However, a little more than a month ago, I had an unprotected sexual encounter with a new partner, and I’ve noticed some urethral “itching” (not exactly “burning”) and very faint discharge. He contacted me this week to say he also has symptoms of an std and has been treated, but I don’t know what if anything he tested positive for. I would say that the symptoms for me are much more noticeable in the last 24 hours. I previously had chlamydia that had pretty obvious symptoms about 7-12 days after the encounter, so it seems odd to me that this would take well over a month to materialize. Is that normal?

At any rate, I won’t have a chance to be seen for an STD panel for a few days. I wondered if there was some combination of the doxy/azithromycin that I could take that would give me a high level of confidence to treat chlamydia and/or gonorrhea. I would be willing to do the whole 36 day regimen if it would “guarantee” treatment for both, but I know neither antibiotic is recommended for gonorrhea, and I also wouldn’t know how to dose the amount properly, except that when I treated my chlamydia in the past I took 1,000 mg of azithromycin in one dose to clear it. 

Are you able to provide me with any guidance on how I could use my current supply of antibiotics to treat myself until I can be seen for testing?

Let me first say that ureaplasma is virtually never an STI or cause of STI symptoms.  Ureaplasma are common bacteria which are normally found in the genital tract.  Years ago there was concern that they might be a cause of NGU but more recent, better studies have shown that this is not the case.  Unfortunately, some labs continue to offer testing as part of their STI screening, a problem which all too often leads to unnecessary treatment related to continuing misunderstanding.  The treatment regimen that was prescribed for you is much more than would normally be treated for most STIs.

Second, regarding your symptoms and recent notification from your partner that he was symptomatic and has been treated, life would be much, much easier if you had more information.  There are many possible causes of the symptoms you have described.  If you could find out what he was treated for, or what he was treated with, it would guide what sort of treatment would be recommended for you.  Alternatively, getting yourself tested, both for gonorrhea and chlamydia, as well as for NGU would be helpful.  I'm not too worried about gonorrhea as gonorrhea symptoms are typically more prominent than what you describe.  Chlamydia or non-chlamydial NGU would be more likely at this time.  

Treatment before you test will obscure things and neither of the medications you've been prescribed would reliably treat gonorrhea.  If it is urgent that you be treated, 7 days of doxycycline is recommended therapy for chlamydia and NGU.

I hope this information is helpful.  If anythng is unclear, please use your up to two follow-ups for clarification.  EWH

I would say the symptoms I’m having contine to be slightly more prominent. It’s starting to feel slightly more like a “burn” with a still somewhat minimal but present discharge. I won’t be able to be tested until next week, so I’d like to start the doxycycline since I have it available and would like to address my symptoms. 

But can I ask if that would lead to any complications if it turned out I had gonorrhea instead? I know that antibiotic resistance can be a problem and wasn’t sure if taking the wrong antibiotic would make things worse. I also assume that if I started doxycycline, it probably would mess with the effectiveness of testing for gonorrhea? Would doxy also suppress symptoms without actually resolving the infection or would the symptoms likely remain?

Part of me feels like it would just be convenient to take the medicine since I’m sure it would reliably treat chlamydia / NGU and it’s available to start now, but I don’t know what kind of problem it might cause for identifying or treating gonorrhea separately if that turned out to be the cause or also present. 

I figured I would also like to get more of a full STD panel and didn’t know if being on an antibiotic would affect test results for something like syphilis. 

I'm surprised you can't find testing wherever you are.  I know of nowhere on earth where that is not possible

I haven’t taken any medicine yet bc I have been waffling over whether I should just wait till my schedule opens up, which should be soon at this point anyway, but I’m still curious about two things. In your last comment you mentioned that my symptoms are most consistent with NGU, and I didn’t know if you meant NGU “but not chlamydia” or symptoms of NGU “including chlamydia.” 

Also, what would make my symptoms less likely than  gonorrhea? And how often would gonorrhea be asymptomatic? I would say that two times I have noticed what seemed like a thicker discharge, but both times were within a couple hours of having masturbated and I figured it was most likely some kind of residual semen and that a thick discharge wouldn’t just “come and go,” but I figured I would ask just to have the info. 

You are correct that the symptoms of gonorrhea would not tend to come and go in severity.

We provide up to 3 responses to each client's questions.  This is my 3rd response.  I hope that the information I have provided has been helpful.  EWH