Understanding Ureaplasma: Symptoms, Testing, and Treatment Options

Ureaplasma is a tiny strain of bacteria that lives in your urinary and genital tracts. There are two main Ureaplasma species: Ureaplasma urealyticum and Ureaplasma parvum. Of the two, Ureaplasma parvum is the more commonly detected species in the vaginal microbiome — though both are still being studied, and much remains unknown about how each behaves. 

Like its more senior relative, Mycoplasma, Ureaplasma is a type of bacteria known as a Mollicute, characterized by the absence of a cell wall. This means it's pretty hard to study and diagnose Ureaplasma.  

Ureaplasma is a common member of the vaginal microbiome, found in 40-80% of non-symptomatic vaginal microbiomes. It doesn't usually cause symptoms, but some research has linked it to some reproductive health complications. Just like Candida (the fungus behind yeast infections) and Gardnerella (the bacteria most commonly linked to bacterial vaginosis), Ureaplasma can exist in your vaginal flora in small doses without causing symptoms or issues. 

That said, researchers are constantly learning more about Ureaplasma, but it’s still pretty misunderstood. Research on female health is sorely lacking — let alone research on Ureaplasma — and remember that just because something is under-researched doesn't mean it's disproven or not real.  

Many women (including in the Evvy community) feel like a Ureaplasma infection is at the root of their symptoms, and those experiences are entirely valid. We know it can be very frustrating to deal with non-stop symptoms only to be told: "nothing is wrong with you." That's why there needs to be a comprehensive understanding of Ureaplasma's role in vaginal and reproductive health.

To help you understand it, we summarized the available (and admittedly limited) scientific literature on Ureaplasma, including what it could mean for your sexual health. And if you're experiencing symptoms and want to know whether Ureaplasma parvum or urealyticum is present, Evvy's at-home Vaginal Health Test can detect both species as part of a full picture of your vaginal microbiome.

Key takeaways

• Ureaplasma parvum and Ureaplasma urealyticum belong to the Mollicutes class of bacteria, defined by the absence of a cell wall.
• U. parvum is the more prevalent of the two species, detected in the vaginal microbiomes of people with no symptoms at all. Its presence alone is not a cause for concern.
• Most people have no symptoms, and when symptoms do occur, they can include unusual vaginal discharge, a burning sensation when peeing, pelvic pain, and vaginal irritation — all of which overlap with other vaginal infections like BV or UTIs.
• Current clinical guidelines only recommend treating Ureaplasma parvum when symptoms persist after other causes have been ruled out, or when it's detected alongside other disruptive pathogens.
• Context is everything. A positive U. parvum result is most meaningful when interpreted alongside the full picture of your vaginal microbiome, including what other bacteria are present and at what levels.
• Evvy's Vaginal Health Test with the Expanded PCR Panel can detect Ureaplasma parvum, differentiate it from U. urealyticum, and provide a comprehensive view of your vaginal microbiome, with results in 1 to 3 days.

What is Ureaplasma parvum?

Ureaplasma parvum is one of two Ureaplasma species, and it's the one most commonly found in the urinary and reproductive tracts. Despite how often it turns up in testing, it remains one of the least understood members of the vaginal microbiome.

Ureaplasma parvum is considered a commensal bacterium, meaning it can live in the body without causing harm. It's been detected in the vaginal microbiomes of people with no symptoms at all, which is why its presence alone isn't automatically a red flag. That said, researchers are still working to understand what tips Ureaplasma parvum from harmless passenger to potential contributor to symptoms — and whether it behaves differently from its sister species, U. urealyticum.

Ureaplasma parvum vs Ureaplasma urealyticum

Ureaplasma parvum and Ureaplasma urealyticum are closely related, but they're not the same, and emerging research suggests they may behave quite differently in the body.

Ureaplasma parvum is smaller (the name parvum means "small" in Latin) and is the more common of the two species. Studies suggest it's found at higher rates in people without symptoms, which is one reason it's generally considered the more commensal of the two. U. urealyticum has been more consistently studied in relation to clinical conditions such as urethritis, though research in female patients specifically remains inconclusive.

