WHEN Claire (not her real name) was told by an ex over text in January that she might have mycoplasma genitalium (Mgen) – a little known sexually transmitted disease – she was confused.
She said: “I’d never heard of it. So, very frantically, I messaged all my girlfriends and then googled it. But even then, I couldn’t find too much about it.”
Claire wasn’t showing any symptoms but still rang Sandyford sexual health clinic in Glasgow to get tested. Ten days later she got the result: it was positive.
Mgen, while usually symptomless, has been described as a “growing concern” by sexual health specialists. Finding new treatment options is also said to be “an urgent healthcare priority”.
Mainly caught through unprotected sex, Mgen can cause vaginal discharge and pelvic pain in women and pain while urinating for men. Worryingly, it has also been linked with preterm birth, miscarriage and infertility.
There are also concerns that Mgen has the potential to become a “superbug”, which means a bacterium which is resistant to available antibiotic treatments.
Mgen is thought to infect 1 to 2 in every 100 adults aged 16-44 years in the UK who are sexually active.
Relatively few studies, however, have looked at exactly how common it is.
This is in part due to the fact that Mgen isn’t widely tested like other STDs as well as its often symptomless nature.
The British Association of Sexual Health and HIV (BASSH) currently only recommends testing for people with specific symptoms and certain groups including those with pelvic inflammatory disease and urethritis – which NHS services in Scotland and England adhere to.
UK Health Security Agency data suggests it may be spreading quickly, with 5,109 cases identified in England in 2021, up from 79 in 2015 - a 640% increase. This may have also been due to increased testing, however.
Meanwhile, data on its prevalence and spread in Scotland is scarce.
Following a Freedom of Information request asking for any data on the prevalence or number of infections of Mgen recorded in sexual health clinics across Scotland, Public Health Scotland said it doesn’t hold that information.
NHS Greater Glasgow and Clyde told The National there had been “no significant increases” in the city in recent months.
A spokesperson for BASSH said the prevalence of Mgen “remains fairly stable”. They added: “It is important to recognise that the infection does not cause harm in the majority of cases, and that only a relative minority will go on to develop symptoms.
“Access to reliable diagnostic and resistance testing is not always available however, which can create challenges in ensuring the right patients get the right treatment.”
Claire found it worrying that she didn’t know how long she might have had Mgen, especially given it has been linked with infertility if left untreated.
She said: “It’s really hard to tell how long you’ve had it for. I still don’t know who had it first – if I gave it to him or he gave it to me. I’ve had STI tests before but I’d never been tested for Mgen. I could have had it for years and just not known.
“If it goes untreated for a certain amount of time, it can have implications on your fertility. So, that was one thing that I was a bit worried about.”
The relative lack of testing is by design according to BASSH, as “inappropriate” testing and treatment could exacerbate Mgen’s antimicrobial resistance.
The spokesperson said: “Asymptomatic screening is not warranted or recommended because of the low risk of harm to individuals and the lack of cost benefit in widespread testing.
“A key concern in the management of Mgen is avoiding practices that can exacerbate antimicrobial resistance. Recent years have seen worrying trends in the emergence of multi-drug resistant sexual infections and inappropriate testing and treatment is a major driver of this.”
Claire was quite shocked about the amount of medication she was given. The nurse at Sandyford prescribed her two courses of antibiotics, and had to be very precise about when she took them as well as being careful about certain types of minerals and avoiding dairy.
The list of potential side effects was also quite long.
Finding new treatment options is an “urgent healthcare priority” according to BASSH.
The spokesperson added: “Of major concern is the lack of commercial interest in developing new antibiotics and other agents to treat Mgen.
“There is currently a very limited range of effective treatment options for Mgen; those that we currently have available are long courses of antibiotics with side effects and their use is further complicated by the high prevalence of resistance.
“This can make infection very difficult to treat for those who need it, which can cause further complications and health risks.
“More clinical trials for effective agents are needed, with more investment into the development of new and effective antibiotics an urgent healthcare priority.”
