Last Updated on July 29, 2021 by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT
How do you get NGU/How can you get Nongonococcal Urethritis? Nongonococcal Urethritis Causes:
Nongonococcal Urethritis (NGU) is a bacterial infection of the urethra in people with penises (and more rarely, in people with vulvas/vaginas), usually caused by another sexually transmitted infection (STI), most often Chlamydia.
NGU is usually caused by another STI that was transmitted via oral, vaginal, or anal sex, but can also be caused nonsexually and perinatally.
Nonsexual:
- Urinary tract infections
- An inflamed prostate gland due to bacteria (bacterial prostatitis)
- A narrowing or closing of the tube in the penis (urethral stricture)
- A tightening of the foreskin so that it cannot be pulled back from the head of the penis (phimosa)
- The result of a process such as inserting a tube into the penis (catheterization)
Perinatal:
During birth, infants maybe exposed to the germs causing Nongonococcal Urethritis in passage through the birth canal. This may cause the baby to have infections in the:
- Eyes (conjunctivitis)
- Ears
- Lungs (pneumonia)
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How to tell if you have NGU? Nongonococcal Urethritis Symptoms:
Nongonococcal urethritis usually does not present obvious symptoms. If you do have symptoms, they may include:
- Genital discharges
- Pain or burning while urinating
- Itching
- Genital soreness
Those with nongonococcal urethritis of the throat may experience a sore throat.
How to know if you have Nongonococcal Urethritis? NGU Tests:
A doctor can diagnose nongonococcal urethritis through visible urethral inflammation (swelling), a urethral swab or oral swab, or a Pap smear.
Relief spells (Rolaids?!) NGU Treatment:
Nongonococcal urethritis is treated by antibiotics.
What’s going to happen to me?!!?! NGU Expectations:
With the correct diagnosis and treatment, nongonococcal urethritis usually clears up without any complications.
However, NGU can lead to permanent damage to the urethra (scar tissue called urethral stricture) and other urinary organs in all people.
Things to be aware of… NGU Complications:
Left untreated, nongonococcal urethritis in people with penises can lead to:
- Epididymitis (inflammation of the epididymis, the elongated, cordlike structure along the posterior border of the testes) which can lead to infertility if left untreated.
- Reiter’s syndrome (arthritis)
- Conjunctivitis
- Skin lesions
- Discharge
Nongonococcal urethritis in people with vulvas/vaginas can lead to:
- Pelvic Inflammatory Disease (PID) which can result in ectopic (tubal) pregnancy
- Recurrent PID may lead to infertility
- Chronic pelvic pain
- Urethritis
- Vaginitis
- Mucopurulent cervicitis (MPC)
- Spontaneous abortion (miscarriage)
In all people:
- Infections caused by anal sex might lead to severe proctitis (inflamed rectum).
References
- Symptoms
- Frølund, Maria, et al. “Urethritis-associated pathogens in urine from men with non-gonococcal urethritis: a case-control study.” Acta dermato-venereologica 96.5 (2016): 689-695.
- Read, Tim RH, et al. “Symptoms, Sites, and Significance of Mycoplasma genitalium in Men Who Have Sex with Men.” Emerging infectious diseases 25.4 (2019): 719-727.
- Ng, Andrea, and Jonathan DC Ross. “Trichomonas vaginalis infection: How significant is it in men presenting with recurrent or persistent symptoms of urethritis?.” International journal of STD & AIDS 27.1 (2016): 63-65.
- Jordan, Stephen J., et al. “Defining the Urethritis Syndrome in Men Using Patient Reported Symptoms.” Sexually transmitted diseases 45.7 (2018): e40-e42.
- Horie, Kengo, et al. “‘Haemophilus quentini’in the urethra of men complaining of urethritis symptoms.” Journal of Infection and Chemotherapy 24.1 (2018): 71-74.
- Testing
- Horner, P., et al. “Should we be testing for urogenital Mycoplasma hominis.” (2018).
