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 tiny bacterium that can colonise the genital and urinary tract — and sometimes the rectum. While many people carry ureaplasma without symptoms, it can occasionally cause urethritis or other inflammation. Rectal testing for ureaplasma isn’t routine and is usually reserved for specific clinical situations such as persistent symptoms or research.
Here’s what to know.
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What Is Ureaplasma?
- A small bacterium without a true cell wall
- Two main species — Ureaplasma urealyticum and Ureaplasma parvum
- Commonly found in the genital tract of healthy adults
- Can occasionally cause urethritis, cervicitis or other inflammation
- Role as a true STI is debated
When Rectal Testing Is Used
| Situation | Why |
|---|---|
| Persistent rectal symptoms after STI testing | Looking for less common causes |
| Research studies | Investigating ureaplasma’s role |
| Specialist clinical assessment | Ruling out unusual infections |
How the Test Works
Rectal ureaplasma testing uses NAAT (nucleic acid amplification testing) on a rectal swab. The sample is sent to a lab for processing. Results take a few days.
Is Ureaplasma an STI?
Ureaplasma’s status as an STI is debated. Many people carry it without symptoms, and treating asymptomatic ureaplasma isn’t usually recommended. When it causes symptoms (urethritis, cervicitis), treatment is appropriate.
Treatment
- Doxycycline 100mg twice daily for 7 days is often used
- Azithromycin in some cases
- Treatment usually only when symptoms are present
- Test of cure not routinely needed
Why Routine Testing Isn’t Recommended
- Ureaplasma is common in healthy people without symptoms
- Treating asymptomatic carriage isn’t beneficial
- Routine antibiotic use contributes to resistance
- Testing leads to over-treatment
When to Consider Testing
- Persistent urethral or rectal symptoms after standard STI testing is negative
- Recurring symptoms despite previous treatment
- Specialist evaluation in unusual situations
Where to Get Tested
- Specialist sexual health clinics
- Some research-oriented services
- Not usually offered as part of standard STI screening
Read more: Mycoplasma genitalium | Multi-site STI testing | What is chlamydia?
Frequently Asked Questions
Should I ask for a ureaplasma test?
Usually not as part of routine screening. It’s reserved for specific situations.
Does ureaplasma always need treatment?
Only when it’s causing symptoms. Asymptomatic carriage is common and doesn’t usually need treatment.
Can ureaplasma cause infertility?
Evidence is unclear. It may play a role in some cases but is not a confirmed major cause.
Related reading
- Can You Have Chlamydia and Test Negative?
- Comprehensive Test: Chlamydia, Gonorrhoea and Herpes
- Chlamydia and Gonorrhoea Lab Test
- Chlamydia Rapid Test Kits: What to Know
- Home Chlamydia and Gonorrhoea Tests: How They Work
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.
