[Question #834] Testing 5 days after finishing doxycycline

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100 months ago
I went to my doctor as I was having balanitis symptoms. He tested me for chlamydia and gonorhea and as a precaution put me on 4 weeks of doxycycline 100mg twice a day. The tests were negative. I finished the dose on June 2nd. I am still having symptoms and I am scared that I have chlamydia or gonorhea and initial test was a false negative. I want to get retested. If I test for std's 5 days after completing doxycycline will it affect the results?
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H. Hunter Handsfield, MD
100 months ago
Welcome to the forum. Thanks for your question.

You were managed in a puzzling fashion. I cannot imagine a cause of balanitis that would respond to doxycycline, and especially see no need for treating as long as 4 weeks. Are you sure your doctor was treating you only for balanitis? Or maybe prostatitis, for which this is a more typical treatment?

In any case, neither chlamydia nor gonorrhea causes balanitis. Also, there has never been a strain of chlamydia resistant to doxycycline, and 1 week treatment is always enough for chlamydia. In theory gonorrhea could resist doxycycline for a month, but very unlikely. These facts, plus the negative tests before you were treated, are proof neither of these STDs was the cause of your problem. There is no point in testing for them again; it would just be a waste of money.

The main causes of balanitis, especially in uncircumcised men, are various non-STD bacteria; yeast (thrush); or "nonspecific" balanitis, a problem of hygiene. All of these usually clear up with regular retraction of the foreskin and washing with soap and water 2-3 times a day; or, if yeast is suspected, with an antifungal cream like miconazole. If you have phimosis, i.e. a tight foreskin that prevents retraction, circumcision may be necessary. There are other, rare causes of balanitis, best diagnosed by a dermatologist.

So for sure this isn't an STD problem. Discuss these thoughts with your doctor, or with a dermatologist.

I hope this has been helpful. Best wishes--  HHH, MD


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100 months ago
Thank you doctor Hunter for your reply. I also had frequent urination problem and yes he did mention prostatitis too. The reason I want to be retested is the symptoms are still there. But if I was to retest would the doxycycline dose ending just 5 days back affect the result?
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H. Hunter Handsfield, MD
100 months ago
Chlamydia or gonorrhea also do not cause prostatitis. I'm not surprised your symptoms didn't improve; most prostatitis is not due to infection. Antibiotics are tried, but usually don't help much, so your situation is typical. Anyway, your continued symptoms for sure aren't due to persisting gonorrhea or chlamydia, which you never had. But the answer to your question is yes, the antibiotic would interfere with test reliability. If you insist on going ahead with gonorrhea/chlamydia testing knowing it is unnecessary, wait until about 2 weeks after finishing doxycycline.

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100 months ago
This is what happened. On march 8th I had possible exposure. I started noticing white dry stuff build up under my penis after about 10 days and just kept washing it for a few weeks. When it did not go away and after reading the internet I got my self tested for std's on April 15th. All tests came back negative. Then I went to see my doctor and he said it looks like candida balanoposthitis. He prescribed me Mycolog II cream to apply on the penis glans twice a day and once a day terbinafin. He asked me to do this for 2 weeks. I am uncircumsized by the way. After 2 weeks I stopped the medicine as doctor suggested and the symptoms came back. There was no white stuff but penile discomfort and forskin sticking to the head and difficult to pull back. I could pull it back all the way but it is not easy. Also if I masturbate it becomes really red. I also developed frequent urination. At this point my doctor tested for uti and he said it might be prostatitis. So he put me on doxycycline for 2 weeks alongwith flomax (tamsulosin) once a day. He also asked to continue applying the cream and terbanifine. After 2 more weeks the symptoms wont go away so I went back to him. He asked me to see a urologist. I have the urologist appt on June 17. My doctor asked me to continue taking the doxy for another 2 weeks continue applying the cream until I see the urologist. As I said the doxy 4 weeks dose finished on June 2. And I stopped applying the cream as it has steroid and I am a little scared of taking so many medicines. So I went back to test for all std's today. Should I send pictures?
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H. Hunter Handsfield, MD
100 months ago
Thanks for the clarifications.

This is no STD, regardless of the timing of onset after a "possible exposure". There are no STDs that cause these symptoms and problems. And anyway, the large majority of unexplained genital symptoms are not STDs and are unrelated to sexual exposures. (I have a book titled Genital Dermatology Atlas. It has 300 pages. Of those, only 15 pages deal with STDs.)

This forum is strictly related to STD issues, not diagnosis of genital symptoms that clearly are not STDs. And we do not examine clinical photos or attempt to make any diagnosis; this forum is for general advice, not for medical care.

Each new forum question includes two follow-up comments and replies, and we have reached that limit. So that concludes this thread. Continue to work with your urologist, and perhaps with a dermatologist. I hope this discussion has helped you sort things out. Best wishes.

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