Ureaplasma and mycoplasma are three different tests that get talked about as one, and only one of them is an established sexually transmitted infection. Mycoplasma genitalium is a recognized cause of urethritis in men and cervicitis in women, and the CDC recommends testing specific patients for it. Ureaplasma species and Mycoplasma hominis are a different situation: the CDC states that testing for them is not recommended in the standard cervicitis workup, and there is no FDA-cleared test for them in the United States. TrufaMED runs all three at our Surfside clinic when a physician decides the clinical picture calls for it, and the point of this article is to explain when that is.
We are asked for these tests more often than we used to be, usually by people who found the names online after a standard panel came back negative and symptoms did not resolve. That is a reasonable place to end up. It is also where a lot of unnecessary antibiotics get prescribed, so it is worth understanding what each test actually detects.
The three organisms, kept separate
| Organism | Status | CDC position on testing |
|---|---|---|
| Mycoplasma genitalium | Established cause of urethritis and cervicitis | Test men with recurrent non-gonococcal urethritis. Test women with recurrent cervicitis. Consider in pelvic inflammatory disease. Screening people without symptoms is not recommended. |
| Ureaplasma urealyticum and Ureaplasma parvum | Commonly detected in people with no symptoms | “Testing for U. parvum, U. urealyticum, Mycoplasma hominis, or genital culture for group B streptococcus is not recommended” in the cervicitis workup. |
| Mycoplasma hominis | Same category as ureaplasma | Same. The CDC does list it among organisms that “might be associated with certain PID cases.” |
Those quotes are from the CDC Sexually Transmitted Infections Treatment Guidelines, 2021, which remains the current edition as of August 2026. Everything below rests on that document unless another source is named.
Mycoplasma genitalium: the one that behaves like an STI
M. genitalium is sexually transmitted and it causes real disease. The CDC attributes to it roughly 15 to 20 percent of non-gonococcal urethritis, 20 to 25 percent of nonchlamydial NGU, and 40 percent of persistent or recurrent urethritis in men. In women it is associated with cervicitis and pelvic inflammatory disease.
That last figure is the reason this test exists in practice. A man treated for urethritis whose symptoms return is far more likely to have M. genitalium than anything else, and it will not show up on a chlamydia and gonorrhea panel.
There is an FDA-cleared molecular test for it, cleared for urine and for urethral, penile meatal, endocervical and vaginal swabs. So this is not a fringe or research-only test. It is a standard NAAT with a real regulatory clearance behind it.
The CDC does not recommend screening people without symptoms. The guideline is direct about it: “Screening of asymptomatic M. genitalium infection among women and men or extragenital testing for M. genitalium is not recommended.” The reason is that the consequences of asymptomatic infection are not known, so finding it in someone with no symptoms creates a treatment decision nobody has good evidence for.
Why treatment is a two-stage course and not one pill
This is the part that matters most and gets explained least.
Azithromycin resistance in M. genitalium is now the norm rather than the exception. The CDC states that molecular markers for macrolide resistance range from 44 to 90 percent across the United States, Canada, Western Europe and Australia. A single one-gram dose of azithromycin, the old reflex for a lot of genital infections, selects for resistant strains in 10 to 12 percent of cases. The guideline says plainly that it “should not be used.”
What the CDC recommends instead is a two-stage, resistance-aware course. Where resistance testing is available and the strain is macrolide-sensitive, that is doxycycline for seven days followed by an extended azithromycin course. Where the strain is resistant, or where resistance testing is not available, it is doxycycline 100 mg twice daily for seven days, followed by moxifloxacin 400 mg once daily for seven days. Resistance-guided therapy has cure rates above 90 percent.
One more thing worth knowing if a previous clinician reached for a cephalosporin: M. genitalium has no cell wall, so penicillins and cephalosporins do nothing to it. This is a genuine reason a course of treatment can fail without anyone doing anything wrong.
Ureaplasma and Mycoplasma hominis: a different conversation
These two get grouped with M. genitalium because the names look similar and because commercial panels sell them together. Clinically they sit somewhere else entirely.