- Abbott, Collette E., et al. “A case of rectal ureaplasma infection and implications for testing in young men who have sex with men: the P18 cohort study.” LGBT health 4.2 (2017): 161-163.
- Trembizki, Ella, et al. “Opportunities and pitfalls of molecular testing for detecting sexually transmitted pathogens.” Pathology 47.3 (2015): 219-226.
- Davies, Nicola. “Mycoplasma genitalium: the need for testing and emerging diagnostic options.” MLO Med Lab Obs 47.12 (2015): 8.
- Zhang, Zhanguo, et al. “NGU: Development of a two‐bed circulating fluidized bed reactor system for nonoxidative aromatization of methane over Mo/HZSM‐5 catalyst.” Environmental Progress & Sustainable Energy 35.2 (2016): 325-333.
- Treatment
- Bachmann, Laura H., et al. “Advances in the understanding and treatment of male urethritis.” Clinical Infectious Diseases 61.suppl_8 (2015): S763-S769.
- Couldwell, Deborah L., and David A. Lewis. “Mycoplasma genitalium infection: current treatment options, therapeutic failure, and resistance-associated mutations.” Infection and drug resistance 8 (2015): 147.
- Romano, Sarah S., et al. “Long Duration of Asymptomatic Mycoplasma genitalium Infection After Syndromic Treatment for Nongonococcal Urethritis.” Clinical Infectious Diseases (2018).
- Kissinger, Patricia, et al. “Azithromycin treatment failure for Chlamydia trachomatis among heterosexual men with nongonococcal urethritis.” Sexually transmitted diseases 43.10 (2016): 599.
- Tabrizi, Sepehr N. “Mycoplasma genitalium: update on diagnosis, treatment and resistance.” Pathology 47 (2015): S50.
- Prevention
- Workowski, Kimberly A. “Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines.” Clinical Infectious Diseases 61.suppl_8 (2015): S759-S762.
- Hogben, Matthew, et al. “Partner services in STD prevention programs: a review.” Sexually transmitted diseases 43.0 0 1 (2016): S53.
- Ong, Jason J., et al. “Should female partners of men with non-gonococcal urethritis, negative for Chlamydia trachomatis and Mycoplasma genitalium, be informed and treated? Clinical outcomes from a partner study of heterosexual men with NGU.” Sexually transmitted diseases 44.2 (2017): 126-130.
- Territo, Heather, and John V. Ashurst. “Nongonococcal Urethritis (NGU).” StatPearls [Internet]. StatPearls Publishing, 2018.
- Ekiel, Alicja, et al. “Prevalence of Urogenital Mycoplasmas Among Men with NGU in Upper Silesia, Poland. Preliminary Study.” Polish journal of microbiology 65.1 (2016): 93-95.
- Transmission
- Saxena, Ajit, Reetika Dawar, and Upasana Bora. “Haemophilus parainfluenzae urethritis through orogenital transmission.” Indian journal of sexually transmitted diseases and AIDS 39.2 (2018): 127.
- Ong, Jason J., et al. “Should female partners of men with non-gonococcal urethritis, negative for Chlamydia trachomatis and Mycoplasma genitalium, be informed and treated? Clinical outcomes from a partner study of heterosexual men with NGU.” Sexually transmitted diseases 44.2 (2017): 126-130.
- Workowski, Kimberly A. “Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines.” Clinical Infectious Diseases 61.suppl_8 (2015): S759-S762.
- Hogben, Matthew, et al. “Partner services in STD prevention programs: a review.” Sexually transmitted diseases 43.0 0 1 (2016): S53.
- Read, Tim RH, et al. “Symptoms, Sites, and Significance of Mycoplasma genitalium in Men Who Have Sex with Men.” Emerging infectious diseases 25.4 (2019): 719-727.
Anonymous
Well I got Ngu from a Uti which I had gotten from being pregnant. I wish my ex doctor would have explained it in detail because the doctor focused on STDs instead explaining it can be caused from a urinary tract infection and I lost the love of my life. He want even speak to me. I was innocent.
