Ureaplasma

Ureaplasma symptoms in men

• Painful urination.
• Wetness at the penile tip.
• Unusual or foul-smelling discharge.
• Urethral discomfort.

Ureaplasma symptoms in women

• Painful urination
• Unusual or unpleasant discharge
• Abnormal vaginal discharge
• Lower abdominal pains

Many patients with Ureaplasma can be asymptomatic (showing no symptoms). If Ureaplasma is living in harmony with the body it will produce no symptoms and cause no harm. This is known as a asymptomatic colonisation/carriage and does not require any further action.

Ureaplasma is commonly present without causing disease. Associations with conditions such as urethritis, cervicitis, pelvic inflammatory disease and other complications have been reported, but causality is uncertain.

In people with antibody deficiencies, Ureaplasma can rarely cause serious infections affecting the lungs, joints or bones.

There is no reliable incubation period for Ureaplasma. Most carriage is asymptomatic. Symptoms such as dysuria or genital discharge have many possible causes, so other established causes should be assessed before attributing them to Ureaplasma.

Ureaplasma is caused by bacteria called Ureaplasma urealyticum or Ureaplasma parvum. These bacteria commonly live in the genital and urinary tract without causing symptoms. They can be spread through:

• Vaginal, oral, or anal sex
• Pregnancy or childbirth from mother to baby

The presence of Ureaplasma does not necessarily mean there is an infection or that treatment is needed. Clinical significance depends on factors such as symptoms, the Ureaplasma species detected, and whether other causes of symptoms have been excluded.

Factors associated with Ureaplasma carriage or detection include:

• Having a new sexual partner
• Having multiple sexual partners
• Having unprotected sex

Bacterial vaginosis and changes in the vaginal microbiome have also been associated with Ureaplasma detection, but BV should not be considered a proven cause or risk factor for Ureaplasma infection.

You can reduce the likelihood of sexual transmission by:

• Using condoms consistently and correctly during vaginal and anal sex
• Using barriers during oral sex
• Avoiding sharing sex toys, or cleaning them and using a new condom between partners

Routine testing for Ureaplasma in people without symptoms is not generally recommended. If you have symptoms or concerns about an STI, speak with a Specialist about appropriate testing.

Yes. Condoms reduce the risk of Ureaplasma transmission but do not eliminate it completely. The bacteria may be spread through contact with genital skin not covered by a condom or during oral sex.

No. Ureaplasma is not known to spread through kissing. It is primarily transmitted through sexual contact, including vaginal, anal, and oral sex.

No. Ureaplasma is not spread through sharing towels, bedding, clothing, toilets, or other personal items. The bacteria do not survive well outside the human body and are primarily transmitted through sexual contact.

No. Ureaplasma is not a blood-borne infection and is not transmitted through blood transfusions. It primarily lives in the genital and urinary tract and is spread through sexual contact or, less commonly, from a mother to her baby during pregnancy or childbirth.

Ureaplasma can be detected using a PCR (polymerase chain reaction) test, which identifies the bacteria's DNA. Samples may include:

• A vaginal swab (self-collected or clinician-collected)
• A first-catch urine sample for people with a penis

Because Ureaplasma is not usually included in routine STI screening, a specific PCR test may be required. However, detecting Ureaplasma does not necessarily mean it is causing disease or symptoms. Results should be interpreted alongside symptoms and clinical assessment.

A PCR test is commonly used to detect Ureaplasma. Depending on your anatomy, testing usually involves:

• A vaginal swab
• A first-catch urine sample

Ureaplasma may be included in a multiplex PCR panel, which tests for several infections from a single sample. Where available, testing should distinguish between U. urealyticum and U. parvum. However, detecting Ureaplasma does not establish that it is the cause of symptoms, so other established causes should also be assessed.