Some research suggests that U. urealyticum may be more likely to trigger an inflammatory response, while U. parvum tends to coexist more quietly with the rest of the vaginal microbiome. However, both species can be present simultaneously, and standard testing doesn't always distinguish between them, making it harder for researchers (and patients) to draw clear conclusions.

This is where polymerase chain reaction (PCR) testing has an advantage. Unlike culture-based methods, PCR can identify and differentiate between Ureaplasma parvum and Ureaplasma urealyticum in the same sample. Knowing which species is present (and at what levels) can help you and your provider make more informed decisions, especially if you're dealing with persistent or unexplained symptoms.

What causes Ureaplasma?

Good question. Experts aren’t fully clued into the causes of Ureaplasma. Research shows that it can be passed during unprotected sex, but it’s not considered a sexually transmitted infection (STI). 

One study found that Ureaplasma was more common in women who had multiple sexual partners, but other research found it in women who had never been sexually active. 

Ureaplasma symptoms 

Ureaplasma is usually harmless when living in balance with other bacteria in the body because your immune system and vaginal microbiome typically keep it in check. However, Ureaplasma bacteria can become problematic when they’re present alongside other harmful pathogens.

Research suggests that Ureaplasma can follow the crowd. If it’s alongside disruptive bacteria (such as Gardnerella, Prevotella, and E.coli), it may act disruptively. 

Ureaplasma is considered an indicator species. That means that if high amounts of Ureaplasma are present in the vaginal microbiome, it’s likely that other disruptive, symptom-causing bacteria are there as well. Because of this, it’s difficult for researchers to substantially prove that Ureaplasma is the sole cause of symptoms.

This also means that the symptoms associated with a Ureaplasma infection often overlap with those of other vaginal infections. Things to look out for include:

• Abnormal vaginal discharge
• Painful urination
• Lower abdominal discomfort or pelvic pain
• Vaginal irritation or itching.

These symptoms aren't specific to Ureaplasma parvum. They could point to BV, a yeast infection, a UTI, or another vaginal microbiome imbalance. That's why symptoms alone can't tell you what's going on, and testing is the only way to know for sure whether U. parvum is present and whether it might be contributing to how you're feeling.

Can Ureaplasma cause complications? 

Ureaplasma is a common bacterium that is usually harmless for most women. However, some recent studies have suggested that it might be linked to certain more severe health conditions. 

It's important to note that most of this research is correlational, meaning it has yet to establish a direct cause-and-effect link between Ureaplasma infections and reproductive health complications. But it might be a vital piece of the puzzle when it comes to understanding the role of Ureaplasma in female sexual health. 

UTIs

In recent years, there has been debate about the role of the Ureaplasma species U. urealyticum in urinary tract infections. However, to this day, research hasn’t demonstrated a definitive link between the two. According to some studies, treating conditions such as urethritis, cystitis, and upper renal tract infections in women not only improves the protective state of the vaginal microbiome but can also eliminate Ureaplasma.

Preterm birth

Ureaplasma has been found in higher numbers among people who have experienced pregnancy issues such as preterm birth. While we're not sure of its exact role in pregnancy complications just yet, current research suggests that Ureaplasma is unlikely to be the direct cause of premature birth. Scientists are investigating whether Ureaplasma might be a passive bystander or an indicator of a broader underlying condition, such as bacterial vaginosis (BV), which is linked to adverse pregnancy outcomes.

Fertility issues 

Some studies suggest a possible link between Ureaplasma and infertility. However, it's not entirely clear whether Ureaplasma directly causes infertility. One study did find that women with unexplained infertility tend to have U. urealyticum more often and suggested they should be tested for a Ureaplasma infection, but no definitive connection between the two has been established yet.

Cervicitis 

Like preterm birth and urinary tract symptoms, we don’t have conclusive research to prove Ureaplasma’s role in cervicitis (inflammation of the cervix). Both cervicitis and higher levels of U. urealyticum are often found in women who have a high number of sexual partners. That said, it's unclear whether a Ureaplasma infection causes cervicitis or whether other factors contribute to its development, with Ureaplasma simply present.

BV

Although Ureaplasma is often found alongside BV-associated microbes, research suggests it’s less correlated with BV than Mycoplasma.

How to test for Ureaplasma at home and at the clinic

Ureaplasma isn’t on most routine STI panels, but you can test for it at home with Evvy’s Vaginal Health Test, or in clinic with your healthcare provider. 

