Mycoplasmosis

Urogenital mycoplasmosis is one of the most significant sexually transmitted diseases in recent years. The responsible agents are Mycoplasma hominis and Mycoplasma genitalium, small intracellular bacteria.

These bacteria lack a cell wall, making them difficult to detect using various laboratory methods such as polymerase chain reaction (PCR), culturing on special media, and serological tests. Mycoplasmosis is often asymptomatic as long as the human immune system remains relatively stable. However, factors such as pregnancy, childbirth, abortion, hypothermia, or stress can activate the mycoplasmas and lead the disease to progress to an acute form.

Transmission Routes of Mycoplasmosis

Urogenital mycoplasmosis infection primarily occurs through sexual contact. Domestic transmission via contaminated underwear, sponges, or linens is also possible. Additionally, there is a possibility of intrauterine transmission and infection of the baby when passing through the birth canal of an infected mother. According to studies, intrauterine transmission occurs in about 10 to 15% of cases and infection at birth in 30 to 50% of cases, making it a significant issue for prevention.

Possible Complications

Mycoplasmosis can cause various diseases and complications, such as: inflammation and damage to the mucous membranes of the urogenital system, spread of infection to other organs through the bloodstream, decreased immunity, and development of secondary infections.

• pyelonephritis;
• prostatitis;
• urethritis;
• arthritis;
• sepsis;
• meningitis;
• pneumonia;
• ACUTE RESPIRATORY INFECTIONS;
• pregnancy and fetal abnormalities;
• postpartum endometritis.

Mycoplasmosis in Women

Mycoplasmosis in women can occur during unprotected vaginal intercourse. Mycoplasmas infect the epithelium of the vagina, cervix, and cervical canal.

The incubation period lasts from 15 to 20 days, but in 70% of cases, the infection is asymptomatic. In fact, mycoplasmas have the ability to mask the host's immune system and do not cause pronounced inflammation in the early stages of the disease.

Characteristic Symptoms

Infection with Mycoplasma genitalium causes a painful pelvic inflammatory syndrome related to infection of the genital tract. This is manifested by:

• itching, burning, and pain in the urethra;
• slight mucus discharge, swelling of the folds in the urethral area or between the clitoris and the urethra;
• Vaginal discharge is observed, sometimes bleeding after intercourse or between periods.
• sensation of heaviness and pain in the lower back or lower abdomen, sometimes worsened during menstruation.

If left untreated, this infection can lead to infertility, miscarriages, premature births, or even fetal death. As in men, reactive arthritis may occur.

In women, the entry point for the infection is the genital tract, and the infection can spread to other organs of the reproductive system.

Mycoplasmosis in Men

In men, mycoplasmosis begins to manifest 3 to 5 weeks after infection. The infection first affects the urethra, and then inflammation may spread to other organs.

Characteristic Symptoms

Infection with Mycoplasma genitalium results in urethritis with discharge and burning sensations in the penis, while urinating or at rest.

• slight periodic discharge from the urethra, sometimes after urination or defecation;
• itching and pain in the urethra are rare;
• recurring pain in the pelvic area, perineum, groin, sacrum, and thigh;

This infection can be complicated by pain and swelling in the testicles (epididymitis), or even reactive arthritis.

Treatment of Mycoplasmosis

The basic treatment for mycoplasmosis relies on antibiotics to which mycoplasmas are sensitive. The most commonly used are macrolides (e.g., azithromycin), tetracyclines (doxycycline), and fluoroquinolones (levofloxacin). The choice of medication depends on the type of pathogen, antibiotic sensitivity, and the characteristics of the patient's organism. To increase the effectiveness of treatment, two or three antibiotics may be prescribed simultaneously in combination with immunomodulators and anti-inflammatories.

The therapy often includes the following steps:

1. Prescription of antiprotozoal agents to prepare the body.
2. An antibiotic treatment to suppress the infection.
3. Antifungal medications for the prevention and treatment of fungal complications.

An integrated approach to treatment minimizes the risk of relapse and avoids complications associated with mycoplasmosis.

Mycoplasmosis and Pregnancy

Pregnancy in the Natural Cycle

Mycoplasmosis during pregnancy can lead to severe complications, including placental abnormalities, premature birth, fetal infection, and postpartum infections in the mother. It is recommended to screen for mycoplasmas before planning a pregnancy to minimize risks. If an infection is detected, it is necessary to follow a safe antibiotic treatment for pregnancy, under the supervision of a doctor.

IVF and Mycoplasmosis

During in vitro fertilization (IVF), the presence of mycoplasmosis may reduce the chances of successful embryo implantation and increase the risk of infectious complications. Before starting an IVF protocol, screening for infections, including mycoplasmosis, is mandatory. If an infection is detected, treatment must be completed before ovarian stimulation to ensure optimal conditions for conception and pregnancy.

Prevention of Mycoplasmosis

To reduce the risk of contracting mycoplasmosis, it is important to follow the recommendations below:

• the use of barrier contraceptive methods (condoms);
• regular medical check-ups, especially before planning a pregnancy;
• adherence to personal hygiene rules;
• avoiding casual sexual relationships;
• timely treatment of genitourinary infections.

Preventive measures and prompt consultation with a doctor help avoid complications and preserve reproductive health.