A sexually transmitted infection (STI) that occurs due to certain bacteria and viruses, but can also be caused by urethral trauma, is called nongonococcal urethritis (NGU). The most common symptoms include itchiness, irritation, discharge, and pain during urination. If you are diagnosed with this condition, it is recommended to inform all your sexual partners because it may help them too. In most cases, this condition is treated with antibiotics. It is also very important to administer these medicines exactly as prescribed by your doctor, even if you do not have symptoms. Otherwise, the infection may return, and it becomes more difficult to treat.
While NGU can occur during unprotected sexual intercourse with a partner who is infected, there are non-sexual causes of this condition. Sometimes, this condition is called nonspecific urethritis (NSU).
In general, this is a common condition that mostly affects males.
Symptoms
The symptoms are often different among people because it depends on several factors. For example, the severity of the infection, gender, and age. Check some symptoms in men below:
- Discharge from the penis
- Dysuria (pain during urination)
- Abdominal pain
- Itching, irritation, and tenderness
- Pain while ejaculating (dysorgasmia or orgasmalgia)
In more severe cases, males may also experience the following symptoms. Examples include:
- Testicular swelling or pain
- Infertility
- Fever
- Chills
- Fatigue (extreme tiredness)
- Headaches
Commonly, females with NGU have fewer symptoms compared to men. These include:
- Vaginal discharge
- Pain during urination or sexual intercourse (dyspareunia)
- Irregular menstrual periods (spotting or cramping throughout the month)
Sometimes, NGU does not cause any symptoms. However, if any of the symptoms listed above occur, immediately contact your healthcare professional.
Causes and Risk Factors
There are multiple causes of this condition, including sexual and nonsexual causes. For example
Sexual Causes
The most common sexual cause of NGU is STIs that pass from one person to another through unprotected vaginal, oral, or anal sexual intercourse. While the most common germ that causes NGU is chlamydia, it may also occur due to other bacteria. For example:
- Mycoplasma genitalium
- Ureaplasma urealyticum
- Haemophilus vaginalis
Moreover, NGU may also happen due to herpes simplex virus and Trichomonas vaginalis, but it is less common.
Nonsexual Causes
These include:
- Phimosis (foreskin that is too tight)
- Foley catheter – People who use this catheter to drain urine from the bladder may also develop NGU.
- Urethral stricture (narrowing of the urethra)
- Urinary tract infections (UTIs)
In most cases, the symptoms appear within 14 to 21 days after exposure to bacteria or viruses. Furthermore, doctors have identified some factors that could increase your risk of developing NGU. For example:
- Gender – Men often are more prone to NGU than females.
- Age – In most cases, people develop this condition between the ages of 15 and 30.
- Unprotected sexual intercourse
- Multiple sexual partners
- Trauma to the urethra (for instance, an injury or the use of a Foley catheter)
What Happens if Nongonococcal Urethritis is Left Untreated?
In most cases, this condition does not cause any complications, even without treatment. However, some people may also experience the following ones. For example:
- Epididymitis – This condition causes inflammation in the tube behind the testes (epididymitis) and testicular pain.
- Reactive arthritis (also known as Reiter’s syndrome) – This is a type of arthritis that negatively affects your back, joints, urinary tract, and eyes.
- Skin lesions
- Vaginal infections – These include mucopurulent cervicitis (MPC) and vaginitis. If you do not get treatment for vaginal infections, it may lead to infertility and pelvic inflammatory disease.
Generally, you should see a doctor every time you notice symptoms in the genital area.
How to Prevent Nongonococcal Urethritis?
Doctors may recommend the following tips to reduce the risk or even prevent NGU. For example:
- Use new condoms or dental dams during sexual intercourse
- Avoid sexual intercourse if you suspect your sexual partner may have an STI
- You are tested for NGU or other sexually transmitted infections before sexual intercourse with a new partner
It is also recommended to perform regular STI tests if you have multiple sex partners.
Diagnosis
The diagnosis of NGU often begins with a physical examination to check for irregularities linked to the disease. Therefore, they may also ask some questions about the symptoms and your medical history to get more clues about your disease. However, to confirm or rule out NGU, doctors often perform a bacterial culture test from one of the following areas. For example, the urethra, cervix, rectum, or throat. Moreover, they may also perform the following tests. These include:
- Blood tests
- Urinalysis (urine tests)
- Other laboratory tests of your penile or vaginal discharge
Treatment
Sometimes, this condition goes away on its own, but to protect your sexual partners, you should see a doctor as soon as the symptoms occur. Most NGU cases are treated with antibiotics. This is a group of medicines used to treat bacterial infections. For example:
- Doxycycline
- Macrolide antibiotics (such as Azithromycin)
If you are allergic to the previous medicines, doctors may prescribe Erythromycin or Ofloxacin. The treatment with antibiotics should be taken by you and your partner. Otherwise, you will develop this infection again.
Frequently Asked Questions
How soon after treatment will I feel better?
Usually, people notice improvements within 1-2 weeks after starting the treatment with antibiotics. If the infection is left untreated, it may go away on its own in a few weeks to several months.
How long is a person with NGU contagious?
A person with NGU remains contagious until he/she finishes the full course of antibiotics and symptoms go away. It is also recommended to abstain from sex until the treatment is finished.
Can I get NGU again?
Yes, this infection may affect the same person multiple times. For instance, if you are following a course of antibiotics but your sex partner is not, you may get this infection again during sexual intercourse.
Is NGU the same as gonorrhea?
While both STIs can cause similar symptoms, they are different infections. For instance, gonorrhea is caused by a bacterium known as Neisseria gonorrhoeae (N. gonorrhoeae), but NGU may occur due to different bacteria as well as trauma. Moreover, these STIs are treated differently. Ask your healthcare provider if you have additional questions.