A Ureaplasma test involves collecting a swab sample from your vagina, uterine lining, or urethra, or providing a urine sample. There's usually no need to worry about getting tested for Ureaplasma unless you're experiencing symptoms or if treatments for other bacterial infections haven't been effective. Testing for Ureaplasma is typically a process of elimination rather than the first course of action.

However, it can be helpful to get a complete picture of all the different types of bacteria and fungi in your vaginal microbiota. By doing so, you and your doctor can determine whether Ureaplasma coexists with harmful pathogens like Gardnerella or protective bacteria like Lactobacillus, which could be influencing its ability to cause symptoms.

How the Evvy at-home test works for Ureaplasma

With the Evvy Vaginal Health Test, you can easily get an insight into the microbial makeup of your vagina. Our results provide information on each bacterial species, including whether it is beneficial or disruptive, along with relevant research and appropriate treatments. This way, you can chat with your doctor and develop a care plan that works best for your body, unique microbiome, and specific needs.

Research has shown that Mollicutes (such as Ureaplasma and Mycoplasma) are often present in the vaginal microbiome at very low levels. If you are interested in testing for Mollicutes, make sure to add our Expanded PCR Panel to your Vaginal Health Test, which is designed to detect these bacteria at lower levels. 

Testing for Ureaplasma with Evvy couldn’t be simpler: 

1. Order an Evvy Vaginal Health Test (make sure to add the Expanded PCR Panel).
2. Collect your vaginal swab sample at home (follow the kit guide).
3. Mail the prepaid test kit to the lab.
4. Get digital results in a few days.
5. Review your report for Ureaplasma/Mycoplasma detection, vaginal microbiome insights, and next-step guidance. 

Ureaplasma spp. NAA

A Ureaplasma spp. nucleic amplification (NAA) test (also called NAAT) is a highly sensitive molecular diagnostic tool used to detect the genetic material (DNA or RNA) of microorganisms, including Ureaplasma species.

NAATs are a useful way to detect Ureaplasma in clinical samples, often from the genitourinary tract. This can include samples from urine, cervical swabs, vaginal swabs, or urethral swabs. Ureaplasma can be tricky to culture because it doesn't have a cell wall and needs specific conditions to grow. That's why NAAT is such a great option — it skips the culture step and goes straight to detecting the organism's genetic material.

The process is pretty straightforward. First, a sample is collected, then the nucleic acids are extracted. Next, the target DNA or RNA is amplified using techniques like PCR. Finally, the amplified products are detected to confirm the presence of Ureaplasma.

NAATs are incredibly effective for detecting very small amounts of genetic material. The only downside is that it detects only the organisms targeted by the test, so you must know what you're looking for.

NAATs aren't generally used to analyze vaginal bacteria because they can't provide information on other microorganisms in the sample or the broader microbiome.

That's why Evvy's Vaginal Health Test uses a combination of metagenomics and PCR. Evvy's vaginal microbiome test detects all microorganisms present in a sample, including unknown or unexpected pathogens, providing insights into the overall microbial community in your vagina.

Ureaplasma is a normal (and generally harmless) part of the vaginal microbiome. Having Ureaplasma present on its own isn't something to worry about. 

That said, Ureaplasma is considered an indicator species, so it's helpful to get a full picture and know whether high amounts of Ureaplasma are accompanied by other disruptive, symptom-causing bacteria. 

How long do results take and how accurate are they?

Evvy’s Vaginal Health Test uses advanced PCR technology to help you easily detect Ureaplasma. PCR is a highly accurate and sensitive method for detecting Ureaplasma, even at very low levels, with reported sensitivities and specificities often above 90%. It’s also better at finding Ureaplasma than traditional culture methods. 

One of the best things about PCR is that it gives you faster test results and can even identify different species (like U. parvum and U. urealyticum) at the same time. Plus, it works well even if your sample has other bacteria that might interfere with culture tests. This is especially helpful because Ureaplasma is a commensal bacterium that tends to hang around other disruptive species. With our Expanded PCR Panel, you’ll receive your preliminary results in as little as one to three days. 

What does a positive Ureaplasma parvum test mean?

