Mycoplasma genitalium oral sex

[Mot3]

After looking Online for info about m gen there is a lot of conflicting information. Almost every std site and government info site says the m gen can be acquired though oral sex. However, if you read the scientific literature, it says that the have not been able to detect it in the throat of people. Most notably sex workers and men who have sex with men. I have also read on the expert forum on this website and in 2014 Dr Hunter Mansfiled has also said that oral transmission is not possible and has never been documented. Why would all the other websites say this. Is it just to scare people into practising safe sex or have I missed something.
Link to Dr hunter Mansfield post http://www.medhelp.org/posts/STDs/Mycoplasma-genitalium-transmission--partner-disclosure/show/2206930

[Mot3]

Thank you for your help. Please can you answer just one last question.
I was mostly worried about M Gen seeing that all other std were ruled out. Is there any concern regarding other causes of ngu from oral sex with regard to having vaginal sex with my wife. She has also been treated with 7 days doxycyline and has no symptoms. .
Thanks you

[HowardH]

STD management guidelines in the UK (e.g. BASHH and/or the NHS GUM clinics) tend to be very similar to CDC's.

NGU symptoms typically start to improve in a couple of days of starting treatment and should be pretty much gone by 7-10 days, although sometimes as long as 2 weeks til the last minor drip or twinge.

If you're getting care at a GUM clinic or a dedicated sexual health clinic (e.g. London's Freedom Health or similar), you can be confident you are getting truly expert care. If so, follow their advice, or consider asking your doc to refer you to such an expert resource if you think your NGU doesn't clear completely.

That will have to be my last comment. Best wishes.

[Mot3]

I'm in the uk so cdc guidelines don't apply here. Should the doxycyline have cleared the ngu by now or do the symptoms gradually fade away over a couple of weeks ?
Thanks

[HowardH]

CDC treatment guidelines suggest a specific sequence for NGU that doesn't respond to treatment:  Initial NGU should be treated with either azithromycin (single dose) or doxycycline 7 days; if it persists (by professional exam, not just symptoms), give the alternat drug, i.e. azithro or doxy, whichever wasn't used first, PLUS metronidazole to cover trichomonas; and if still persists, try moxifloxacin, generally considered the best drug against M genitalium. Specific testing for M gen is not recommended, because approved testing is not widely available.

The CDC recommendations do not distinguish NGU acquired by genital versus oral sex. For oral, it probably is reasonable to go through the same sequence, but there is less confidence it would work, because neither trich nor M gen is known to be acquired by oral sex. OTOH, these drugs have activity against a wide range of other bacteria (probably including most oral bacteria), so it is still a reasonable sequence to try.

See your doctor to confirm you still have active urethritis. (Urinary discomfort without visible discharge usually doesn't count.) If so, remind him or her of the CDC recommendations. (They can be confirmed on line at www.cdc.gov/std. The current guidelines are dated 2010, but no change is expected in new 2015 guidelines that probably will be released in the next month or two.)

[Mot3]

My symptoms have not cleared up yet. I took a 7 day course of doxycyline that I finished on Sunday. It's niw Tuesday and I still have symptoms. Should they have cleared up by now? If not, how long does it take for them to clear.
Thanks

[HowardH]

In fact, a common theory among researchers is that NGU from oral sex may not be an infection at all in the usual sense -- i.e. not caused by any perticular germ. Instead, it may just be the body's reaction to exposure to a bunch of new bacteria that it isn't used to. Some researchers believe this is why NGU after oral sex seems to be common in peoplpe in new or non-monogamous relationships, but rare after oral sex by a spouse or other regular partner. In regular partnerships, the men's urethras have long since adapted to their partners' oral bacteria.  Whatever the reasons, no research has ever found a serious complication from NGU not caused by chlamydia or M genitalium, either in infected men or their female sex partners. If your symptoms have cleared up, you can safely go forward on the assumption you don't have anything to worry about.

[HowardH]

You had an accurate reply in a previous thread. M genitalium is not known to be transmitted by oral sex.

The "scientific literature" you quote undoubtedly is more reliable than non-scientific sources of information, and I doubt there are any scientifically reliable sites -- government (e.g. CDC or otherwise) -- that say M genitalium can be acquired by oral sex. Dr. Handsfield's statement looks accurate to me. Nobody tries to "scare people into practising safe sex". The fact is that there are lots of things not known about many STDs, which in turn leads to wild guesses, assumptions, etc, even by usually knowledgeable resources.

The cause of over 90% of NGU from oral sex is entirely unknown. The best bet is that normal oral bacteria are often the cause. In any case, is is generally believed to be harmless, both for infected men and their sex partners. And you were treated and your symptoms cleared up. So what's the big deal now?  It's time to let this go.