Ureaplasma and the Vaginal Microbiome: Symptoms, Testing, Risks and When to Treat

October 26, 2026 Pinc Wellness

By Danni Bichler, Clinical Naturopath and Founder of Alivio Health · Last reviewed: October 2026

If you've tested positive for Ureaplasma, you might be wondering whether it explains your symptoms and whether you need treatment. I see this often in my naturopathic clinic, and the answer depends on more than the positive result alone. Your symptoms, history and the rest of your vaginal microbiome all matter. Let's take a closer look!

Key takeaways

Ureaplasma is a very common bacterium, carried by an estimated 40–80% of sexually active women, often with no symptoms.
A positive test does not automatically mean you have an infection or need treatment.
Ureaplasma is not included in standard STI screens. It needs a targeted PCR swab or a vaginal microbiome test.
Research links Ureaplasma to some pregnancy complications, but the evidence is mixed and still evolving.
Treatment decisions should consider your symptoms, history and whole vaginal microbiome, not the test result alone.

What is Ureaplasma?

Ureaplasma is a group of very small bacteria belonging to a class called Mollicutes. Unlike many other bacteria, they do not have a cell wall. This matters because antibiotics that work by targeting bacterial cell walls, such as penicillins, do not work against Ureaplasma.

Ureaplasma parvum vs Ureaplasma urealyticum

The two main species found in the genital tract are Ureaplasma parvum and Ureaplasma urealyticum.

U. urealyticum is often associated with more severe infections than U. parvum, and is more likely to be found in people who have symptoms. U. parvum is generally detected more frequently in the vaginal microbiome and is more likely to clear on its own without treatment. However, I still see it causing problems for some people.

How common is Ureaplasma?

Ureaplasma is commonly carried, with studies reporting genital carriage in around 40–80% of sexually active women.¹ A positive result therefore does not automatically mean you have an infection that needs treatment.

What are the symptoms of Ureaplasma?

Many people have no symptoms at all. Others who test positive may experience:

Pain or burning when urinating
Urinary urgency or frequency
Persistent vaginal or vulval irritation
Changes in vaginal discharge, including thick white discharge
Spotting between periods or bleeding after sex
Pain during sex or ongoing pelvic pain

In my clinical experience, Ureaplasma sometimes appears in people who have been struggling with recurrent BV, thrush or urinary symptoms despite previous treatment.

Because Ureaplasma-associated symptoms overlap with many other conditions, it is very important to assess the surrounding vaginal environment. It's also worth knowing that a large Melbourne study did not find a clear link between Ureaplasma and specific genital symptoms in non-pregnant women,² which is one reason a positive result needs careful interpretation.

Is Ureaplasma always the cause?

Sometimes Ureaplasma alone is not the culprit. Instead, it is part of an overall imbalanced vaginal microbiome (I go through this further in the "Should Ureaplasma be treated?" section below). My clinical observation is that Ureaplasma deserves more attention in some complex, recurrent cases.

How do you get Ureaplasma?

Ureaplasma can be shared through sexual contact, including genital and oral contact. It can also pass from a mother to her baby during pregnancy or birth.

Does a positive result mean recent transmission?

Because carriage can persist without symptoms, a positive result cannot tell you when it was acquired or who it came from. It is not evidence of recent transmission or infidelity. In Australia, Ureaplasma is not routinely managed in the same way as established STIs such as chlamydia or gonorrhoea.

Could Ureaplasma affect fertility and pregnancy?

Studies have investigated associations between Ureaplasma and:

Spontaneous preterm labour and birth
Preterm prelabour rupture of membranes (when the waters break before 37 weeks and before labour begins)
Inflammation or infection of the membranes and amniotic fluid, known as chorioamnionitis
Low birth weight
Pregnancy loss, including miscarriage
Stillbirth or other perinatal losses

A 2022 systematic review found associations between Ureaplasma and several of these outcomes, but concluded the current evidence is not strong enough to say Ureaplasma causes them.³ Research on female infertility is similarly mixed, with some reviews finding a link with U. urealyticum and others not.^4,5 Changes in sperm health have also been studied.

If you are pregnant, trying to conceive or experiencing urinary or genital symptoms, your results should be assessed alongside your symptoms, medical history and broader microbiome, with a practitioner or fertility team involved where appropriate.

Should Ureaplasma be treated?

Context is everything. A positive test alone does not establish that Ureaplasma is responsible for your symptoms.

That does not make persistent symptoms unimportant. It means we need to investigate them carefully.

Questions I consider in clinic

What symptoms are present and when did they begin?
Have BV, Candida, UTIs and established STIs been appropriately assessed?
What does the rest of the vaginal microbiome look like?
Which protective Lactobacillus species are present, and how much?
Is there clinical evidence of inflammation?
What treatments have already been used, and did symptoms improve?
Could skin irritation, hormonal changes, pelvic floor tension or vulvodynia be contributing?
Is pregnancy, fertility treatment or a significant obstetric history relevant?