A positive Ureaplasma parvum test can feel alarming, but it doesn't automatically mean something is wrong.

Ureaplasma parvum is one of the most common inhabitants of the vaginal microbiome, detected in healthy people without symptoms. A positive result simply means the bacteria are present in your urogenital tract. On its own, that's not a diagnosis, and it doesn't necessarily require treatment.

What matters most is context. A positive Ureaplasma parvum test result is most meaningful when it's interpreted alongside the rest of your vaginal microbiome. If U. parvum is present in high amounts alongside other disruptive bacteria — such as Gardnerella or Prevotella — it may indicate that your microbiome is out of balance. If it's present alongside healthy, protective Lactobacillus bacteria, it's far less likely to be contributing to your symptoms.

This is why a comprehensive test is more useful than a simple positive/negative result. Knowing that you have Ureaplasma parvum is one piece of information. Knowing what else is present in your vaginal microbiome is what gives you and your provider something to actually work with.

Current clinical guidelines don't recommend treating Ureaplasma parvum based on a positive test result alone. Treatment is typically only considered when symptoms persist after other causes have been ruled out, or when U. parvum is detected alongside other pathogens.

How to treat Ureaplasma 

Ureaplasma treatment guidelines are pretty much nonexistent — surprise, surprise. There is currently no universal clinical guidance on treating Ureaplasma, and any treatment plan should be determined on an individual basis.

Current clinical guidelines recommend treating Ureaplasma infections only when other pathogens are present or when other infections and conditions have been ruled out, and symptoms persist. That said, many members of the vaginal health community feel that Ureaplasma was the cause of their symptoms and that treating Ureaplasma helped resolve their symptoms. 

Evvy’s vaginal microbiome test can help people and their doctors identify all microbes that may be related to symptoms, but much more research is needed to understand whether, how, or why treating Ureaplasma could improve vaginal health.

If your doctor prescribes treatment for a Ureaplasma infection, it will involve a course of antibiotics — but there's a caveat. Most antibiotics attack a bacterium's cell wall, but Ureaplasma has no cell wall. This means only certain antibiotics, called macrolides (like azithromycin), can effectively treat Ureaplasma. 

If I have Ureaplasma, does my partner need to be treated?

More research is needed to determine whether partner testing and treatment are necessary for Ureaplasma. At this time, partner treatment is only recommended for STIs, but there’s no data showing it's helpful for bacterial infections or Ureaplasma. That said, the bacteria can be transmitted via sexual contact, so if you were experiencing symptoms, you might prefer that your partner receive treatment, too — just to be safe rather than sorry. It’s really important, however, that you discuss this with your healthcare provider. 

FAQs about Ureaplasma

Is Ureaplasma spp an STD?

Although it can be transmitted during sexual intercourse, neither Ureaplasma urealyticum nor Ureaplasma parvum is considered a sexually transmitted disease (STD). Research shows that even people who aren't sexually active can have Ureaplasma bacteria present in their bodies.

Is Ureaplasma the same as UTI?

No, Ureaplasma is not the same as a urinary tract infection (UTI), though they can sometimes be related. Ureaplasma refers to a type of bacterium that is part of the Mollicute family. It is commonly found in the genital or urinary tract of healthy women, but some research has linked it to issues like urethritis, pelvic inflammatory disease (PID), or complications in pregnancy (note: it's unclear whether this link is causal or just a correlation). Ureaplasma is typically transmitted through sexual activity, although it can also naturally exist without causing symptoms. A UTI, on the other hand, is an infection of the urinary tract, most commonly caused by bacteria like Escherichia coli (E. coli). UTIs typically affect the bladder (cystitis) but can also impact the kidneys (pyelonephritis) or the urethra. While Ureaplasma infections and UTIs are different, Ureaplasma can occasionally cause urinary symptoms that feel a lot like a UTI, such as a burning sensation when you pee or some pelvic discomfort. Getting the proper diagnosis through lab tests is really important for figuring out what's going on and finding the best way to treat it.

Is Ureaplasma a big deal?

While some research links Ureaplasma to other health conditions, such as UTIs, premature birth, fertility issues, and cervicitis, it’s unclear whether having Ureaplasma in one's genital tract is cause for concern. Ureaplasma is generally harmless for most people and never causes symptoms or complications.  

