It started like a thousand other things do in women’s health: with a vague burning sensation and a doctor telling me everything looked “normal.”
Not a UTI, not yeast, not bacterial vaginosis (also known as BV). I was “healthy”—supposedly. Except I wasn’t. I was peeing 15 times a day, wincing through sex, and googling words I didn’t know how to pronounce while clutching my heating pad. I had done everything right: peeing after sex, chugging water, drinking cranberry juice, and popping Azo. And, still, it felt like an elephant had taken up residence on my bladder. At 3 a.m., unable to get any real sleep, I doomscrolled the internet. It was as if social media had read my mind or looked inside my body when it offered up a word I’d never seen before: Ureaplasma.
Medical terms rarely stop the scroll for me. My idea of clickbait is an A-list breakup rumor or “the strappy sandal that turned everyone’s head at Fashion Week.” But once I saw Ureaplasma, it imprinted on me. The word started showing up everywhere, like an ex-boyfriend in a small town you can’t seem to escape.
I found it in Reddit forums full of women comparing chronic pain, in online medical journals, in TikTok comments that read like a collective scream. Ureaplasma isn’t technically an STI, but it can be sexually transmitted. It’s not considered harmful—until it is. And most maddeningly, many doctors won’t even test for it. Cool.
I returned to my doctor two weeks later, symptoms more or less the same, and demanded a full PCR panel, the kind they don’t offer unless you know to ask for it. And there it was: Ureaplasma parvum, brazenly thriving. I brought the results to another doctor, who dismissed me, adding, “That’s normal commensal flora that exists in the human genital tract. It probably doesn’t mean anything.” I asked if it could be causing my symptoms. She said “maybe.” I asked if I should treat it. She said “maybe.” I asked if I could give it back to my partner. She said “maybe.”
There is no worse answer in medicine than maybe, especially when your body is begging for answers.
Thankfully—and I’ll spare that rant for another time—I have access to top-tier care. I’m not limited to whichever in-network provider my insurance assigns me. And yes, I fully recognize that’s a privilege, which is precisely why I’m writing this in the first place.
That access led me to two experts: Angelish Kumar, a board-certified urologist, and pelvic pain specialist Sonia Bahlani. Both had previously appeared on my podcast, Going Mental, so I knew they were willing to talk frankly.
Kumar explained that “Ureaplasma and Mycoplasma are extremely tiny bacteria that live in the genitourinary tracts of both men and women. For many people, they simply exist in harmony with other microbes, colonizing without causing infection or inflammation.” But in others, she noted, they can trigger pain—it’s frustratingly different from person to person.
I asked whether these bacteria were considered sexually transmitted infections. “Technically, yes,” she said. “They are transmitted through sexual contact, and so if the decision is made to treat the bacteria, the sexual partner should also be treated.”
Which naturally begs the question: If Ureaplasma and Mycoplasma are sexually transmitted and can cause symptoms, why aren’t they routinely tested for, especially by ob-gyns, urologists, and primary care doctors?
Kumar broke it down: “Because these bacteria can exist without causing any problems or symptoms in many people. So testing would really be indicated in women who have symptoms, such as vaginal discharge or pelvic pain.”
Even then, the decision to treat isn’t always straightforward. Bahlani emphasized a more conservative approach: “If someone has no symptoms, I typically don’t recommend testing or treatment,” she said. “Treating colonization can lead to unnecessary antibiotics, resistance, and patient anxiety. Testing makes sense when there are ongoing pelvic or urinary symptoms that don’t have another clear cause.”
Kumar sees it all the time: women being treated for Ureaplasma based on inconclusive or partial lab results, only to find that the true culprit was something else entirely. “They get doxycycline for the Ureaplasma but still have symptoms,” she said. “And it turns out it’s really a persistent E. coli UTI causing their symptoms, not the Ureaplasma.”
The broader issue, and the one that makes this so frustrating, is how often women end up in diagnostic limbo, especially when their symptoms don’t match a textbook case.
“The way infections manifest in individual people can vary based on that person’s genetics, immune system, microbiome, diet, lifestyle, and environment,” Kumar told me. “When we treat patients, we are not just treating a lab result, we are treating an individual person. This is why medicine is both art and science.”
Bahlani put it more bluntly. “Medicine is built around clear yes/no diagnoses, but many pelvic pain conditions live in the gray. When something doesn’t fit neatly into a box, patients often get dismissed. Ureaplasma is just one example of how our health-care system struggles with nuance.”
She added that this isn’t just about one bacterium—it reflects a broader pattern: “It highlights how women’s symptoms are often minimized when tests come back ‘normal.’ If the bacteria isn’t routinely screened for, patients may be told nothing is wrong, even when they’re suffering.”
In a medical culture obsessed with binaries—positive or negative, clean or infected—Ureaplasma is a nightmare. I know because I had an undiagnosed infection for four months. It’s the guy who “doesn’t believe in relationships” but still sleeps in your bed five nights a week.
In my case, I was treated with antibiotics. The symptoms improved but didn’t fully go away. Not until my partner was treated too. He had never been tested. No symptoms. “I feel fine,” he said. But for me, not feeling fine had become a full-time job.
What’s most frustrating is that this is the norm: Countless people with chronic pelvic or urinary pain find themselves stuck in the perpetual hell of partial diagnoses, ambiguous lab results, and vague treatment plans.
And when something doesn’t show up on the standard panels, it often doesn’t get a second glance. Instead of a clear path to care, we have to take matters into our own hands and become our own microbiologists and armchair experts.
So the next time you feel that burning sensation and order meds from a direct-to-consumer prescription service, talk to your doctor. Ask about Ureaplasma and Mycoplasma: the bacteria no one’s testing for, but too many of us are living with.