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.
Combined testing for mycoplasma and ureaplasma checks for two related groups of bacteria that can occasionally cause urethritis and other genital tract symptoms. Mycoplasma genitalium is increasingly recognised as a significant cause of non-gonococcal urethritis, while ureaplasma’s role is more debated. Combined testing makes sense for people with persistent symptoms after standard STI screening.
Here’s what to know.
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What’s Being Tested
| Organism | Significance |
|---|---|
| Mycoplasma genitalium (Mgen) | Known cause of urethritis, cervicitis, PID; treatable |
| Ureaplasma urealyticum | Sometimes linked to symptoms; often asymptomatic |
| Ureaplasma parvum | Often part of normal flora |
| Mycoplasma hominis | Sometimes associated with bacterial vaginosis |
How the Test Works
- NAAT (PCR) on urine, vaginal, throat or rectal samples
- Results identify each organism separately
- Some tests also check for macrolide resistance in Mgen
- Lab processing takes a few days
When This Test Is Used
- Persistent urethritis after standard STI testing
- Recurring symptoms despite treatment
- Suspected mycoplasma genitalium
- Specialist clinical evaluation
Mycoplasma Genitalium
Mgen is the most clinically significant of these organisms. It can cause:
- Non-gonococcal urethritis in men
- Cervicitis in women
- Pelvic inflammatory disease
- Often silent infection
Treatment
- Mgen with no resistance — doxycycline 7 days then azithromycin
- Mgen with resistance — doxycycline then moxifloxacin
- Ureaplasma — doxycycline if symptoms warrant treatment
- Test of cure recommended for Mgen
Resistance Concerns
Mycoplasma genitalium has developed widespread resistance to azithromycin globally. This is why testing now often includes resistance profiling, and why treatment guidelines have changed.
Where to Test
- NHS sexual health clinics (some offer Mgen testing)
- Specialist clinics
- Some home test kits include Mgen
- Not always part of routine screening
Should Asymptomatic People Test?
Routine testing for asymptomatic mycoplasma and ureaplasma isn’t recommended. Testing is reserved for symptoms or specific clinical situations.
Read more: Mycoplasma genitalium | Curing Mgen | Ureaplasma test
Frequently Asked Questions
Should I be routinely tested for mycoplasma and ureaplasma?
Not routinely. Testing is for symptoms or specific clinical reasons.
Are these infections serious?
Mgen can cause pelvic inflammatory disease and infertility if untreated. Ureaplasma is less clearly harmful.
Can I get tested at home?
Some home kits include Mgen. Check before ordering.
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.
