Mycoplasma genitalium (M. gen) is a bacterium and an increasingly common sexually transmitted infection (STI) in both men and women. This microscopic organism colonizes the mucosal surfaces of the urogenital tract, often infecting the urethra, cervix, or rectum. Advances in molecular testing have confirmed M. gen’s role as a public health concern, despite its historical difficulty to study due to its small size. Understanding transmission is key to managing its spread and preventing complications. Untreated infection can lead to urethritis in men and cervicitis or pelvic inflammatory disease in women.
The Primary Routes of Transmission
M. gen transmission involves unprotected sexual contact with an infected individual. The bacterium requires the exchange of bodily fluids and direct contact between infected mucosal surfaces to successfully pass to a new host. Vaginal and anal intercourse are the most common and effective routes for spreading the infection.
During vaginal intercourse, the bacterium is exchanged between the urethra and cervix, where it often resides in high concentrations. Anal intercourse also carries a high risk, as M. gen can infect the rectal lining, particularly among men who have sex with men. Transmission can occur even without full penetration, through genital-to-genital rubbing or skin-to-skin contact in the genital area.
Oral-genital contact is a possible route, though the likelihood of transmission via this pathway is lower than vaginal or anal contact. The bacterium can also be transferred indirectly by sharing uncleaned sex toys or by touching the genitals with contaminated fingers. A significant factor in the continued spread of M. gen is that many infected individuals, estimated to be between 20% and 50% of cases, show no symptoms but remain contagious.
Assessing Situational Risk Factors
Certain behaviors and circumstances significantly amplify the probability of acquiring M. gen. A higher number of sexual partners is directly linked to increased opportunity for exposure and subsequent infection. Studies show that individuals who report more partners over a given period face a greater chance of being infected.
The inconsistent or complete absence of barrier protection, such as condoms, is a major factor in transmission. Condoms create a physical barrier that prevents the exchange of infected genital secretions, substantially reducing risk. Individuals who are sexually active at a younger age also face a statistically higher risk of infection.
The presence of other concurrent STIs is another contributing element. These infections can compromise the integrity of the mucosal lining in the genital tract, making tissues more vulnerable to colonization by M. gen. Engaging in sexual activity while impaired by substances can also lead to a failure to use barrier methods, increasing the overall risk of exposure.
Addressing Non-Sexual Transmission
M. gen transmission is overwhelmingly confined to sexual contact. The bacterium is fragile outside the human body and requires the specific environment of the genital tract’s mucosal cells to survive and replicate. Therefore, the infection is not passed through casual contact with inanimate objects.
There is no scientific evidence that M. gen can be transmitted through contact with toilet seats, shared clothing, swimming pools, or communal bathing facilities. The bacterium cannot survive long enough on these surfaces to establish an infection.
A different form of non-sexual transmission is the vertical or perinatal route, where a mother passes the infection to her newborn during childbirth. While recognized, this is not a primary or frequent mode of transmission in the general population. The risk is associated with the infant’s exposure to infected genital secretions as they pass through the birth canal.
Strategies for Preventing Spread
Reducing the risk of M. gen infection centers on implementing consistent protective measures during sexual activity. The most effective strategy is the consistent and correct use of external or internal condoms for all vaginal and anal intercourse. Barrier methods significantly lower the probability of contact with infected genital secretions.
Regular STI screening is another measure, especially for individuals who have multiple partners or whose partner has recently been diagnosed with an STI. Testing allows for the early detection and treatment of M. gen, interrupting the chain of transmission. Prompt treatment is necessary because the infection is highly contagious and often involves partner co-infection.
Communication with partners is a necessary part of prevention. Sexual partners must be informed if a diagnosis is made so they can be tested and treated concurrently. Avoiding sexual activity until both partners have completed treatment and confirmed the infection is cleared prevents immediate re-infection. Maintaining a long-term, mutually monogamous relationship with a tested negative partner is also a reliable way to avoid transmission.