Some people report substantial improvement after treatment directed at Ureaplasma. Others have taken multiple antibiotic courses without their symptoms resolving. Both experiences reinforce the need to assess the whole clinical picture.

How is Ureaplasma tested?

Ureaplasma is often not included in routine vaginal swabs, urine cultures or standard STI screens. Your GP may not recommend testing, because current guidelines, including the European STI Guidelines position statement, do not support routine Ureaplasma screening.⁶ Private testing is available when appropriate.

Ureaplasma testing for women

In women, Ureaplasma can be detected through a targeted vaginal PCR swab or a broader vaginal microbiome test. I prefer microbiome testing for complex or recurrent symptoms because it also shows the protective and potentially disruptive bacteria present.

Ureaplasma testing for men

For men, testing may involve a first-catch urine sample or a specific semen test for Ureaplasma.

What does Ureaplasma treatment involve?

Medical treatment

The first-line medical approach is a specific antibiotic protocol prescribed by your doctor.

Naturopathic support for the vaginal microbiome

As a naturopath, I work alongside medical treatment to support the broader vaginal microbiome. Where indicated, this can include individualised intravaginal prescriptions, herbal treatments, probiotics and prebiotics. It also includes addressing coexisting imbalances and supporting the vaginal environment during and after antibiotics, particularly for people prone to recurrent BV or thrush.

Should my partner be treated?

If you have an ongoing sexual partner, treating you both at the same time may be appropriate to reduce the risk of re-exposure, depending on your individual circumstances.

Ureaplasma FAQs

Is Ureaplasma an STI?

Ureaplasma can be passed on through sexual contact, but it is not managed as an established STI in Australia like chlamydia or gonorrhoea. It is commonly carried without symptoms, so it is often considered part of the genital microbiome rather than a classic STI.

Can Ureaplasma go away on its own?

Yes, it can. Ureaplasma parvum in particular often clears without treatment. Whether treatment is needed depends on your symptoms, test results and wider vaginal microbiome.

Does Ureaplasma cause BV?

Research has not shown that Ureaplasma causes BV. However, it can be present alongside BV, thrush or other imbalances, which is why it is important to look at the whole vaginal microbiome when symptoms keep coming back.

Can my partner reinfect me with Ureaplasma?

It is possible to be re-exposed through sexual contact with an ongoing partner. If you are being treated, your practitioner may suggest treating your partner at the same time.

Should I be tested for Ureaplasma during pregnancy?

Routine testing in pregnancy is not currently recommended. If you are pregnant and have symptoms, a previous positive result or a history of pregnancy complications, talk with your doctor or obstetric team about whether testing is appropriate for you.

Can men have Ureaplasma?

Yes. Men can carry Ureaplasma, often without symptoms. It can be detected through a first-catch urine test or a semen test.

Need help understanding your Ureaplasma results?

If Ureaplasma has appeared on your results, or you're struggling with recurrent vaginal infections or urinary symptoms, I can help you make sense of what's happening and develop a plan tailored to you.

I'm Danni, a clinical naturopath and founder of Alivio Health. I offer online consultations that look at your symptoms, history and vaginal microbiome to guide treatment and support lasting improvements in your vaginal health.

A special offer for Pinc Wellness readers

Receive $50 off your initial consultation with the code PINC50, available to the first 6 clients who use it.

Book your consultation here , or email hello@aliviohealth.com.au if you have any questions.

About the author

Danni Bichler is a clinical naturopath and the founder of Alivio Health, specialising in vaginal microbiome health, recurrent BV and thrush, and urinary symptoms.

References

Waites KB, Katz B, Schelonka RL. Mycoplasmas and ureaplasmas as neonatal pathogens. Clinical Microbiology Reviews. 2005;18(4):757–789. Read the review
Plummer EL, Vodstrcil LA, Bodiyabadu K, et al. Are Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum associated with specific genital symptoms and clinical signs in nonpregnant women? Clinical Infectious Diseases. 2021;73(4):659–668. Read the study
Jonduo ME, Vallely LM, Wand H, et al. Adverse pregnancy and birth outcomes associated with Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum: a systematic review and meta-analysis. BMJ Open. 2022;12(8):e062990 (corrected 2023). Read the review
Ma C, Du J, Dou Y, et al. The associations of genital mycoplasmas with female infertility and adverse pregnancy outcomes: a systematic review and meta-analysis. Reproductive Sciences. 2021;28(11):3013–3031. Read the abstract
Tantengco OAG, de Castro Silva M, Velayo CL. The role of genital mycoplasma infection in female infertility: a systematic review and meta-analysis. American Journal of Reproductive Immunology. 2021;85(6).
Horner P, Donders G, Cusini M, et al. Should we be testing for urogenital Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum in men and women? A position statement from the European STI Guidelines Editorial Board. JEADV. 2018. Read the statement
Australian STI Management Guidelines for Use in Primary Care. ASHM. sti.guidelines.org.au

This article is for general educational purposes only and is not a substitute for personalised medical advice. Please speak with your GP, specialist or qualified practitioner about your individual situation, especially if you are pregnant or trying to conceive.