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Mycoplasma Genitalium: Testing and Treatment
Medically reviewed by Dr Vafa Derakshan, MBBS, FRACGP · AHPRA MED0001663310 · Last reviewed: 23 September 2026
Mycoplasma genitalium (MG) is a bacterial STI that's becoming harder to treat because of antibiotic resistance. It often causes no symptoms, and it's tested differently from other STIs.
Symptoms
MG can cause pain when you pee and discharge from the penis or vagina, similar to chlamydia. It can also cause bleeding after sex and pelvic pain, and can lead to pelvic inflammatory disease (PID).
Who should be tested
Australian guidelines recommend testing people with symptoms, such as ongoing urethral symptoms, cervicitis, pelvic pain or bleeding after sex, and the ongoing partners of someone with MG. Testing people without symptoms isn't recommended, because it can lead to unnecessary antibiotics and more resistance.
How you're tested
A urine sample or swab, with the lab also checking whether your infection is resistant to the usual first-choice antibiotic. Resistance testing makes treatment far more likely to work.
Treatment
Treatment is two stages of antibiotic tablets: 7 days of one antibiotic, then a second antibiotic chosen according to the resistance result. Your doctor can prescribe this by eScript. A test of cure is recommended 2 to 3 weeks after treatment finishes.
Why it's hard to treat
In Australia, more than 60% of MG infections are resistant to the usual first-choice antibiotic (over 80% in men who have sex with men), and resistance to the main second-line antibiotic is approaching 20% in many cities. That's why testing is targeted and treatment is guided by resistance results.
Partners
Ongoing partners should be tested and treated.
When to be seen in person
If you have pelvic pain, fever or pain during sex, tell your doctor, as you may need an examination for PID.
Frequently asked questions
Should I get tested for Mycoplasma genitalium without symptoms?
Usually not. Guidelines recommend testing people with symptoms and the ongoing partners of someone with MG, to avoid unnecessary antibiotics and resistance.
Can MG be treated online?
Yes, in most cases. Treatment is antibiotic tablets, prescribed by eScript and guided by resistance testing.
Why does MG need two antibiotics?
Guidelines use a 7-day course of one antibiotic followed by a second antibiotic chosen from your resistance result. This two-stage approach gives the best chance of cure.
Do I need a test after treatment?
Yes. A test of cure is recommended 2 to 3 weeks after finishing treatment.
Sources: ASHM Australian STI Management Guidelines: Mycoplasma genitalium.
