References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Ureaplasma is a type of bacteria that naturally lives in the urogenital tract of many people without causing problems. It only becomes an issue when it overgrows or causes inflammation, leading to symptoms like discharge, pain when urinating, or pelvic discomfort. Whether ureaplasma should always be treated is a matter of ongoing clinical debate.
If you’ve tested positive for ureaplasma or have been told you might have it, this guide explains what it is, when it needs treatment, and how it’s managed.
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What Is Ureaplasma?
Ureaplasma urealyticum and Ureaplasma parvum are small bacteria that live in the urogenital tract. They’re found in up to 40-80% of sexually active adults, often without causing any symptoms or problems. They’re part of the normal genital flora for many people.
Ureaplasma becomes clinically relevant when it:
- Overgrows and causes symptoms (urethritis, cervicitis)
- Is found alongside unexplained inflammation
- Is identified as the cause of non-gonococcal urethritis (NGU) after chlamydia and gonorrhoea have been ruled out
- Is found in the context of fertility problems or pregnancy complications
Is Ureaplasma an STI?
This is debated. Ureaplasma can be transmitted through sexual contact, but it’s also found in people who have never been sexually active. BASHH does not classify it as a straightforward STI in the same way as chlamydia or gonorrhoea. It’s better described as a potential pathogen that can be sexually transmitted but isn’t always sexually acquired.
Symptoms
Most people carrying ureaplasma have no symptoms. When it does cause problems:
In men
- Watery or clear discharge from the penis
- Burning or stinging when urinating
- Urethral irritation or itching
- Less commonly: testicular pain (epididymitis)
In women
- Unusual vaginal discharge
- Pain during sex
- Burning when urinating
- Lower abdominal or pelvic pain
- In pregnancy: linked to premature birth, low birth weight, and chorioamnionitis (infection of the membranes around the baby)
Testing for Ureaplasma
Ureaplasma is detected using a PCR (polymerase chain reaction) test on a urine sample or genital swab. It is NOT included in standard STI screens. You typically need to request it specifically.
Testing is usually recommended when:
- You have persistent urethritis or cervicitis symptoms
- Standard chlamydia and gonorrhoea tests are negative
- You’ve been treated for chlamydia but symptoms persist
- You’re being investigated for fertility problems
- You have recurrent miscarriage or premature birth (your obstetrician may test)
Important: a positive test alone doesn’t necessarily mean you need treatment, because ureaplasma is so commonly carried without problems. Treatment is only recommended when the bacteria is causing symptoms or complications.
Treatment
When treatment is indicated, the options are:
- Doxycycline: 100mg twice daily for 7 days (first-line)
- Azithromycin: Extended course if doxycycline fails or is contraindicated
- Moxifloxacin: Reserved for resistant cases
Antibiotic resistance in ureaplasma is increasing, particularly to macrolides (azithromycin). Resistance testing may be recommended if first-line treatment fails.
Sexual partners should be treated simultaneously if ureaplasma is being treated as a sexually acquired infection, to prevent reinfection.
Should Asymptomatic Ureaplasma Be Treated?
This is the key question. Current BASHH guidance does NOT recommend routine screening for or treatment of asymptomatic ureaplasma. Because it’s carried by so many people without problems, treating everyone who tests positive would mean giving antibiotics to millions of people who don’t need them.
Treatment is recommended when:
- Ureaplasma is the likely cause of symptoms (after ruling out other infections)
- There are pregnancy complications potentially linked to ureaplasma
- A fertility specialist recommends treatment as part of investigation
Read more: Ureaplasma test | What is NGU? | Mycoplasma genitalium
Frequently Asked Questions
Can ureaplasma go away on its own?
Some ureaplasma infections may clear spontaneously, but this is unpredictable. If you have symptoms, treatment with antibiotics is recommended rather than waiting.
Can ureaplasma cause infertility?
There is some evidence linking ureaplasma to reduced sperm quality in men and tubal factor infertility in women, but the evidence is not definitive. Many people with ureaplasma have no fertility problems. If you’re struggling to conceive, your fertility specialist may include ureaplasma testing as part of a broader investigation.
Is ureaplasma the same as Mycoplasma genitalium?
No. They’re different organisms, though both belong to the Mycoplasmataceae family. Mycoplasma genitalium is more clearly pathogenic and is associated with higher complication rates. They require different diagnostic tests.
Should my partner be treated for ureaplasma?
If you’re being treated for symptomatic ureaplasma, your sexual partner should also be tested and treated to prevent reinfection. If your ureaplasma is asymptomatic and incidentally detected, partner treatment is not routinely recommended.
Related reading
- Abnormal Genital Discharge and Chlamydia
- Can Mycoplasma Genitalium Be Cured?
- Can You Get Chlamydia From Kissing?
- Can You Have Chlamydia and Test Negative?
- Chlamydia and Gay Men: What to Know
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
