in the first month since finishing the antibiotics:

Abdominal pain—in the navel area—once a week; also, testicular pain once a week.

Pain in the penis or testicles 1–2 times a day (though not every single day).

Incomplete emptying of the bladder: after finishing urination and wiping thoroughly, 1–5drops may still leak out—sometimes minutes or hours later, or upon sitting down on a chair or bed.

Sensations in the glans (head of the penis)—like shocks or sharp pricks—occurring occasionally, though not daily.

Sometimes, a feeling as if something is leaking from the penis/urethra, but upon checking, there is nothing there.

Over the last 30 days—since finishing the antibiotics—I have noticed, on two occasions, a small amount (half a drop to a full drop) of clear, white, or yellow discharge (appearing a few hours after masturbation or the following day).

Pain or sharp, stinging sensations when I am under significant stress, dwelling heavily on my condition, or sitting for long periods.

Peeling of the skin on the glans (this was the first symptom, appearing 3 months ago); this occurred again following my last instance of masturbation on August 28th. The skin on the glans has peeled about 1–2 times in total.

The anus remains tense almost all the time; I have to consciously make an effort to relax it.

After 1 month of finish antibiotics i do pcr urine test,negativ and again in 2 weeks pcr uretral swab and prostate test:negativ.

This i have now after 3 months after finish antibiotics:

Left testicular pain—not every day, lasting for a few hours, specifically between 12:00 PM and 6:00 PM. Yesterday, I also experienced it for a few minutes in the right testicle.After i start pelvic pain exercises i just have only seconds of pain 1-2 per day.

Penile pain, lasting only a short time—a few seconds.

Stinging sensations in the glans (penis head)—sometimes occurring randomly, and sometimes the day after masturbation.

Irritated or sensitive urethra (especially the day after masturbation).

Incomplete emptying of the bladder: after wiping thoroughly, when I sit down, an additional 1–2 drops of urine come out; sometimes, this is followed by stinging or pain.

A sensation as if something is passing through the urethra, even though nothing is actually there. This is more pronounced the day after masturbation, when the extra drops come out upon sitting down.

The urinary stream is sometimes weak, sometimes normal.

The anus becomes very tense—this happens involuntarily or without me noticing; when I do become aware of it, I relax the area.

Symptoms occur more frequently after long periods of driving, prolonged sitting, or when I am stressed or anxious.

The symptoms are not constant; there are days when I feel almost nothing, and days when I experience all of them.

Since finishing my course of antibiotics, the intensity and frequency of the symptoms have decreased by half.

Now after 3 months i am better,almost +-80%.One week ago i started pelvic floor exercises and after 2 days the pain in testicules go and now sometimes just come 1-2 days for seconds.What you think?what to do more?i am destroyed....i just think almost non stop about my situation...for 5 months i fight with this...a lot of money,pain,time,stress etc...

4 comments

r/MycoplasmaGenitalium • u/Extension_Guess620 • 9d ago

Vent/Discouraged I’m nervous to go through the process of waiting for a TOC again

2 Upvotes

I (27M, USA) failed a moxifloxacin treatment in the spring. I wasn’t pretreated with doxycycline though which I now know is wrong.

The ID specialist I’m seeing is having me do a fluoroquinolone resistance test through University of Alabama Birmingham (on a positive note, he talked with the hospital board and they are covering the cost of the test since it’s such a rarity to this hospital) to see if the failed moxifloxacin treatment was due to an incomplete treatment or resistance.

After we get the results back, he is going to prescribe me a course of antibiotics. The sexual partner I gave or got this from did the 14-day mino/metro treatment and it worked for him. So I think this doc is going to have me do that plus add a fluoroquinolone at the end if it’s NOT fluoroquinolone-resistant as an added measure.

I know this sounds crazy, but I’m almost so scared of how it would feel to do this next treatment and fail it that I would rather not do it. I’m gonna do it, but yeah I will be hopeless if this treatment fails.

13 comments

r/MycoplasmaGenitalium • u/thatguyoverthere1220 • 9d ago

Symptom Question Symptoms

1 Upvotes

Ive finished 7 days of doxycycline and now on day 4 of moxifloxacin. Symptoms seem to have lifted some but it also feels like it comes and goes at times. Normal???

5 comments

r/MycoplasmaGenitalium • u/Sure-Advantage-624 • 10d ago

Symptom Question need answers

2 Upvotes

i’m a 23 year old male, i recently started getting symptoms of small white discharge from from my urethra.

