[Question #9095] MGen and the Plasmas

36 months ago

Hey guys, thank you for taking the time to respond to my question.

Recently during a bout of health anxiety brought on by my wife experiencing post coital bleeding, I learned about MGen and the Plasmas and that I had never been tested for them ever, and neither had she.

In Australia you can request to be tested for Mgen but the other 3 plasmas are not considered STIs and dont have Pathology codes. You need to order American testing.

In Aus we are lucky, all of our pathologies use PCR/TMA testing for Mgen and my prefered lab uses Roche Cobas machines which i have been told are one of the most reliable machines for detecting Mgen

My questions from here:

1. My partner got a speculum assisted cervical swab for Mgen and came back Negative, is cervical swab accurate enough to be taken at face value?

2. I got urine tested, it wasnt my first urine of the day but there had been a few hours gap and i came back Negative, can i trust this?

3. Is it worth chasing testing for the other 3 plasmas if there is no signs of UTI, BV or other symptoms? I see the community is a bit divided and places like Reddit are currently telling every woman to be tested for Ureaplasma.

Thanks in Advance!

H. Hunter Handsfield, MD

36 months ago

Welcome back to the forum. I'm happy to address these issues. However, I need to point out that you are over-concerned. There was no reason for you or your wife to be tested for Mycoplasma genitalium, and for sure not for the other bacterial you have mentioned. Let's start with some basic facts.

There are four bacteria of potential interest here: Mycoplasma genitalium, M. hominis, Ureaplasma urealyticum, and U. parvum. Of these four, ONLY M. genitalium is known to cause symptoms or disease. All are sexually transmitted -- that is, they are routinely shared by sex partner; if one has it, the other is exposed and probably infected. But that alone doesn't make them dangerous or important. There are literally hundreds and maybe thousands of other bacteria exactly the same. (The medical terminology is "microbiome" -- the collection of bacteria that naturally inhabit all of us. Of course the genital microbiome of sexually connected couples is largely shared. No surprise, right?)

The reason that only M. genitalium, and not the other three, are available for testing in Australia but are in the US is that the Australian STI and public health authorities are better and smarter; or at least better able to affect common sense policies. PLEASE do not seek testing for M. hominis, U. urealyticum, or U. parvum from a US lab or anywhere else. They cause no disease and should not be included in STI test panels -- which happily is the policy in Australia but not my own misguided country.

Going back to M. genitalium, nearly universal advice is to NOT test healthy people without symptoms, no matter their sexual history. The policy both in your country and the US Centers for Disease Control and Prevention (CDC) is that M gen testing should be reserved for people with symptoms that do not respond to standard treatment for other STIs -- and not to test people without symptoms. It sounds like your doctor or clinic acceded to your request, but I have to say I do not know why they did so. I would have expected their advice to not be tested in absence of symptoms.

Now to your specific tested:

1,2) Yes, you can trust your wife's negative result with a cervical specimen, and your own negative result on a urine specimen. (Why did you think you both needed testing anyway???)

3) As already mentioned above, definitely do not seek testing for the others. Whether positive or negative would make no difference in your health now or in the future. They are just normal components of the human genital microbiome.

Finally, I'd like to give another plug for your country's STI systems. If you ever have reason to be concerned about STIs, you would never go wrong by visiting your nearest federally supported sexual heath centre. Australia's SHCs are the world's very best network of STI/HIV clinical services. You'll never go wrong with their clinical evaluation and advice. (If you happen to be in Sydney or Melbourne, those SHCs are the best of the best. I am a close colleague and friend of some of the leaders there.)

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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36 months ago

Thank you again Dr Triple H for taking the time to respond to me and help me with my health anxiety.

Its definitely heartening to hear your praises for our sexual health system here. I will say having reviewed NHS, CDC, Canadian Health as well as reviewing personal stories from fellow western nations I did see a gargantuan difference in approach to STIs in favour of Aus.. Especially in Australia having a firm policy in no prescription of ABx without diagnosis (i unfortunately have friends who travel to SEA and live on Doxy and ive read enough horror stories about super Gonorrhoea)

I live in Melbourne and have many friends, some of which who are HIV positive who swear by the MSHC, the only reason i havent attended is its very difficult to get to unless you live near the CBD and are free during business hours. That being said they do write the literature and guide lines for our regular GPs so most GPs refer to their literature anyway.

My GP tested us due to our normal STI screens being clear and my partners Post Coital bleeding, plus my history of high risk sex plus years ago I had a scare for a disease i had never heard of and a doctor just prescribed me a massive dose of Azithromycin for a week and didnt bother to test for cure and i couldnt remember the disease name and couldnt get my records. Also it was the first time my GP had heard of it and prides himself in taking sexual health seriously.

In regards to the other plasmas, I will take your advice. Unless my partner develops disease.. We will let the diseases leave our minds and sleep easy.

Also an update from our last discussion, i saw a dermo and got a full thorough check, he was very confident i didnt have warts so thank you for helping answer my HPV questions as well.

H. Hunter Handsfield, MD

36 months ago

I'm glad to hear you already have a perspective on your country's SHCs and their leadership in STI prevention and clinical services, with MHSC often in the lead. Also pleased to learn there was a valid clinical reason for testing for M. genitalium. That said, I would not have recommended you be treated with azithromycin simply on the basis of your sexual history, but that's a judgment call that I cannot strongly criticize. And nice to hear you don't have genital warts.---
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36 months ago

Hey Dr Triple H, since youve answered all my plasma questions.. I might ask you some more HPV questions.

Is it true that most people will clear warts even if left untreated?

I just saw a youtube video from std centre new york with Dr Slava Fuzayloff suggesting that 85% of people will experience warts in their life time. What do you think of that stat?

(for reference https://stdcenterny.com/articles/genital-warts-versus-skin-tags.html)

Can HPV cause non warty discolouration on the penis in your experience?

Thanks again!

H. Hunter Handsfield, MD

36 months ago

The opportunity for follow-up comments is intended for clarity and additional detail about the original question, not to open entirely new topics. Hence very succinct replies. Yes, genital warts typically are cleared by the immune system in a few months. 85% seems high; I wonder if the speaker is referring to childhood (non sexually transmitted) warts as well as genital. Studies from Scandinavia (I forget which country), where all medical records are available in publicly accessible databases, suggest 25-35% of people seek treatment at least once for genital or anal warts, and I see no reason to suspect it would be much different in other industrialized countries. I'm not sure what "warty discoloration" means. I'm not aware that warts or HPV can cause skin color changes as the only clinical manifestation.

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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