[Question #4248] Ureaplasma

31 months ago

I was recently diagnosed with Ureaplasma. Here is my history:

I was sexually abstinent from July 2010 until March 2016. In March 2016, I met my current partner, who is married. Our relationship is monogamous in the regards that I do not and have not had sex with anyone else and he has sex with his wife and me (without her knowledge).

I was screened for all STI’s prior to starting the relationship and everything was negative including Ureaplasma. I have my results in-hand so I know that I was screened for Ureaplasma. I continued annual screenings – April 2017, no Ureaplasma. Again, May 2018, no Ureaplasma. I recently suffered a terrible vaginal infection and went to my doctor. She told me in the office that it looked like I had an STI and she treated me in the office. When my results came back, I only tested positive for Ureaplasma. She told me that it is not considered an STI; however, it is passed sexually and very contagious. And, since my previous tests were negative, I was recently infected and that all parties involved should be treated if we wanted to permanently get rid of it.

My partner and I are very upset. I have not been with anyone else and neither has he besides his wife. My partner believes the following: the ureaplasma was dormant or inactive and something changed with my natural vaginal flora that allowed it to get out of balance. This caused the infection and positive test. However, my doctor tells me this isn’t possible. She says based upon all of the negative tests that we were all newly infected by someone else. She says my negative tests prove that we did not have this from March 2016 through May 2018. She says even if someone is asymptomatic but carries the bacteria, the test will always be positive.

Can you help us? Based upon my history, is my doctor correct? Is the only possible explanation for this positive result is that we were infected by someone other than the three of us after May 2018?

Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome to the Forum and thanks for your detailed description of your situation.  I'll try to help.  The topic of ureaplasma is a complex, frequently misunderstood one and I must say, I was relieved to her that your doctor told you that this is not an STI in the classical sense- she is correct. 

Ureaplasma is a widespread bacteria which is part of the normal colonizing bacteria present in many persons genital tracts.  Sexually active persons do share their bacteria and if your partner was colonized with ureaplasma it would be quite likely that you would become colonized with it as well.  While shared within couples, ureaplasma is not associated with symptoms or complications.  (other bacteria are also shared in this way, through sex, trough kissing, etc.)

Your doctor is also correct that once colonized with ureaplasma, people tend to stay colonized and that while treatment may suppress the organism, most of the time it will return after treatment. 

Given your well documented prior negative tests for ureaplasma, it is more likely than not that your partner is colonized with ureaplasma and that you have become colonized as well.  It is not clear that your recent symptoms were due to your ureaplasma- there are many other non-STI causes of vaginal discharge, the most common being called bacterial vaginosis which is a disruption of the normal bacterial balance in the vagina.  This may be what happened and may have been unrelated to the presence of your ureaplasma.

I hope this information is helpful.  This is a complex topic.  If there are further questions, please feel free to use your up to two follow-up questions for clarification.  EWH
---
31 months ago
Dr. Hook, 
Thank you very much for answering both of my questions. It isn't my partner's fidelity that concerns me as much as it is his wife's. I trust that he isn't with anyone else. But, we also need to feel safe in terms of the total relationship.

As a follow up to the Ureaplasma, my doctor told me that it was highly contagious and that my negative test results from March 2016 to May 2018 meant and proved that no one was colonized with it during this time. She says that my positive result in August 2018 meant that one of use contracted it after May 2018 and passed it to the others. Do you agree with this assessment based upon what you know about contracting it? 

Was it possible for my partner to have it for 2.5 years before passing it to me or is her assessment more accurate?

Thank you very much.
31 months ago
My apologies... as a follow-up. When I tested positive for the Ureaplasma, I tested negative for all other STI's and I tested negative for Bacteriol vaginosis and negative for a yeast infection.
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
To use a phrase I used before, in these situations, we can never say never but I would say that it is considerably more likely than not that the ureaplasma was acquired in between your prior test and the test in May 2018.  So yes, I do agree with your doctor although this statement cannot be made definitively.  It would be most unlikely for your partner to have the ureaplasma for 2.5 years and for you to be repeatedly tested negative.  EWH
---