Posts in Category: Sexual Health

Ureaplasma Detection and Treatment

What Is Ureaplasma Infection?

Ureaplasma is a kind of bacteria, which originates from the family of bacteria most commonly known as Mycoplasma. Mycoplasma are the smallest living species among the prokaryotes and their biological properties include the lack of a cell wall, Gram stain reaction and their neurosusceptibility to common antimicrobial prescribed medicines, such as beta-lactum. These kinds of bacteria are extremely difficult to spot and treat, as they are microscopic.

Another characteristic that differentiates them from the normal bacteria is that they lack a cellular boundary or cell wall. This is what makes them less susceptible to common antibiotics as the outer cell wall of the bacteria assists the drug to attack the bacteria. This makes them unique as their resistance to regular antibiotics, like penicillin, makes them difficult to treat.

Its Effects on Men and Women

Mycoplasma organism usually infects the respiratory tract and urogenital tracts in humans. Ureaplasma bacteria however is, as its name suggests, usually found in the urogenital tract and the major root cause of most urinary tract infections. This bacterium affects both men and women and in young men, it is associated with non-gonococcal, non-chlamydial urethritis (inflammation of the urethra). In men, the Ureaplasma infection can occur and can cause nonchlamydial nongonococcal urethritis. 40%-80% of women, who are sexually active, are also affected by the Ureaplasma infection and this organism is also found in women, when they are not sexually active or in the absence of the disease itself.

How Can It Be Transferred?

Like any other form or type of bacteria, these bacteria can be passed from person to person, as well as through direct sexual contact. However, they are not considered sexually transmitted infections (STIs). As compared to other STIs, like Chlamydia and gonorrhea, Ureaplasma infection doesn’t pose a very high rate of transmission through sexual contact. Moreover, it is not considered an STI, because it can be generally found in the genital tracts of healthy individuals, as compared to STIs that always cause disease.

The Ureaplasma infection can be transferred vertically from an expecting mother to her child, either at the time of the birth, by nosocomial acquisition through transplanted tissues or in the uterus. Ureaplasma infection can occur in the reproductive tract of both men and women and it is often difficult for the medical professional to refer to them as reproductive tract pathogens as they are also found in healthy couples as well as those who are infertile.

These bacteria can lie dormant without causing any disease and showing any symptoms. In addition to that, if the cervical cultures do indicate the presence of Ureaplasma and mycoplasma, it doesn’t in any way indicate sexual misconduct or infidelity by a partner.

What Are the Symptoms?

While men can experience symptomatic prostatitis or epididymitis, women experience symptoms less frequently but they can range from dysuria to abnormal vaginal discharge. There are several symptoms of the disease or the Ureaplasma infection, which include genital discharge or experiencing excruciating burning pain while urinating. For accurate results, separate samples of the reproductive secretions of both partners should be tested for a live culture, including sperm and cervical mucus.

Please remember that it is impossible to diagnose any urethral infections form the symptoms – a test is necessary. Testing for Ureaplasma is done by PCR although cultures are also available but less reliable.

Can It Cause Infertility or Miscarriages?

When the Ureaplasma infection is present in a woman’s cervical section, it can unintentionally be transferred into the uterine cavity through the insertion of a catheter into the uterus at the time of embryo transfer or intrauterine insemination. Many researchers have pointed out that the presence of Mycoplasma and Ureaplasma can play a dominant role in the infertility and miscarriage in a small number of cases, but they have yet to prove how they are able to cause impairment to the reproductive function. Due to this reason alone, many clinics and doctors don’t commonly treat Ureaplasma or mycoplasma.

How Can It Be Treated?

There are several ways to treat Ureaplasma infection, and the most common is to take antibiotics like a tetracycline or a fluoroquinolone. If the doctor tests you and your partner, and the cervical cultures for Ureaplasma and mycoplasma are positive, then they will likely be treated with antibiotics like doxycycline. Azithromycin also works and Moxifloxacin is used as a last resort.

Bacterial Vaginosis Explained

Vaginal Bacteriosis, or more commonly referred to as Bacterial Vaginosis, is a leading vaginal infection in women of child-bearing age. Although one of the primary causes for this infection is having sexual contact with a new partner, this condition is not a Sexually Transmitted Infection (STI).

It is most commonly confused with other vaginal infections such as candidiasis and trichomoniasis. Both of these infections are caused by bacteria. On the other hand, Bacterial Vaginosis (BV) arises when there is an imbalance in the natural flora (friendly bacteria) of the vagina. The natural flora of the vagina is predominantly comprised of 95% Lactobacillus bacteria which limits the growth of unhealthy bacteria within the female genitalia.

What Are The Causes Of BV?

Although the precise cause of BV is not known, the following factors are said to contribute towards the imbalance in Lactobacilli within the vagina:

  • Having multiple sexual partners
  • Using certain hygiene products such as douche
  • Smoking

More on the causes here.

What Are The Signs And Symptoms Of BV?

Symptoms are the feelings that the patient experiences that are particular to a particular condition. In the case of BV, about 50% of the women are asymptomatic. Nonetheless, some of the common symptoms are:

  • Sensation of burning during urination
  • Itching on the labia (lips) of the vagina
  • Pain in the lower abdomen or pelvic area
  • Pain during sex
  • Smell worsens after sexual intercourse
  • Abnormal vaginal bleeding

Signs refer to the changes that the doctor or other people will notice. These include:

  • Watery and thin vaginal discharge
  • Grey or white vaginal discharge
  • Discharge has a ‘fishy’ smell

Who Is At Risk?

The following women are at a higher risk of getting Bacterial Vaginosis:

  • Women with multiple sexual partners
  • Women who frequently practice douching
  • Women who smoke

What Kinds Of Medication And Treatment Options Are Prescribed?

The diagnosis of BV is established through a pelvic exam and after analyzing a sample of vaginal discharge. These include wet mount, Whiff Test, Oligonucleotide probes and checking vaginal pH. A positive Whiff test and detection of clue cells in the vaginal discharge are confirmatory factors of BV.

Antibiotics such as Metronidazole (Flagyl), Clindamycin and Tinidazole are prescribed and may be taken orally, or ovules and creams can be used on the vagina. Pregnant ladies however, have to take medication orally. The treatment continues for 7 days.

Although these are effective treatment options, 25% women report a recurrence of the infection within the next 4 weeks.

You can find out more about treating recurrent BV at this BMJ article.

Does BV Give Rise To Any Other Complications?

BV increases the risk of:

  • Miscarriage in pregnant ladies
  • Preterm delivery
  • Infection after delivery
  • Catching a Sexually Transmitted Infection such as HIV
  • Pelvic Inflammatory Disease or endometriosis
  • Limit your sexual partners
  • Avoid douching
  • Quit smoking
  • Use condoms

How Can You Prevent BV?

It is necessary to practice good hygiene and use protection if you have a female sex partner.

With the help of the above information, you will be able to make sure that you deal with Bacterial Vaginosis effectively.

Getting Tested for Bacterial Vaginosis

As the symptoms for Bacterial Vagninosis can be similar to other diseases, it is essential that patients are tested for a variety of potential causes and also that sexually transmitted infections are ruled out. The sort of testing that should be performed should include a microscopy, culture and PCR. If you take a look at this page on website then this will give you a good overview of the testing that you should be recommending to patients.