I have wanted to write about this topic for a long time, because I often see it in the clinic, but it is a bit difficult to write, especially in the part of mycoplasma where there are still a lot of controversies, and sometimes the different opinions of doctors may cause problems for patients. The English words for chlamydia and mycoplasma are very different, but for some reason the Chinese translation is only one word different, which sometimes confuses the patient and even the doctor. We will try to explain them in a question and answer format.
1.What are Chlamydia and Mycoplasma?
Chlamydia and Mycoplasma are both bacteria. There are several types of bacteria that belong to them and can make people sick. For example, Chlamydia includes Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci, and Chlamydia veterinaryis. Mycoplasmas include Mycoplasma pneumoniae, Mycoplasma histolytica, Mycoplasma urealyticum, and Mycoplasma genitalium. The main ones related to genitourinary diseases are: Chlamydia trachomatis: the most common bacteria causing STDs.
Mycoplasma genitalium: In recent years, it has become a common cause of STDs, second only to Chlamydia trachomatis and gonorrhea.
Mycoplasma urealyticum: It is still controversial whether it is considered an STD because it can be found in many healthy women and can be considered a normal bacterium, but sometimes patients have urinary tract infections or vaginitis that can be due to it, so it can be considered an opportunistic pathogen.
*Mycoplasma and Chlamydia are the three bacteria mentioned above*.
2. What symptoms can chlamydia and mycoplasma infections cause?
Women infected with chlamydia or mycoplasma are most often asymptomatic! Many female patients are tested for it during a physical examination before they know they have an infection, otherwise they don’t feel it. If there are symptoms, they are usually an abnormal vaginal discharge or a burning and stinging sensation when urinating.
Common symptoms in men who are infected include stinging and burning sensation when urinating or abnormal discharge from the urethra. Most of the so-called non-gonococcal UTIs are caused by chlamydia or mycoplasma.
3. How is chlamydia and mycoplasma transmitted?
These three bacteria are transmitted through sexual intercourse, oral sex, and anal sex are all ways of transmission. Sauna, hot springs, swimming pools are not infected with these diseases, sometimes the patient will ask about.
4, if someone is infected with chlamydia and mycoplasma, but there are no symptoms, so is it not necessary to treat it?
People who have no symptoms usually do not know they are infected, unless they are detected during a physical examination, or when the patient is worried about sexual behavior and asks for an examination. There is some controversy as to whether or not to do treatment for an infection without symptoms. It is now accepted that patients should be treated if they have Chlamydia trachomatis, including sexual partners, regardless of whether they have symptoms or not. The main reason is that chlamydia can increase a woman’s chance of getting pelvic inflammatory disease and can lead to infertility. Pregnant women with chlamydia are also at risk for preterm delivery, so screening for chlamydia is now part of prenatal testing, and in the United States, women under the age of 25 who have had sex are recommended to be screened regularly for Chlamydia trachomatis. Like chlamydia, mycoplasma infections are most often asymptomatic, especially in girls.
There is no accepted recommendation for screening, however, because the medical community is inconclusive as to whether mycoplasma, like chlamydia, can cause pelvic inflammatory disease or infertility or preterm birth …… The association is definitely there, except that many patients with these problems do not have mycoplasma infections, and many patients with mycoplasma infections have been able to get pregnant, have babies, and without preterm delivery. Furthermore, some studies have shown that even when mycoplasma infections are detected and treated in asymptomatic pregnant women, they do not seem to help prevent preterm birth or to improve the health of the fetus. Therefore, screening for mycoplasma is not currently recommended for prenatal testing of pregnant women.
5. What about patients with symptoms? Do I need to be treated?
Treatment should be done, including treatment of sexual partners, regardless of whether they have symptoms or not. The main reason is that chlamydia can increase a woman’s chance of getting pelvic inflammatory disease and can lead to infertility. Pregnant women with chlamydia are also at risk for preterm delivery, so screening for chlamydia is now part of prenatal testing, and in the United States, women under the age of 25 who have had sex are recommended to be screened regularly for Chlamydia trachomatis. Chlamydia trachomatis and Mycoplasma genitalium are both STDs, so treatment is recommended regardless of symptoms. Treatment is also recommended for the sexual partners of these patients, regardless of whether they have symptoms or not.
In women, the symptoms are consistent with vaginitis or urinary tract infection, such as excessive leucorrhea, odor, or frequent, urgent, or painful urination. If the test reveals these two bacteria, treatment is recommended for her sexual partner regardless of symptoms. Mycoplasma urealyticum is a bit controversial. If the vaginitis or UTI is caused by it, the patient certainly needs treatment, but what if she has a sexual partner? Because Mycoplasma urealyticum can be considered an opportunistic pathogen and can be detected in more than 70% of women with a sexual history, vaginitis or UTIs caused by it are not necessarily related to sex. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.
6, when doing gynecological checkups, should we regularly check for chlamydia or mycoplasma?
Currently in the United States, regular screening for chlamydia is recommended, especially for young women under the age of 25 who have had sexual intercourse, and for prenatal testing, but this is related to their cultural background. It does not seem to be required in China. As for mycoplasma, no screening is recommended unless symptoms are present. There are also symptoms that have to be related to a bacterial infection to be tested. For example, if you go to the doctor because you have irregular periods, but nothing else is wrong, then testing for mycoplasma or chlamydia is not very meaningful. Because even if you find out to do the treatment, probably not help to regulate the period, but bring unnecessary worry to the patient.
7, mycoplasma or chlamydia to diagnose how?
The patient’s urine or vaginal secretions can be examined.
8, how to treat mycoplasma or chlamydia?
The treatment of these two bacteria is currently based on the drug azithromycin, an antibiotic that can be taken 1000 mg at a time, just take it once.
9, mycoplasma or chlamydia how to prevent it?
Since they are transmitted by sexual intercourse, it is important to wear condoms to reduce or avoid contact with the bodily fluids of sexual partners, not only for mycoplasma or chlamydia, but also for the prevention of all STDs, including gonorrhea, herpes, AIDS, etc.
10.I went to the hospital for a gynecological checkup and the doctor said I have mycoplasma, but I have no symptoms, should I take medication?
First of all, this examination should be checked for mycoplasma is quite controversial, and generally not recommended, mediocre. But since the test was done, it depends on which mycoplasma the patient is referring to? If it is genital mycoplasma, treatment is currently recommended, including for sexual partners. If it’s Mycoplasma solium, it’s not so clear. I don’t recommend testing healthy people for mycoplasma or treating asymptomatic Mycoplasma solium infections.