[Question #8395] Risk of Mycoplasma Genitalium (MG) Question

45 months ago

Thank you for taking my question. I am a 42 year old male who had an unprotected sexual encounter on a business trip. After too much to drink I ended up having unprotected vaginal sex with a female I met at the hotel. After 3 weeks I started having some discomfort in my penis. I have an uncomfortable feeling that seems to be more pronounced at certain times than others. Sometimes I feel it more in the head of my penis and sometimes its more in the center, kind of a sensation in the urethra. It ranges from a dull pain to a little more sharp towards the head of my penis. I don't have any burning during urination and I don't seem to have any discharge or noticeable sores but the feeling is usually more pronounced right before or after urination or sex. I have noticed I have been urinating more frequently.

For piece of mind I ordered a basic test panel which included 5 tests, HIV 1 & 2 (4th generation), Chlamydia, Gonorrhea, Syphilis. I added trich just to cover my bases. All tests came back negative. The one thing I didn't test for and frankly didn't even know this existed was mycoplasma genitalium (MG).

My questions:

1) Do my symptoms indicate any concern over mycoplasma genitalium? Its seems this is some newer STI and what confused me is this doesn't seem to be offered in any STD panel. Should I test for this and how would I do so if it doesn't seem to be offered by any of the places to get a STI test panel?

2) I feel confident in the test results I received but wanted to make sure 3 weeks was sufficient time to test for all the above STIs. I have resumed unprotected sex with my partner based on the results.

From reading the other questions its seems that a one time unprotected occurrence is low risk and absence of any discharge seems to also indicate this could be more anxiety or my body adjusting to foreign bacteria being introduced into my system. I did notice some blood on my sheets the next morning from the female so should must have either been just start

Edward W. Hook M.D.

45 months ago

Welcome to our forum and thanks for your question. I’ll be glad to comment. You have been tested thoroughly and should believe the results of the test you have. Testing at three weeks following your encounter would certainly provide accurate results.

Mycoplasma genitalium is a relatively recently described STI and there remains much to be learned about this infection. When persons develop symptoms due to mycoplasma genitalium the symptoms are typically either a urethral discharge or pain on urination. Neither discomfort at the head of your penis or in the middle of the shaft of the penis or symptoms which suggest mycoplasma genitalium infection. The symptoms you describe, do not suggest mycoplasma genitalium. Thus, in response to your specific questions:

1. No, the symptoms you describe are not suggestive of mycoplasma genitalia and I see no reason for testing.

2. Your three week results are entirely reliable and should be believed. There is no reason for additional testing.

I hope this information is helpful. My advice is to put your concerns behind you and move forward without continuing concern. EWH

---

45 months ago

Thanks Dr. Hook. I will take your advice and move ahead knowing that my testing was sufficient.

Is there anything else that could explain the discomfort I am feeling? If you don't think the symptoms match with MG does it seem this is probably some kind of general urethritis or non harmful bacteria that my body is adjusting to? I also bought an over the counter UTI test that checked for leukocytes and nitrites and that test also came back normal.

In my initial question it cut off at the end, it was supposed to say I noticed some blood on my sheets the next morning from the female so should must have either been just starting or ending her period so I didn't know if that added any kind of additional risk.

Thanks again for the help.

Edward W. Hook M.D.

45 months ago

I hardly endorse your plans to put your concerns aside and move forward without further hesitation.

Thanks as well for your description of your symptoms. I am quite comfortable with assuring you that the symptoms you describe in no way suggest an STI. On the other hand, the encounter you described was sounds rather vigorous. Remembering that the penis is a highly vascular organ which can be subject to trauma and even internal bruising, I would guess that this is the origin of your symptoms. When these sorts of things occur, they typically resolve without any problem over a week or two. My advice is to see what happens over the next week or two. As long as the symptoms do not progress or worsen, I would wait at least two weeks before seeking further evaluation. I suspect this will pass.

I hope this perspective is helpful. EWH

---

45 months ago

Thanks for the response. Based on your initial response that I have been tested thoroughly and should believe the results and your follow up response that you are quite comfortable with assuring the symptoms I describe in no way suggest an STI I have no follow up questions. My primary concern was passing something to my partner and your answers indicate I should be confident I have nothing to pass.

I do just want to clarify this line: " I hardly endorse your plans to put your concerns aside and move forward without further hesitation". I am guessing you meant you endorse the plan to move forward based on your responses. Please let me know if I am misreading otherwise you can feel free to close this thread.

Edward W. Hook M.D.

45 months ago

Your interpretation is correct. Believe your tests. It is time to move forward. This will end this thread. Take care. EWH ---

45 months ago

Thanks Dr. Hook. Take care.