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Ureaplasma or not?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Ureaplasma or not?

I've been with my current partner for more than a year, we're monogamous and we've used condoms every time we've had sex.  We were both tested at the begining of our relationship and we both came back negative for infections including ureaplasma, but for the last 6 months I've had abnormal vaginal discharge, itching, swelling and pain.  In that time I've had yeast infections and bacterial vaginosis which have been treated.  Even after retesting and making sure the infections are gone, some the symptoms, like itching and discharge, remain.  I've been tested for STD's and other infections but the only thing that came back last time was ureaplasma.  

Is it possible that ureaplasma would cause any or all of these problems I'm having?  I've read about ureaplasma and it seems very benign, so I'm wondering if the test panels I've had done aren't catching something.  What should I be screened for and how can I make this my last pelvic exam for a while?

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Welcome to the STD forum.  I'll try to help, but I can't come up with any clear answer for you -- exept that Ureaplasma is probalby not the cause of your symptoms.

Recurrent, unexplained vaginal discharge can be a very frustrating problem both for the patient and her health care provider(s).  Often a specific cause cannot be found, and it is possible that some cases are due to bacteria that have not yet even been discovered.  Most cases are probably not due to any STD.

The presence of prominent itching, swelling (of the labia, I assume), and pain often suggests a yeast infection.  Usually yeast can be diagnosed easily without special tests, but sometimes requires a culture to make sure that unusual types of yeast are not present.  That's one thing you can ask your doctor or clinic about.  These symptoms also could be caused by trichomonas.  That too is often easily diagnosed just by looking at vaginal fluid under a microscope, but sometimes not; if you have not had a culture or PCR test for trich, ask your doctor about that as well.  (Trich is an STD; if you have it, your partner will also require treatment.)

Recurrent herpes could cause these symptoms, but not if they are more or less continuous.  But if you're having periods of discharge, pain, and labial swelling for something like 1-2 weeks at a time, then no problem for several weeks, then recurrent herpes might be possible -- especially if examination shows open sores or ulcers.  I think this is very unlikely, but worth discussing with your doctor or clinic.

Having ureaplasma in the genital tract is entirely normal; at any point in time it is present in at least 50% of sexually active persons, and probably all of us have it at one time or another.  Its importance is debated by STD specialists, but the weight of evidence it that it generally causes no symptoms and we never test for it in my STD clinic.  Some types of ureaplasma cause some cases of nonconococcal urethritis (NGU) in men, but it has never been shown to cause any health problem in women.  

So talk to your doctor about yeast and trich.  Even if testing isn't done, treatment could be tried to see if your symptoms improve -- both are very easy, with single dose treatment available for either infection.  But it would be best to have tests for them if not yet done.  However, I'm afraid there is a good chance these things won't help; as I said above, some cases are just unexplained.  If the problem continues, ask your doctor or clinic to refer you to an ObG who also specializes in infectious diseases.

Good luck--  HHH, MD
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H. Hunter Handsfield, M.D.Blank
University of Washington
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