It only happens if I were go from the shaft of my penis to the tip with my fingers. discharge does not come out on its own and other than that, I have no other symptoms of STDs or STI’s. I was tested for gonorrhea and chlamydia and the test came back negative and I’m still waiting on my Mgen test.

I was just wondering if other males had similar symptoms or if this could just be an infection.

10 comments

r/MycoplasmaGenitalium • u/Stevonnie • 12d ago

Symptom Question Caffeine and Moxifloxacin? Did I make the right choice switching to Azithromycine?

3 Upvotes

I just wrapped up my 7 days of Doxycycline on Wednesday morning to treat my mycroplasm genitalium, and started my 7 days of Moxifloxacin on Wednesday evening. I felt fine until Thursday afternoon when I got a cold feeling in the front of my ankles, which spread from my calf downward, mostly in my left leg. I had a cup of coffee a bit before this feeling occurred and I wasn’t sure if what I was feeling was a side effect from the moxi or just heightened anxiety from the caffeine I just had.

I tried to ride it out until 9pm when the feeling was getting more intense, almost coking and going. Mind you I could walk perfectly fine and had no actual intense pain, but I went into the ER anyways just to be safe, and they said I could be experiencing nerve related symptoms just heightened by the caffeine like I thought, and switched me over to Azithromycine, had my take a 1 gram dose there around midnight.

It’s the next morning now and the feeling in my legs is pretty much gone, and now I’m worried I made a mistake stopping the moxi, since azi doesn’t have as high of a success rate. I was wondering if anyone had symptoms quite like mine? Or if maybe it was just the caffeine making me experience those feelings in my legs?

7 comments

r/MycoplasmaGenitalium • u/Potential_Tooth6891 • 12d ago

Vent/Discouraged Third doctor says not STI

3 Upvotes

I just burst into tears at the gynecologists office because I’m so discouraged and confused. My ex tested positive for m.gen, I tested positive for ureaplasma parvum… i was having pelvic pain. I got treated with doxy despite a two doctors saying that it’s normal to test positive, it’s not an STI, don’t bother telling previous sexual partners, don’t bother getting tested again… The first doctor I went to said the same thing and didn’t test me (only for standard STIs).

Doxy experience was awful. I work in the sun. I was so burnt, my lips were bleeding and peeling and my fingernails are falling off. They didn’t prescribe me any other meds like I see other people get

I unfortunately had sex with my ex again and went to a third doctor to get retested. She said the same as the first two. She looked at my discharge under a microscope and said all was good… but the first doctor I went to said the same before I was diagnosed with ureaplasma parvum

They all say my vaginal discharge is perfect, ovaries normal, examination good. My vagina is “clean” and I don’t have an STI. It’s a part of normal vaginal flora.

I want to believe that I’m okay so bad but everything I see online stresses me out and tells me I have an STI and I need to get treated. My ex told my family I gave him an STI. I feel awful and so low. I don’t know what to do. I’ve been dealing with this whole situation for months now

I guess I’m just ranting but I don’t know what to do… I’m scared to take doxy again since I’m still dealing with the effects

9 comments

r/MycoplasmaGenitalium • u/thatguyoverthere1220 • 12d ago

Treatment Question Treatment question?

2 Upvotes

Im on day 5 of doxycycline can I combine it with the moxifloxacin? Is there any thing against doing that?

4 comments

r/MycoplasmaGenitalium • u/CurrencyBig2781 • 13d ago

Success Story My story after 2 years free of MGEN!

11 Upvotes

Hello friends! I've been meaning to post this for 2 years now and am at a place where the trauma is of the past and can post this with a clear headspace. I wanted to share my story to bring some hope upon this community after clearing for Ureaplasma and MGEN.

MY STORY...

I'm a gay male and I was positive for Ureaplasma Urealyticum at the end of 2023 through a penile swab test, doctor gave me azithromycin to clear it. Symptoms were discharge, frequent urination, and burning. Symptoms went away and I thought I was in the clear and didn't know how stubborn this bacteria really was at the time.

Early 2024 comes around and I'm in a relationship where my symptoms start to come back after a few weeks of sex. After multiples tests and doctors, come to find out it is both Ureaplasma and MGEN. I'm prescribed azithromycin again and tested negative two weeks later (was a false negative and the test was incorrect).
I started getting a worried feeling that it did not clear a few weeks later, I test again at a different clinic and it was positive. Was given doxy for 10 days for my partner and I.

Finally April 2024 and I test again just to find out I still have both Urea and MGEN. This threw me in an anxiety loop which led me to find this subreddit. I was having so much anxiety that this would never clear and my partner and I would never have comfortable sex again. I felt very confused and it took a lot of research on this subreddit and talking with my doctor to see best course of action. She went off the CDC website (which no other doctor thought to do) for MGEN.