What does it mean if you have Ureaplasma?

Ureaplasma is very common, and more than half of women have the bacteria in their urogenital tract. Unless a Ureaplasma infection is the sole cause of unpleasant symptoms, you don’t need to worry about it! 

How long can Ureaplasma go undetected?

Ureaplasma is mostly asymptomatic, so you might not know you have it. But unlike undiagnosed STIs or other vaginal infections, having Ureaplasma isn’t necessarily cause for concern.

Can I test for Ureaplasma at home?

Yes, you can test for Ureaplasma at home with comprehensive vaginal health tests like Evvy’s Vaginal Health Test and Expanded PCR Panel. This test uses advanced metagenomic sequencing and PCR technology to analyze your vaginal microbiome and detect microbes such as Ureaplasma that may not be included in standard clinical panels. Many traditional doctors’ offices don’t routinely screen for Ureaplasma unless there are persistent or severe symptoms, so an at-home option can be helpful if you’re experiencing discomfort, recurrent infections, or simply want to understand your microbiome better. After testing, you can share your results with your healthcare provider to discuss personalized next steps, such as treatment or ongoing monitoring.

Can I test for Ureaplasma parvum at home?

Yes — Evvy's at-home Vaginal Health Test with the Expanded PCR Panel can detect Ureaplasma parvum and differentiate it from Ureaplasma urealyticum. Standard STI panels don't include Ureaplasma, so if you're experiencing symptoms and want answers, an at-home test is a great place to start. You'll get results in one to three days, plus guidance on next steps.

How do you get rid of Ureaplasma parvum?

Most people don't need to "get rid of" Ureaplasma parvum. It's a normal part of the vaginal microbiome and doesn't always cause problems or require treatment. If your doctor recommends treatment based on your symptoms and test results, it will typically involve a course of macrolide antibiotics such as azithromycin. Because U. parvum lacks a cell wall, standard antibiotics won't work against it, so it's important not to self-treat.

Why don’t doctors test for Ureaplasma?

Many doctors don’t routinely test for Ureaplasma because it’s considered a “commensal” microbe, meaning it often lives in the vagina without causing symptoms. Clinical guidelines typically recommend testing only if you’re experiencing chronic symptoms, such as recurrent infections. However, research is revealing more about Ureaplasma's role in disrupting the vaginal microbiome, which is why proactive testing, like Evvy’s Vaginal Health Test, can provide valuable insights. This broader approach helps identify imbalances that may not trigger immediate concern in a standard medical setting but could be contributing to ongoing symptoms.

Does STD testing test for Ureaplasma?

Standard STI tests typically don’t include Ureaplasma because it isn’t classified as an STI. Most routine testing focuses on pathogens like chlamydia, gonorrhea, and HIV, leaving microbes like Ureaplasma undetected. If you’re experiencing symptoms such as unusual discharge, irritation, or recurrent infections, a more comprehensive test, such as Evvy’s Vaginal Health Test, can help identify Ureaplasma and other microbes that might be contributing to your discomfort. 

How to treat Ureaplasma in pregnancy?

Treating Ureaplasma during pregnancy requires careful coordination with your healthcare provider. In some cases, Ureaplasma is harmless and doesn’t require treatment. However, if you have symptoms or a history of complications such as preterm birth, your doctor may prescribe antibiotics that are safe for pregnancy, such as azithromycin. It’s important not to self-treat, as the wrong antibiotic or dosage could be ineffective or unsafe. 

How did I get Ureaplasma parvum if I didn't cheat?

Ureaplasma parvum isn’t an STI. While it can be passed through sexual contact, it's also found in people who have never been sexually active, meaning you can have it without any kind of infidelity involved. It's a naturally occurring bacterium that many people carry without ever knowing, and a positive test result says nothing about anyone's sexual behavior.

Should I be worried about Ureaplasma parvum?

Almost certainly not. Ureaplasma parvum is incredibly common, usually harmless, and rarely needs treatment. If you have symptoms, a positive result is useful information — but it's just one piece of the puzzle. The most important thing is getting a full picture of your vaginal microbiome so you and your provider can figure out what's actually driving your symptoms, rather than treating U. parvum in isolation.