An accurate diagnosis depends on several factors, including:

• Using a PCR test rather than a bacterial culture
• Providing the correct sample, such as a vaginal swab or first-catch urine
• Following sample collection instructions, such as not urinating for at least 2 hours before a urine sample
• Interpreting the result alongside your symptoms, as Ureaplasma can be present without causing illness

Yes. Symptoms associated with Ureaplasma are non-specific and can overlap with several other conditions, including:

• Chlamydia
• Gonorrhoea
• Mycoplasma genitalium
• Bacterial vaginosis (BV)
• Thrush
• Urinary tract infections (UTIs)

A PCR test can detect Ureaplasma, but a positive result does not necessarily mean it is causing the symptoms. Other established causes should also be investigated and excluded where appropriate.

PCR/NAAT testing is the preferred method for detecting Ureaplasma. Bacterial culture is not available for Ureaplasma testing in the UK. Blood tests are not recommended for detecting a current Ureaplasma infection.

No. A physical examination cannot confirm Ureaplasma because its symptoms are similar to many other conditions. A PCR test on a vaginal swab or first-catch urine sample is needed to make the diagnosis.

No. Although you can collect a sample at home using a self-testing kit, the sample must be analysed in a laboratory using a PCR test. Because Ureaplasma can be present without causing symptoms, test results should be interpreted alongside your symptoms and medical history.

The long-term outlook is generally very good. Many people carry Ureaplasma without developing symptoms or health problems. Where U. urealyticum is clinically significant, it may be associated with urethritis, particularly in men. Associations with pelvic inflammatory disease (PID) and pregnancy complications, including preterm birth, have been reported, but causality remains uncertain.

No. Treatment does not provide protective immunity, so recolonisation or reinfection can occur. To reduce the risk of reinfection, practise safer sex and follow your Specialist’s advice regarding partner assessment or treatment where clinically indicated.

You can reduce the risk of recurrence by:

• Taking antibiotics exactly as prescribed, if treatment has been recommended
• Ensuring current sexual partners are assessed and treated if clinically indicated
• Avoiding sex as advised by your Specialist during treatment
• Using condoms to reduce the risk of sexual transmission or reinfection

If Ureaplasma is thought to be causing your symptoms, it is generally recommended that you tell your current sexual partner. This allows them to seek assessment and treatment if needed, helping to reduce the risk of reinfection.

You can reduce the risk of passing on Ureaplasma by:

• Following your Specialist’s advice if treatment is recommended because Ureaplasma is considered clinically significant
• Avoiding sexual contact as advised by your Specialist during treatment
• Using condoms during vaginal and anal sex
• Ensuring current sexual partners are assessed and treated if clinically indicated

Ureaplasma can be passed from mother to baby during pregnancy or childbirth. Most babies who acquire the bacteria remain healthy. Ureaplasma has been associated with complications such as preterm birth, low birth weight, or newborn infections, but these are associations and do not prove that transmission causes these outcomes.

Most people with Ureaplasma have healthy pregnancies. However, in some cases it has been associated with:

• Preterm birth
• Premature rupture of membranes (waters breaking early)
• Infection of the membranes or amniotic fluid (chorioamnionitis)
• Newborn infections, particularly in premature babies

Ureaplasma is commonly found in the genital tract, including during pregnancy, and often causes no symptoms. Prevalence varies considerably between populations and testing methods. Because it is often part of the normal genital microbiome, routine screening during pregnancy is not generally recommended.

If treatment is needed during pregnancy, your clinician will prescribe an antibiotic that is considered safe for pregnancy. Options may include:

• Azithromycin
• Erythromycin

Doxycycline is generally avoided during pregnancy. Treatment is only recommended when the potential benefits outweigh the risks.

You can help reduce the risk of complications by:

• Attending all routine antenatal appointments
• Practising safer sex to reduce the risk of new infections or reinfection
• Seeking medical advice if you develop symptoms such as unusual discharge or pain
• Taking any prescribed treatment exactly as directed

Ureaplasma may occasionally contribute to postpartum infections, such as endometritis, but this is uncommon. Ureaplasma is not known to be transmitted through breast milk. If treatment is needed while breastfeeding, your clinician will prescribe an antibiotic that is appropriate for both you and your baby.