The CDC’s position in the cervicitis workup is a single sentence: testing for U. parvum, U. urealyticum and Mycoplasma hominis is not recommended. On urethritis it says the data are inconsistent, and that “the majority of men with Ureaplasma infections do not have overt disease unless a high organism load is present.” The one place it allows a possible role is pelvic inflammatory disease, where M. hominis and U. urealyticum “might be associated with certain PID cases.”
The European STI Guidelines Editorial Board put it more bluntly in a 2018 position statement in the Journal of the European Academy of Dermatology and Venereology: “At present, we have no evidence that we are doing more good than harm detecting and subsequently treating Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum colonizations/infections.” That group notes asymptomatic carriage is common, that most people carrying these organisms never develop disease, and that widespread testing and treating drives antimicrobial resistance.
There is also a practical point that almost never gets mentioned. There is no FDA-cleared test for Ureaplasma or Mycoplasma hominis in the United States. Every ureaplasma result in this country comes from a laboratory-developed test. That does not make the result meaningless, and these are well-established laboratory methods. It does mean the result deserves interpretation by a physician rather than treatment on sight.
When testing for these is actually worth doing
A physician here will generally order M. genitalium testing when:
- Urethritis in a man has come back after treatment, or never fully cleared
- Cervicitis in a woman has recurred after doxycycline or azithromycin
- There is pelvic inflammatory disease and the standard regimen is not working
- A partner has tested positive
The genital mycoplasma profile covering ureaplasma and M. hominis comes into the conversation in a narrower set of situations: persistent symptoms with a fully negative standard panel and a negative M. genitalium result, certain fertility workups where a specialist has asked for it, and cases where a physician is working through pelvic inflammatory disease that is not responding. Being handed a positive ureaplasma result with no symptoms, on the other hand, is usually not a reason to take antibiotics.
We will run the test if you want it run. What we will not do is treat a positive result without a clinical reason, because that decision has consequences beyond the individual patient.
How the testing works at TrufaMED
Collection is straightforward. M. genitalium is usually a first-catch urine sample for men or a vaginal or endocervical swab for women. The genital mycoplasma profile uses urine or a swab depending on which version is ordered. Nothing about the collection is uncomfortable and nothing requires an overnight fast.
These are send-out tests rather than the rapid tests we run in the clinic lab, so results take longer than a strep or COVID swab. A physician reviews the result and calls you, which matters here more than on most panels, because the answer to “what does this positive mean” is genuinely different depending on which organism came back.
Mycoplasma genitalium testing is $350 self-pay. If you are using insurance, the front desk checks your coverage before the specimen is sent. The genital mycoplasma profile covering Ureaplasma species and Mycoplasma hominis is priced separately, and the front desk will quote it before anything is sent. Our published menu is on the self-pay pricing page. For context on the tests you would usually run first, our standard panel covering HIV, syphilis, herpes 1 and 2, gonorrhea, chlamydia and hepatitis B is $450, and chlamydia and gonorrhea PCR alone is $190.
Collection can also happen at your home or hotel rather than at the clinic. That is covered in our guide to STD testing at your home or hotel.
Where to go next
The clinical picture is different enough between men and women that we wrote each one separately. For men, the question is usually urethritis that keeps returning: testing for mycoplasma and ureaplasma in men. For women, it is more often persistent symptoms with negative standard testing, plus questions about pregnancy and fertility: testing for ureaplasma and mycoplasma in women.
TrufaMED is at 9445 Harding Ave in Surfside, open seven days a week. Walk in, book on our sexual health testing page, or call (305) 537-6396.
Frequently asked questions
Is ureaplasma an STD?
Ureaplasma is sexually transmissible but it is not treated as an established sexually transmitted infection the way chlamydia or gonorrhea is. It is commonly detected in people with no symptoms and no disease. The CDC states that testing for Ureaplasma urealyticum and Ureaplasma parvum is not recommended in the cervicitis workup, and notes that most men carrying Ureaplasma do not have overt disease unless the organism load is high. Mycoplasma genitalium is the organism in this group that is an established STI.
