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Non-Gonococcal Urethritis (NGU)

So picture this, you’re about to engage in the hottest iteration of a bedroom activity you can think of. Just before you get it on, you remember that if it (condom) ain’t on, it ain’t on.

We know that using protection methods like a condom greatly reduces the risk of sexually transmitted infections (STIs) as we’ve discussed before but what’s better protection than a condom?

TWO CONDOMS!

Right? Right?  

Well, unfortunately, no. Using two condoms instead of one does not improve your odds of being STI free. In fact, studies have shown that this is actually more detrimental than good. The friction created by the two layers of condoms rubbing on each other creates an unnecessary amount of heat which degrades the integrity of the rubber and ultimately causes it to break or fail.

All you end up with it a bill for two condoms instead of one, friction burn (or chaffing) to both you and your partner, and the fact that you still can be exposed to STIs. 

Really not as worthwhile now right?

via GIPHY

With the risk of STIs, we have discussed the common few infections that transmit via sexual activity before this.

Check this out: What you need to know about sexually transmitted disease.

In this article, let’s review a lesser known STI instead. We’ll focus on Non-Gonococcal Urethritis (NGU).

To put it simply, this is just an inflammation of the urethra (the tube that carries urine from the bladder out of the body) that is caused by an infection other than gonococci (the more common infections).

Infectious urethritis has two main classifications;

  1. Gonococcal urethritis (caused by gonorrhea, also see symptoms of gonorrhoea)
  2. NGU.

Approximately 25% of patients with urethritis are of those with NGU. These tests are not usually carried out routinely and as such, not many people are aware they have it.

How Does One Get NGU?

Most common cause of NGU is sexually transmitted infections (STIs), such as chlamydia. Chlamydia (see: Symptoms of Chlamydia)  is spread during unprotected sex (sex without a condom), including anal and oral sex.

Other infectious causes are:

The latter two being screened via urine testing typically by molecular PCR testing methods. See our STD Screening Packages

However, not all urethritis is brought about by an infection. There are some actions that we carry out seemingly innocently that can cause an irritation therefore an inflammatory reaction to the area.

These include:-

  • products used in the genital area causing irritation (especially lubrications – often times the simple products works best. Do you really need lemon scented, blueberry tasting, spicy hot wings flavour lubricant anyway?)
  • Vigorous sex or masturbation (can you tell I am jealous?)
  • Frequently squeezing the urethra – Often times this happens when we find that there may be some discharge from the urethra to begin with, so we tend to ‘milk’ the area. The forces at play here can damage the urethra causing an inflammatory reaction.
  • The action of sounding (inserting an object into the urethra). Kinky, I know.

NGU can occur in anyone who is sexually active (including oral sex), although not all cases are caused by having sex as aforementioned. You can’t get NGU from kissing, hugging, sharing baths or towels or from toilet seats.

Do I Have NGU?

Signs & Symptoms of Non-Gonococcal Urethritis

It’s not necessary for one to develop immediate symptoms after the exposure. As for NGU, the incubation period takes about 2-6 weeks (long torturous wait!) 

The symptoms of NGU in men can include:

  • A white or cloudy discharge from the tip of the penis
  • Dysuria- burning or painful sensation when you pee
  • Irritation at the tip of penis or itching inside the penis

NGU may be asymptomatic – meaning you do not show symptoms (not really a good thing as it may delay the treatment) but often has symptoms such as burning sensation when peeing, a noticeable discharge or itching noticed within the week following sexual intercourse. Symptoms that start a day or two after sex are not usually caused by an STI.

Also Read: STD Window Period & When to Get an STD Test

How Dangerous is NGU?

So, we all know that anything not protected will bare some form of damage. And any damage that’s not taken care of will be damaged further. 

Although the symptoms might sound like somewhat one can live with (it’s not normal though), if left untreated, a woman may develop pelvic inflammatory disease (PID) from this seemingly unsuspecting infection.

Infection to the penis or the vagina that’s not treated may end up in infertility. So, snip it in the bud while you still have the chance! Seek treatment early! 

Diagnosing Non-Gonococcal Urethritis

Here comes the hard part. You have made up your mind to seek for treatment and now you are anxious. What will happen at the clinic?

You would put on your courageous hat and head towards the clinic. Once you have registered, you will meet the doctor. Detailed history will be taken (no such thing as TMI here! The more detailed the better) 

After short physical examination, doctors will order some investigations. 

Two methods are used to help diagnose NGU

  1. A swab test  – a sample of fluid is taken from your urethra using a swab( looks like a small cotton bud)  it’s not painful but can be uncomfortable for a few seconds
  2. A urine test – typical pee into a specimen cup. Painless.

Mind you, infection is a two way process. No blaming game here. All parties involved should get tested together. 

See: How are STD Throat & Anal Swab Done

Other STIs test will also be offered. However, it’s up to you whether to have these or not, but a test for all infections is definitely recommended. You can discuss this with our healthcare professionals at the clinic.

Test results can take up to 1-2 weeks to be ready.  You may see the doctor earlier if you are feeling anxious or develop other symptoms during the waiting period.

How is NGU treated?

Is it easily treated?

In most cases, yes. These are fairly common and friendly bugs that respond well to antibiotics. Usually a course of five days worth of oral antibiotics are prescribed depending on the infection picked up. 

Main treatment for NGU is short course antibiotics and usually symptoms should start clearing up in about 2 weeks.

It’s important that past and current sexual partners are also treated to prevent any infection spreading. One can get re-infected if they have unprotected sex with someone before he or she is treated.  

Past infection with NGU does not protect a person from contracting the disease again.

When can I have sex again?

Do not have unprotected sex (oral, vaginal, or anal sex without a condom) for 7 days after you and

your partner(s) have been treated. It will take approximately 1 week for the antibiotics to work. The best protection is to abstain from having sex for atleast 1 week and your symptoms have completely cleared up. 

If you are still having symptoms, refrain from having sexual contact and visit your doctor again.

So, I took my antibiotics and no more symptoms. I’m good to go right? 

Not quite yet. You would be given an appointment to see the doctor again once you have completed the antibiotics. Test will be repeated and if the results are negative, you may be set free for now.

However, if you are going to be naughty again, regular STD screening once a year (3-6 months if you badly behave) will be suggested for the betterment of you. 

Preventing non-gonococcal urethritis

Practising safe sex is the best way to reduce the chances of it developing. Barrier contraception, such as condoms, and having regular checks at sexual health clinics will help reduce the chances of contracting STI. 

That said, do not be shy to visit your doctor if you have weird/abnormal sensations post coitus. It’s always better to get these things looked into immediately rather than keeping an infection in the body. Remember to always practice safe sexual activity. These include STI testing for all parties involved (preferably before any activities take place), choosing your partners well, and always using a condom. Just one at a time will do. 

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