Jenelle Marie
Thank you for your comment and I’m glad you mentioned this! While more rarely a result of nonsexual or perinatal factors, those can also be the culprit, so I’ve updated this in-depth to include them. 🙂
Generally, NGU is STI/STD related (I’m guessing that’s why your doc focused on this aspect, of course), but it would have been nice to have known all of the factors, especially for the sake of your relationship. I’m really sorry to hear he isn’t even speaking to you.
Should this happen again (what are the odds right?), there are a couple of things you can do to help avoid the end of a relationship… Were I you, I would have asked to be tested for Chlamydia – if the doc was focusing on the STI/STD aspect as you mention, NGU is most commonly the result of Chlamydia – a negative test for both you and your partner would have helped eradicate suspicion, disgust, or any other feeling your partner was having. As an aside, if this were the result of an STI/STD (as your partner must have assumed), your partner would need to be treated as well, else, you could be reinfected. More importantly, whose to say the infection (had it been an STI) did not come from your partner initially? STIs/STDs can remain in the body for VERY long periods of time without producing obvious symptoms – whose to say (if it were STI/STD related) it hadn’t been there since before the relationship?!?! Most infected people (up to 90% by one estimate) are asymptomatic.
Also notable, 1 in 2 sexually active people contract an STD by the age of 25, annually – in the U.S. – 3 million people contract NGU, at least 1 in 4 people will contract an STD at some point in their lives, and there are over 65 million people (in the U.S.) living with an STI/STD at any one point in time…. I’m telling you all of this, because STIs/STDs are VERY common!!!!
Quite honestly, I wonder why he doesn’t want to talk to you! Does he feel guilty – is he uninformed – has he experienced an STI/STD – has he ever been tested – why is he lacking trust, etc., etc.??? It seems there are some really great questions you should be asking and I would certainly not place the blame on yourself until you get to the bottom of his refusal to communicate…. Sometimes, it’s as simple as education – the majority of people are grossly misinformed when it comes to STIs/STDs.
Hopefully, this helps, and I wish you all the luck sorting this out! Feel free to reach out and let us know what happens!
lisa marie
How long does it take for NGU to be found in the other person after intercourse?
Jenelle Marie
Hi there – this is a great question. If the NGU is caused by Chlamydia and a person takes a Chlamydia Urine Test: Possible Detection – Within the first week, Most Likely Detection – 2 Weeks, Highest Accuracy – 4 Weeks. How long it takes to test positive for any STD can depend on a number of factors though and this post (https://thestiproject.com/std-testing-windows-when-to-get-tested-stds/) talks about those more in detail…
If signs and symptoms do occur they usually show up within 2–4 weeks of contact with an NGU infection, but they can sometimes appear within a day or two (depending on the cause of the inflammation). In mild cases, symptoms may not show up for several months.
You can do a test even if you don’t have any symptoms. It is possible to be tested for signs of inflammation within a few days of having sex, but it may be necessary to wait up to two weeks before you can do a test to check for bacterial causes of infection such as chlamydia as mentioned above.
Your best bet, I think, is to be seen, share your concern and what you think you may have been exposed to, get tested, and then get re-tested 1-3 months following those tests to be certain. 🙂
Jenelle Marie
Hi Lisa Marie –
You’ll have to forgive me as your comment was accidentally overlooked and I didn’t see my lack of reply until now.
If NGU symptoms occur, they usually show up within 1 to 5 weeks after infection and may last only a few hours or days. In mild cases, symptoms may not show up for several months. However, NGU can usually be detected in a test 3 weeks after coming into contact with the bacteria causing NGU.
Hopefully this helps, although, I’m guessing my response is a bit overdue! 🙂
Jojo
I have been reading most post on here and your replies to people on here and i have been following for almost a week now,I have been having NGU which also includes Inflammation.For almost a year now the tip of the penis is kind of inflamed,i also have itching inside,after reading your reply to most people,i had to buy doxy and tinidazole which after 3days i started using it the itching stopped,its been more than a week now and i am still using it,but my mind is still at the Inflammation which looks like sore,when would that take to heal,i really did love to know.
