My Story and Some Advice From Someone With a Medical Background

This is a post I always hoped I’d get to make. I found out from a Mycoplasma test that I contracted Mycoplasma genitalium (Mgen) in early February of this year and experienced a series of treatment failures. Finally, after five months of persistence, I’ve cleared the infection. I’m sharing my experience here in hopes that others can gain insights into the process of diagnosing and treating Mgen — especially from the perspective of someone in medicine.

Background

I’m an Australian doctor and unfortunately contracted Mgen from a former partner. It became clear to me that many doctors are still unfamiliar with Mgen, despite its growing recognition. As a junior surgical doctor, I had never encountered it in clinical practice, though I was aware of other mycoplasma species in respiratory medicine. Fortunately, I have a solid foundation in antibiotic use and a working knowledge of infectious diseases, which helped me navigate this journey.

Initial Episode

My symptoms began about a week after having unprotected sex. I noticed white discharge and mild stinging during urination (dysuria).

Initial Treatments

February – Ceftriaxone and Azithromycin

I requested empirical therapy for urethritis, which in Australia typically covers gonorrhoea and chlamydia. I had already tested negative for both.

One week later, my symptoms returned. I called the clinic and requested 7 days of doxycycline, knowing it was another standard urethritis treatment. Again, symptoms subsided, only to return within 4–5 days. This raised suspicion.

Diagnosis and Positive Result

After researching, I came across Mycoplasma genitalium and discussed my concerns with a GP (not the initial doctor). She was familiar with Mgen and ordered a mycoplasma swab, which came back positive and macrolide-resistant.

She prescribed 14 days of moxifloxacin, as is often done for pelvic inflammatory disease (PID). I was hopeful, having read that many had success with this.

However, three days after finishing the moxifloxacin, the white discharge returned — mostly clear discharge throughout this time.

Contacting a Sexual Centre

Panicked, I followed the advice I now give to anyone diagnosed to contact a sexual health specialist. I reached out to a clinic and was fortunate enough to speak with a doctor within 20 minutes — a professional courtesy often extended to fellow doctors.

They recommended a course of 7 days of doxycycline followed by 10 days of doxycycline with pristinamycin. This combination quelled my symptoms by around day 14. I felt hopeful. But on day 19, I woke up to find white discharge again.

A follow-up test showed Mgen was still present. I was devastated.

Escalating Treatment and Mental Toll

My doctor and I had a long conversation — not only about further treatment but also about my mental health. It had been four months, and I was feeling hopeless.

We decided on:

Minocycline for 21 days, followed by 7 days of doxycycline, then 7 days of doxycycline with sitafloxacin — 35 days of antibiotics in total.

I still had some clear discharge at the end, and I feared the worst. But over time, the discharge gradually disappeared. I had developed the habit of checking for mucus strands in my urine — they were always there.

Final Recovery

Three weeks and one day after completing treatment, I returned for a test of cure (TOC). Though I was symptom-free, I saw one strand of mucus in my first-pass urine sample. I’d read enough stories to feel cautiously optimistic.

The result: Negative.

It’s now been 2.5 weeks since that result, and I remain symptom-free. Though I still think about it often, I believe the infection is finally gone.

Advice and Takeaways

1. See a Sexual Specialist

If you’re in Australia, follow the Melbourne Sexual Health Centre (MSHC) guidelines. Sexual health clinics are far better suited to manage Mgen than GPs, urologists, or even gynaecologists. Mgen is more of an infectious disease issue than a surgical one.

2. Don’t Rely on Extended Regimens Alone

There’s limited evidence supporting extended antibiotic regimens beyond the standard ones, but many (myself included) ask for longer courses “just in case.” Be mindful of antibiotic resistance and consult specialists when in doubt.

3. Be Informed About Fluoroquinolones (“Getting Floxed”)

There’s significant fear around fluoroquinolone, While side effects can be severe, most people tolerate them well. In my infectious disease rotations, we had patients on six weeks of fluoroquinolone without major issues. Reddit often highlights worst-case scenarios, so take those stories with balance.

4. Keep the Faith

Mycoplasma genitalium is not untreatable, and many cases do clear eventually, even without treatment. The key challenge lies in access to proper testing and appropriate antibiotics, which can vary greatly by country.

I was fortunate. In Australia, our healthcare system offers accessible testing and medications. I didn’t pay a cent for pristinamycin or sitafloxacin — a luxury many in other countries don’t have.

Final Thoughts

I’ll check in occasionally for questions but won’t be as active here anymore. I want to thank the founders and members of this subreddit — your stories helped me immensely, especially when I felt alone and uncertain.