Not everyone is familiar with ureaplasma, yet it is a very common infection—much more common than you might think. It can affect both men and women, often without causing any obvious symptoms, and its prevalence is increasing. “There is no official estimate of the sexual transmission of Ureaplasma”, explains Giulio Sozzi, a lecturer in Gynaecology and Midwifery at UniCamillus University. “It is an opportunistic pathogen of the urogenital tract, present in up to 80% of the population in some areas of the world”. In Italy, the number of cases is increasing: “Ureaplasma parvum has risen from 24% to 26%, especially in women, and Ureaplasma urealyticum from 11% to 15%”.
Ureaplasma is a tiny microorganism belonging to the Mycoplasmataceae family. As mentioned by our expert, there are two main variants: Ureaplasma urealyticum and Ureaplasma parvum. The main difference lies in their behaviour and the likelihood of causing illness.
Ureaplasma parvum is the smallest and most common type. It is often found in healthy people without causing symptoms, and can coexist peacefully with the body: it is a bit like a silent guest who sometimes comes and goes without causing any disturbance.
Ureaplasma urealyticum, on the other hand, is more often linked to infections of the urinary or genital tract. For this reason, when detected, doctors pay closer attention and, if necessary, prescribe targeted antibiotics to treat it.
Many people believe that the infection can only be contracted through sexual intercourse, but this is not actually the case. “Ureaplasma can live harmlessly in the genital mucosa until the microbiota is altered”, notes Sozzi. “At that point, the bacteria take the opportunity to proliferate and cause symptoms”. Therefore, it is possible to contract ureaplasma is not exclusively sexually transmitted, such as in cases of stress, lowered immune defences, or alterations in the vaginal microbiota. “These bacteria can survive in the genital mucosa and use urea as a source of energy”, clarifies Sozzi. “This process alters the pH of the vaginal environment, facilitating the appearance of other disorders such as candida or gardnerella—microorganisms that cause intimate infections”.
How to recognise ureaplasma symptoms in men and women
In women, ureaplasma symptoms can include burning, itching, abnormal discharge or pain during intercourse. “In some cases”, adds Sozzi, “it can cause vaginitis, endometritis or salpingitis”.
In men, however, ureaplasma can cause urethritis, prostatitis or epididymitis. “The most common signs include discharge from the urethra and a painful sensation when urinating”, remarks the gynaecologist.
However, patients do not always present symptoms. Ureaplasma can sometimes be completely asymptomatic, which makes it more difficult to detect. Should it always be treated? “Generally, yes”, replies Sozzi. “Although ureaplasma is common in both symptomatic and asymptomatic patients, it is important to carefully assess the situation. Treatment is always recommended in cases of infertility or ureaplasma during pregnancy”.
Ureaplasma in pregnancy: maternal and neonatal risks
During pregnancy, ureaplasma should be monitored carefully. “It can cause miscarriage, preterm birth or puerperal fever in the mother”, warns Sozzi. “In newborns, however, it can cause more serious complications, such as bronchopulmonary dysplasia or central nervous system infections”. If you suspect you have ureaplasma during pregnancy, it is important to have swabs taken and to always follow your gynaecologist’s instructions.
Diagnosis and treatment: clinical approach
Today, diagnosis is made through a vaginal or urethral swab, which is analysed using molecular biology techniques (PCR) or culture tests. “PCR allows for rapid diagnosis”, explains Sozzi, “but only with culture and antibiogram testing can we determine the most effective antibiotics”.
Treatment is not always the same for everyone. “Ureaplasma is showing increasing resistance to various antibiotics, such as macrolides, tetracyclines and fluoroquinolones”, emphasises Sozzi. “This is why it is essential to assess sensitivity to azithromycin, josamycin, ofloxacin and doxycycline”.
But what about the partner? “They must also be tested and, if necessary, treated. Otherwise, there is a risk of reinfection”, warns Sozzi. It is therefore important to interrupt the cycle of reinfection.
If left untreated, ureaplasma can lead to infertility in both men and women, and in some cases can trigger pelvic inflammatory disease or reactive arthritis (such as Reiter’s syndrome). “Prevention and prompt treatment are always the best choice”, reiterates Sozzi.
Can it be prevented? “The presence of the bacterium does not always mean that there is an infection”, concludes Sozzi. “However, to reduce the risk of infection, it is important to practise safe sex”. This is always good advice, as is avoiding excessive use of antibiotics that alter the microbiota and maintaining good intimate hygiene.