Jenelle Marie
Hi Jojo –
Thanks for your question.
If you are still experiencing symptoms after taking your prescription as indicated and for the entire duration directed, I recommend going back in to the medical practitioner that prescribed your medication as they would want to ensure you don’t need additional care/medication and/or that there is not another issue at hand as well.
It’s always best to go in – or in your case, go back in – while you’re experiencing physical symptoms, because things are much easier to diagnose and/or unsuccessful treatment is easier to ascertain when symptoms are present.
Thanks again for reaching out!
Wow!
I am really glad you posted NGU causes. Unfortunately, my partner didnt tell me of past life as a sexually unprotected prostitute or her immediate unprotected partners prior to our relationship until after we started having unprotected sex. I am a veteran with TBI so I dont think too fast. I fell in love with this woman because of her inner beauty and what she does as a healer now in the community. Amazing woman. However, wasnt completely honest in the beginning for fear of judgement. I accepted her as is unknowingly of her past. So, in hindsight, if you and your partner are going to have sex of any type get tested first for any long term releationships or even short term flings which is her history within her community, after the fact. I was not made aware of her lovers within her circle of whom keep tightly knit when ever they “need” each other. So, love yourself and keep your temple clean. At least, NGU is curable if treated immediately and kept clear through follow up. So, learn from my hard lesson. Love yourself and have safe sex as best as possible.
Jenelle Marie
Hi Wow! 🙂
Thanks so much for sharing your story here – my father has a TBI from his time in the military working with pershing missiles, so I can understand where you’re coming from there.
You make some excellent points – everyone should be getting tested before and after each new partner. That would be the ideal, but right now, I think it doesn’t happen because people are largely unaware of their risks.
The present ‘norm’ tends to be similar to what happened in your situation – learning after-the-fact. In time, though, and with the sharing of stories like yours, I think we’ll be able to shift that paradigm and create a culture that is sexually conscientious and healthy.
We don’t get a lot of responses to NGU, so if you’d like to do an interview for us, we’d love to publish your perspective.
Anyhow, thanks so much for sharing your thoughts!
jake
Hi so I have been suffering from some sort of bacteria infection in my urethra for almost a year now. I’m a 35 yr old male and have seen a urologist, they run test and they can never find anything. My pain goes and comes, some times it feels likes it’s on a schedule and I can some times know what to expect and when to expect. The urologist has prescribed me bactrim and while I was on it, my symptoms were very mild, but still present, once I finished the antibiotic the symptoms came right back. What can this be, will it ever go away, I’m starting to think I’ll have this for the rest of my life, is there any hope for me? Please help!
Jenelle Marie
Hi jake –
Urethral symptoms can be tricky to treat…
Sometimes the symptoms of urethritis are slow to settle, or they may return after a week or two. If you have taken antibiotics and there has been no further sex, it is unlikely that any infection is still present. The symptoms most often resolve over time, and you should not need further treatment. If you have had further sex, if the infection was resistant to antibiotics, or you did not take all of the medication as directed, you may need further tests and should consult your urologist or a different urologist.
Occasionally, a man may experience a discharge, or burning on urination but the laboratory tests show no evidence of infection. This condition is called urethral irritation, and it means that the urethra has been affected by something other than an infection.
Possible causes of this include:
• repeated squeezing or milking of the urethra
• very frequent or vigorous masturbation or sexual activity
• concentrated urine caused by dehydration
• caffeine and/or alcohol, some medications
• general illness
• allergies
If it were me, I’d consider getting a second opinion from another urologist. That way, you know the treatment you underwent was adequate, some additional testing might be done, and then they should be able to confirm or refute much of what you’ve already been told.
The good news is, you’ll likely not have this forever, but some additional consult could be helpful to make sure you don’t need more treatment or to direct you toward the steps you’ll need to take to reduce the discomfort you’re experiencing.
Thanks for your question!