Serenity pH Fact Sheet on Ureaplasma & Mycoplasma. Everything you need to know to test and treat a plasma infection..
Mycoplasma and Ureaplasma are the smallest known bacteria known to exist. They have no cell wall which makes them considerably harder to treat than other bacteria because antibiotics usually work by attacking the cell wall. Hence they typically require a dual antibiotic approach to treat them.
Common telltale signs of a Ureaplasma infection include vaginal thrush and BV that won’t respond to any treatment (including Boric Acid), chronic UTIs, a killer itch with no apparent cause, yellow/ green discharge and other chronic vaginal and pelvic issues that persist.
Sometimes Boric Acid or antibiotics will 'hold back' our thrush or BV symptoms while being used. But symptoms will return straight away. Or, the window of treatments working become smaller and smaller until eventually they stop working. These are signs that we might be dealing with Ureaplasma or a co-infection.
Initial symptoms often start after having unprotected sex and subsequently, symptoms tend to flair up after engaging in sexual activity.
Many Drs don't test properly, (or at all) so you need to make sure you're informed and prepared. In fact, most women are told that they have indeed been tested for 'everything' leaving women to suffer unnecessarily for years. This in itself causes many to feel like they have been invalidated, and ignored and unsurprisingly causes great stress and anxiety in sufferers of a plasma infection.
Because the plasmas are so tiny and slow growing they rarely show up in a culture test like other bacteria. They are also unable to be seen under a microscope. Therefore we must do a vaginal swab PCR test or first pass urine (must be PCR not culture) to check for all 4 strains (listed below)..
Urine has to be from your first urine of the day and only the first 10 to 30 mls. VIP - dont test within 1 to 2 months of taking antibiotics or you risk a false negative. The plasmas tend to be undetectable after taking antibiotics and can ‘hide’. We have lately had a few women report false negatives because they tested soon after being on antibiotics! You need to wait at least a month or even 2 for the best chance of it being detected.
The 4 strains are Ureaplasma Urealyticum, Ureaplasma Parvum, Mycoplasma Hominis and Mycoplasma Genitalium. You must test for all four. However, it’s the same (one) test and this test is BULK BILLED in Australia. It is possible to have both Ureaplasma and Mycoplasma at the same time.
For Melbourne girls, please only use Dorovich Pathology and NOT Melbourne Pathology, as they currently REFUSE to test for Ureaplasma, even if your doctor requests it. Feel free to ask me how I know!!!!
Mycoplasma Genitalium is considered an std worldwide. Therefore when symptomatic, it is generally easier to get tested for. But we still sometimes see push back here.
The other three: Ureaplasma Urealyticum, Ureaplasma Parvum and Mycoplasma Hominis are not technically considered STIs, and many consider them commensal. However, we know that's incorrect, especially where there are physical symptoms and pathology that won't resolve despite treatment.
All the rules of not testing or treating asymptomatic / commensal Ureaplasma or Mycoplasma, should go out the window when you are trying to conceive or are pregnant. Plasma infections can be highly problematic and can be responsible for lack of ability to conceive, miscarriages or the passing of Ureaplasma to the baby. Plasma bacteria can pass through the placenta.
Women who are trying to conceive should be screened for Ureaplasma even if it is commensal. It's important to reduce the risk of passing this on during pregnancy. Ureaplasma comes with serious risks during pregnancy and must be treated with urgency.
Partners must also be treated, even if they test negative. Men often test false negatives in urine and need to have their sperm tested.
Most men with Ureaplasma typically present with no symptoms. This contributes to the spreading of Ureaplasma sexually. That being said, some men do experience chronic symptoms, including unusual discharge, pain and urgency when urinating and unexplained pelvic pain.
For Ureaplasma information please visit:
A place to check out our list of doctors who can help. We are trying to grow this directory on a worldwide level:
For support and to ask questions please visit:
Mycoplasma Genitalium is recognised as an STI worldwide. However, ALL the plasmas require that both you and your partner take the appropriate antibiotics to clear them.
For Mycoplasma Genitalium information please visit:
For support and more info please visit:
Please keep in touch with us here at Serenity pH, we are here to help you along the way!
Lastly don’t worry you will get through this. I personally haven't met a woman who didn't recover after treating.
First-line treatment for Ureaplasma (based on current research). There is no official treatment protocol for Ureaplasma atm. Largely due to this being incorrectly labelled as only commensal and despite Ureaplasma being a very high-risk infection to have when pregnant & the ever-growing evidence of the symptoms that it causes
2 weeks doxycycline -100mg twice a day
followed by 1-2.5g Azithromycin 1g taken 12 hours after the last doxycycline and then 0.5g taken daily after until completion. This protocol is considered to give the highest rate of cure but it can be hard on the body for some due to the nature of antibiotics.
Some doctors prefer to prescribe only doxycycline or azithromycin which has a lower rate of cure, but is easier to tolerate with potentially less side effects.
Please note that these antibiotics can have a reduced efficiency when taken with many common medicines and minerals. eg antacids, magnesium, aluminium, calcium, calcium and sodium bicarbonate, acne medicines containing vitamin A and warfarin etc. Consuming dairy should be avoided due to the calcium, which can reduce the effectiveness of the antibiotics. The same thing goes with acidic foods like tomatoes.
Note other antibiotics can be prescribed if you can’t take the first-line duel protocol antibiotics due to availability (in your country), being allergic or with health conditions that prevent consumption or if your strain of plasma is resistant to these. eg Mycoplasma Hominis is usually resistant to Doxycycline but is susceptible to Clindamycin.
Be very cautious about taking Moxifloxacin if your doctor prescribes it, as it can cause diarrhoea and more seriously, tendonitis. Being is a Black Box labelled antibiotic, it should only be used when there is no other antibiotic available to treat your infection. It can cause long term disabilities known as being floxed
There are other antibiotics to try if your plasma strain is resistant to the first line treatment. This can be verified through sensitivity tests.
Partners should not have unprotected sex until a test of cure has been confirmed. This is a test to make sure that your treatment has been successful. It should be performed from 4 to 8 weeks after your last dose of antibiotics to help avoid any false negatives. If possible refrain from having any sex until the test of cure or proceed with caution using protection to avoid passing it back and forth.
Boric Acid Dissovables (suppositories) can help with any vaginal thrush triggered by the long course of antibiotics. Plus they are a treatment for BV as well. They will also help to reduce some of the plasma symptoms eg discharge, but they won’t cure the Ureaplasma. They are wide acting and help balance vaginal pH and destroy biofilm.
Finally, sometimes there is pelvic floor dysfunction after having a plasma infection. Seeing a pelvic floor therapist can be a vital part of recovery. In some cases, pelvic floor dysfunction can be part of a larger issue involving autoimmune and inflammatory issues E.g. chronic pelvic pain syndrome (CPPS) or Pelvic Floor Disorder (PFD).
The plasmas can leave us with residual symptoms even after it’s been cleared. It can take time, even months for everything to go back to normal. Be patient and know that this is considered completely normal. There is light at the end of the tunnel as these symptoms will resolve.
Please keep in mind that if you are experiencing intense burning, itching, tingling and or intense pain deep in your bones and tissues within your vagina, and even radiating down your legs or up your back this can be pain from a pelvic floor disfunction and can be from the prudential nerve being pinched. A Pelvic Floor Therapist can help.
Lastly, it's important to prioritise your mental health as this infection and the ordeal of getting it tested and diagnosed can be tough to cope with. Much of our work at Serenity pH involves helping women and all owners of vaginas with PTSD that may develop. Remember to be kind to yourself. You are on the way to putting this behind you and you are not alone.
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