In mid November I was informed by a recent partner that she has tested positive for BV and MGEN. She told me she was beginning treatment and that I should be tested. I got tested (which came back positive 3 days later) and started being treated with doxy for 7 days followed by moxi for 7 days. I Never had any symptoms. I was told 2 weeks after finishing treatment I can have sex again. After the full 4 weeks the same partner tells me she is also cleared by her doc. Neither of us retested. We had sex again unprotected (foolish, I know). I later asked her what treatment that she was given and she said she took doxy and tinidazole. I can't see anything online about tinidazole being an effective treatment for MGEN, I'm aware many doctors are not familiar with MGEN. My fear is that she was never cured, I was exposed again, and that I could infect someone else in the future.

Questions:

1. is doxy and tinidazole an effective treatment for MGEN? or only for her BV?

2. Assuming I was cured and that I was exposed again, How long should I wait to be tested again with confidence? I see recommendations ranging from 5 days - 21 days post exposure to MGEN.

3. How would you recommend I proceed in this situation? I would really just like to put this all behind me.

Thank you for your help, I appreciate it.

This is a tough situation.  Presuming you remain asymptomatic, I would be tempted to suggest that you just move forward without re-testing.  Admittedly, some of my colleagues would suggest re-testing and if positive, re-treatment although there is a risk that in doing so you would be going down a "rabbit hole".  

I realize that I haven't given you a definitive yes or no and am sorry that I cannot.  Current data are insufficient to provide you with a science-based response.  Part of the way forward should reflect your level of concern/anxiety.  

EWH

P.S. just a reminder- you do not know who gave the M genitalium to the other or whether each of you just happened to have it.  EWH

1. I'm afraid I do have a decent amount of anxiety about the situation. If I decide to test at say 6 days post exposure would you be confident in saying that test is definitive? Or would you say waiting 10-14 days or even longer is necessary to give me a definitive result. Is there an agreed upon timeline that you are aware of?

2. What would you or your colleagues recommend as far as treatment in the event that I do test positive again? I understand if this gets into the "rabbit hole" that you eluded to.

3. I understand you are leaning more toward the side of not testing and just moving on with my life (the recent exposure was sex 3 times but on a single night, if that makes any difference). Can you expand on that and what your thought process is behind it?

Again, thank you for your quick response and your answers to my questions. I do not know who I can trust as far as getting accurate information about this disease besides you. I also understand that the science is not clear with this disease and that hinders your ability to give black and white answers. Thank you for your time and I apologize if my questions seem repetitive.

2.  Welcome to the rabbit hole.  Would probably re-treat with the same regimen

3.  The data on M. genitalium do not prove that it is a pathogen as opposed to a bacterium normally present in the urinary tract in a manner analogous to Ureaplasma which clearly ins not a pathogen.  The are no strong data showing that M. genitalium causes serious complications in infected persons.  

 As I said before, this is a tough area to sort out.  You have one follow-up remaining.  EWH