[Question #5580] Diagnosed with Non-Specific Urethritis -- when can I have sex again?

22 months ago
Hi, on Wednesday 5th of june I visited a Nuru spa and had protected sex with a therapist. A few days later on the 8th/9th I started feeling a burning sensation in my groin, discomfort in lower abdomen and a slight burning sensation when peeing. I then visited a clinic on the 14th and was put on doxycycline for 10 days and also was scheduled for STD test. The test results showed I was negative for HIV,  Syphillis, Hep B and Chlamydia. The doctor essentially said I just have NSU (Non-Specific Urethritis) and I had nothing to worry about.... 

I just finished the 10day course of Doxycycline yesterday (24th june) and the symptoms have essentially subsided, I still feel a little bit burning when peeing but it's hardly noticeable.

My questions are:

- After the infection on the 5th, I did have unprotected sex with my wife on the 7th (no symptoms yet then) -- is there a chance I could've given her anything? My doctor here assured my I cannot have transferred anything to her, but I'm not sure. She didn't show any symptoms up until now.

- When can I resume unprotected sex with my wife?

Thanks so much
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
Welcome to the forum. Thank you for your question.

I am skeptical you actually had nongonococcal urethritis (NGU -- same as NSU, just different words for the same condition). You can't get NGU from protected sex, assuming there was no partial contact, i.e. no brief penetration before or after the condom was in place. And your symptoms are not at all typical for urethriits of any kind. It seems your doctor treated you for possible NGU because of your symptoms and your anxiety. That said, if you did have NGU, the treatment you received was exactly as recommended (actually, more prolonged than necessary -- most experts and authoritative guidelines recommend 7 days of doxycycline). To your specific quetions:

1) I am confident you had no STD and could not have exposed your wife to an infection from the exposure the same day. And in any case, newly acquired NGU -- if you had it -- probably cannot be transmitted until at least a few days after being exposed to it. So your wife is safe on both grounds:  unlikely you had NGU or any STD, and too soon to transmit anything. In other words, I agree exactly with your doctor's advice.

2) You can safely resume sex with your wife at any time.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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22 months ago
Hi Doctor, thank you for your reply.

At the spa, the therapist did rub her genitals against mine — however there was never any penetration and it was at the base of the penis... Im not sure this changes your answers in any way?

It has been 3 weeks after that exposure and I have to say these symptoms are lingering a little bit (burning sensation while peeing, discomfort in lower abdomen) — if it wasn’t NGU what could it have been? And do you think these symptoms will just go away on their own?

Thanks again 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
Genital rubbing without penetration cannot cause NGU, especially when the head of the penis and meatus (opening) were not exposed.

NGU doesn't cause symptoms like you describe. Its main symptom is abnormal discharge from the penis. The most common explanation for symptoms like yours is anxiety and fear of consequences of a regretted sexual decision, raising awareness and sensitivity of minor symptoms or even normal body sensations that otherwise would be ignored or not even noticed. The key to their clearing up usually is understanding and awareness that nothing serious is going on.
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22 months ago
Hi Doctor,

I was relieved after your answer. However as days go by I do notice the burning sensation while urinating and I really don't think this is simply caused by Anxiety .. there's something lingering. Having perused through some other questions I stumbled upon "Mycoplasma Genitalium" -- this sounds like exactly what I could have?

> You get it by having sex with someone who has it. Even if you don't go “all the way”
this could explain me getting it from rubbing genitalia?

In men, the symptoms are:

> Watery discharge from your penis
> Burning, stinging, or pain when you pee

I don't have the discharge, but do have burning sensation....


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My last questions are:

- I assume you don't think I can have this condition, given your first reply that it's safe to have sex again with my wife?

- If I did have it would not be safe to have unprotected sex, correct?

- What would be your final recommendation for me? I really want to be 100% sure I don't have anything before having sex again. Should I go back to the original clinic (who prescribed my Doxycycline  and ask for a Mgen test and another dose of Antibiotics? There is another Genitourinary Clinic near me (I'm based in Manila), which follows a much longer diagnostic + treatment process (5 consecutive days of prostate drainage + urine samples, then followed by culture and 21 days of antibiotics). I've been a bit wary of this approach but it may get to the bottom of this issue? Or do you think I should simply wait for a few more days/weeks and see if it simply clears up by itself? (the issue is that my wife will grow suspicious as to why we're not having sex -- it's been 3 weeks already)
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
As already noted, the main symptom of urethritis is discharge, not urinary discomfort. M. genitalium is unlikley in this sitiuation and I agree with your skepticism about the extensive approach recommended by one of the lincis you describe. Despite your opinion about your symptoms, all I can say is that the vasy majority of men with symptoms like yours have no known infection as the cause and I remain convinced that anxiety (magnifying trivla symptoms or normal body sensations that otherwise ould be ignored or not noticed) is the usual explanation.

That will have to conclude this thread. I hope the discussion has been hellpful.
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