What is the difference between mycoplasma and ureaplasma?
They are different organisms with very different clinical weight. Mycoplasma genitalium is a recognized cause of urethritis in men and cervicitis in women, has an FDA-cleared test, and has specific CDC treatment recommendations. Ureaplasma species and Mycoplasma hominis are frequently found in healthy people, have no FDA-cleared test in the United States, and have no CDC treatment recommendation. Commercial panels often sell them together, which is where the confusion starts.
Should I be tested for ureaplasma and mycoplasma?
Testing for Mycoplasma genitalium is recommended by the CDC for men with recurrent non-gonococcal urethritis and for women with recurrent cervicitis, and can be considered in pelvic inflammatory disease. Screening people with no symptoms is not recommended. Ureaplasma testing is most useful when symptoms have persisted despite a negative standard panel and a negative M. genitalium result. A physician should decide, because a positive ureaplasma result in someone without symptoms usually does not warrant antibiotics.
How is Mycoplasma genitalium treated?
The CDC recommends a two-stage course rather than a single dose. Where resistance testing is available and the strain is macrolide-sensitive, that is doxycycline for seven days followed by an extended azithromycin course. Otherwise it is doxycycline 100 mg twice daily for seven days followed by moxifloxacin 400 mg once daily for seven days. A single one-gram dose of azithromycin is specifically advised against, because macrolide resistance markers now run between 44 and 90 percent. Penicillins and cephalosporins do not work on this organism because it has no cell wall.
Does a standard STD panel include ureaplasma or mycoplasma?
No. A standard panel covers HIV, syphilis, herpes, gonorrhea, chlamydia and hepatitis B. Mycoplasma genitalium, ureaplasma and Mycoplasma hominis are ordered separately. That is the usual reason people come to us having already tested negative everywhere else and still having symptoms.
Can ureaplasma cause infertility?
There is no established causal link, and treatment of ureaplasma is not a recognized fertility treatment. Some fertility specialists order the test as part of a broader workup, and if yours has asked for it we will run it and send the result. What the evidence does not support is treating a positive ureaplasma result in a person with no symptoms as an explanation for infertility. If a specialist is directing your care, bring us their request and we will collect the specimen.
Is there an FDA-cleared test for ureaplasma?
No. There is an FDA-cleared molecular test for Mycoplasma genitalium, cleared for urine and for urethral, penile meatal, endocervical and vaginal swabs. Ureaplasma and Mycoplasma hominis testing in the United States is performed with laboratory-developed tests. Those are established laboratory methods, but the absence of a cleared assay is one more reason to have a physician interpret the result rather than treating it automatically.
How much does mycoplasma or ureaplasma testing cost in Miami?
Mycoplasma genitalium testing at TrufaMED is $350 self-pay. The genital mycoplasma profile covering Ureaplasma species and Mycoplasma hominis is priced separately, and the front desk will quote it before anything is sent out. If you are using insurance, the front desk checks your coverage before the specimen is sent out. For comparison, our full panel covering HIV, syphilis, herpes 1 and 2, gonorrhea, chlamydia and hepatitis B is $450, and chlamydia and gonorrhea PCR alone is $190.
How long do results take?
These are send-out tests rather than rapid in-clinic tests, so they take longer than a same-day strep or flu swab. A physician reviews your result and calls you with it. If you also want same-day answers on the standard infections, those can be collected at the same visit and several of them return much faster.
Where can I get tested in Miami?
TrufaMED is at 9445 Harding Ave in Surfside, five minutes from Miami Beach and two minutes from Bal Harbour, open Monday to Friday 9 AM to 9 PM, Saturday 11 AM to 11 PM and Sunday 12 PM to 8 PM. Walk-ins are welcome seven days a week, and collection can also be done at your home or hotel anywhere in Miami-Dade. Call (305) 537-6396 to arrange either one.