Infection is frequently asymptomatic in women and can also be asymptomatic in men. For men, when symptoms do occur, they can include burning or stinging on urination and discharge from the penis. For women, symptoms can include burning on urination, abnormal vaginal bleeding, and vaginal discharge. Mycoplasma genitalium can also cause pelvic inflammatory disease with pain in the pelvic area and pain during sex. Chronic infection may also lead to tubal-factor infertility and adverse pregnancy outcomes including preterm birth and spontaneous abortion. All of these symptoms and conditions can be caused by other sexually transmitted infections (STIs) such as chlamydia and gonorrhea, and caused by non-STIs as well, making diagnosis difficult without testing.