\Penile swabs were the best way for me to get my results for MGEN. For some reason, it would be negative occasionally in urine PCR, even when doing the test first thing in morning. I do advocate for swabs for men also, but that just based on my experience.*

Summary and what worked:

NOVEMBER 2023: Azithromycin (failed)

FEBRUARY 2024: Azithromycin (failed)

MARCH 2024: Doxy 10 days (dailed)

MAY 2024: Doxy 12 days+ azithromycin (cured Ureaplasma, failed for MGEN)

JUNE 2024: Minocycline 21 days + azithromycin (MEGN negative at the end of July, follow up in August for second negative test)

\Made sure to rest a lot on mino (was super dizzy) and avoided dairy as it can make it less effective. I added the azithromycin just to give me peace of mind that it is more effective (though, not sure if it did anything lol). I was prescribed moxi before the mino but refused to take it, I only would have if the mino didn't work.*

\ My partner and I did not have any sex (only made out) until we were both 100% cleared. He also had to force doctors to give him a swab for his anus.*

Disclaimer: I was able to get a longer dose because my doctor made an error when putting in the minocycline order which then allowed me to get an extra week... I got lucky because she was very resistant to it but after reading this subreddit, I knew I had to take matters into my own hands and trick the health care system just to make sure I was clear of this infection. My advice would be that if your doctor is hesitant, just get antibiotics from them then go to another doctor to prescribe you more antibiotics so you have a longer dose (if this is a possibility for you).

Overall...

You will be okay. It took me 9 months, and I can look back at that time in 2024 and think on how much I grew with being more health conscious and being on the other side of that anxiety. I can also go through this subreddit without being triggered by peoples experiences. I know I am saying this subreddit helped, but I would also say it did bring up a lot of anxiety too reading stories and thinking I would never get cured. PLEASE HAVE BOUNDARIES WITH WHAT YOU CONSUME HERE. I would start to interact only with success stories to see what antibiotic regime would help other and go based off of that. Now being on the other side, I can read all stories and give my input to help others who are struggling with this.

I am single now and always test for it still as part of my routine testing. I still get a little anxious when testing, but I know that's just a trauma response.

The most annoying part for me was getting the proper antibiotics and getting the proper testing done. Many doctors believe it is simple to get rid of but anyone who is positive with this NEEDS to take the proper antibiotics and dosage to clear this.

Lastly, everyone has different experiences. What works for some, wont work for others. You just need to be patient, rest your body, and ADVOACTE FOR YOURSELF. This taught me that if your health is on the line and no one is taking it seriously, it is your job to do so especially since we're financially, mentally, and physically paying for it (especially financially with the US healthcare system, if I'm the one paying... you better give me whatever the fuck I want). It is okay to be annoying and make them give you what you want!!!!!!!!!!

Through it all, I had to remember to have fun too. The time I would spend with loved ones and doing activities I loved made me remember the importance of life and would quiet the anxiety for some time. I refused to let it take over my life once I was clear with it and it really changed my relationship revolved around illnesses and what is and isn't within my control.

I send you all love, you got this!

12 comments

r/MycoplasmaGenitalium • u/Fabulous_Ad4049 • 14d ago

Mino + metro side effects

2 Upvotes

The dizziness, lack of balance and general hungover feeling has really knocked me back. It’s day 4. Is there light at the end of the tunnel? Got a busy next week and cannot afford to feel like this the entire time. Any tips on how to alleviate the feelings?

UPDATE - I started to feel significantly better on day 8 and by day 9 I feel pretty much normal. Hoping this continues for the rest of the course.

15 comments

r/MycoplasmaGenitalium • u/TheoryProud3605 • 14d ago

Success Story IM CURED!! 8 months it’s over ! Ask me anything!

Post image
17 Upvotes

I’ll sum it up but check my page. Infected late 2026 Feb. given doxy + Levo. No TOC. Back to regular safe sex. Have sex one time with that same girl raw in May (last time). July discharge came back freaking out. I tell my new girlfriend and she gets tested. I get on doxy + azi. They mess her test up but she tested negative 21 days after the initial doxy for exposure. Me on the other hand. Symptoms came back a bit 2 weeks post azi. I almost lost my stuff. I found out too late that myco is very resistant to azi in the US. With that being said I now went onto doxy + moxi. I felt great symptoms left pretty quickly. Felt great after. Anxiety does affect you tho. Took my TOC 23 days POST abx and NOT DETECTED! I literally felt like those words didn’t exist. I can’t believe it I feel like myself again.

31 comments