Ureaplasma: When Normal Flora Becomes a Problem
Ureaplasma lives harmlessly in up to 80% of sexually active women. But when it overgrows or when symptoms appear, it causes recurrent UTIs, chronic prostatitis, infertility, and pregnancy complications. Standard tests cannot detect it. Only PCR can.
carry Ureaplasma
What is Ureaplasma urealyticum?
Ureaplasma is one of the smallest known bacteria. It colonises the genital and urinary tracts and is transmitted through sexual contact. In most people it causes no harm. But in certain contexts, it becomes a genuine pathogen.
Does Ureaplasma always need treatment?
This is the most important question on this page. Because so many people carry Ureaplasma without problems, a positive PCR result does not automatically mean you need antibiotics. Your doctor decides based on your symptoms.
- You have symptoms: burning urination, discharge, pelvic pain
- Recurrent UTIs that do not respond to standard treatment
- Persistent urethritis after chlamydia/gonorrhoea treatment
- Investigating unexplained infertility (male or female)
- Pregnancy complications: premature rupture of membranes, preterm labour
- Chronic prostatitis with no other identified cause
- Co-infection with Mycoplasma genitalium or other pathogens
- You have no symptoms at all
- Ureaplasma was found incidentally during routine screening
- You are not pregnant and not investigating infertility
- You have no recurrent UTIs or pelvic pain
- Your partner is asymptomatic (unless you have symptoms)
"Ureaplasma is the result that requires the most interpretation. I see patients who panic about a positive result when they have no symptoms, and I see patients with chronic UTIs whose GP never thought to test for it. The PCR result gives your doctor the information to make the right call."Dr. Samantha Naidoo, MB ChB, FCP (SA), Medical Director, Epicentre
What are the symptoms of Ureaplasma when it does cause problems?
When Ureaplasma shifts from harmless coloniser to pathogen, the symptoms closely overlap with chlamydia, UTIs, and BV. This is why PCR testing is needed to identify the actual cause.
What happens if symptomatic Ureaplasma goes untreated?
In asymptomatic carriers, nothing. But when Ureaplasma is causing symptoms and is left untreated, the consequences can be significant.
Where can I test for Ureaplasma in South Africa without a referral?
Ureaplasma requires PCR testing. It is not included in the Small PCR (4 pathogens) or Express STI (blood). You need the Medium package or above.
Medium PCR (9 pathogens) ⭐ Includes Ureaplasma
Ureaplasma + M. genitalium + M. hominis + chlamydia + gonorrhoea + HSV-1 + HSV-2 + trichomoniasis + E. coli.
Large (14-17 pathogens) Includes Ureaplasma
Everything in Medium + HPV, BV markers, Candida species. Choose Cervical (17) or Penile (14).
XL (35 pathogens) Includes Ureaplasma
Full ecosystem: all STIs + BV + Candida + microbiome markers + syphilis PCR. The complete picture.
Ureaplasma: Your Questions Answered
Is Ureaplasma an STI or normal bacteria?
Both. It is a sexually transmitted organism that colonises 40-80% of sexually active women. In most people it is harmless. But in certain contexts (symptoms, infertility, pregnancy), it becomes a pathogen that needs treatment.
Can standard urine cultures detect Ureaplasma?
No. Ureaplasma does not grow on standard culture media. This is why recurrent UTIs caused by Ureaplasma come back as "culture negative." Only PCR testing can identify it. Epicentre includes it in Medium, Large, and XL packages.
Can Ureaplasma cause infertility?
Yes. In men: reduced sperm motility and count, chronic prostatitis. In women: pelvic inflammatory disease and tubal damage. If you are investigating unexplained infertility, Ureaplasma testing is worth including. The Medium PCR package covers it.
I tested positive but have no symptoms. Do I need treatment?
Usually not. Asymptomatic carriage is very common and does not typically require treatment. Your doctor will interpret the result based on your symptoms, reproductive plans, and overall health. Epicentre provides the data; your doctor makes the call.
My UTIs keep coming back but urine cultures are negative. Could this be Ureaplasma?
Yes, this is a classic scenario. Ureaplasma causes urinary symptoms but does not show up on standard urine cultures. A Medium PCR at Epicentre (R1,508) tests for Ureaplasma alongside Mycoplasma and 7 other pathogens.
Is Ureaplasma the same as Mycoplasma?
They are related but different organisms. Ureaplasma urealyticum and Mycoplasma genitalium are both tiny bacteria that require PCR to detect. They often co-occur. Epicentre's Medium package tests for both, plus Mycoplasma hominis.
How much does Ureaplasma testing cost?
Medium PCR (includes Ureaplasma): R1,508. Large: R1,925. XL: R3,305. Students 10% off. Payflex 4× interest-free. Note: Small PCR (R1,235) does not include Ureaplasma. View all packages →
Other infections in this guide
Recurrent UTIs? Unexplained Symptoms? Test for What Standard Screens Miss.
Ureaplasma requires PCR testing. Standard urine cultures cannot detect it. Epicentre's Medium package includes it from R1,508.
