In late May I developed burning and stinging during urination. No other symptoms. Cleared up after 3 days on its own with no antibiotics. More recently, I developed the same symptoms: burning on urination, but no other symptoms – as far as I can tell I've not had any discharge.  The burning DURING urination is moderate but the pain gets worse AFTER urinating and lasts for about a minute. Overall, the discomfort is moderate - not pleasant but not the worst thing ever.  The symptoms restarted on July 11- six days after my last sexual exposure. The symptoms have been going on for 48 hours.

 When I had this happened in May, my regular doctor prescribed Cipro but I did not take any of it because the symptoms cleared up on their own so quickly. Not thinking much about it, I started with the Cipro now since I already had it. It did not occur to me until after two doses of the Cipro that this may be an STI. The Cipro is not helping with the symptoms.

I am not in a place where I can see my regular doctor or get tested anytime soon. Apart from the Cipro, I have an unused z-pack that has not yet expired. I also have doxycycline. I'm carrying these medications as precautionary travel medicines.

Wondering if you have any advice on whether this is an STI in the absence of discharge. And if you have any suggestions for what to do given that I have these antibiotics but cannot realistically come in for testing or consult with my regular doctor for about 2 weeks.

As you seem to know already, pain on urination or other discomfort in the urethra or penis usually is not due to any STI, unless discharge also is present. That said, the timing in regard to your sexual exposures certainly raises the possibility, and having had burning only for two days, perhaps discharge will develop. But I'm inclined to suspect it will not. Among other things, you are at relatively low risk for STIs, which are increasingly uncommon as men age beyond their forties; and at the same time the frequency of prostate and other genital tract problems rises substantially at your age. We cannot diagnose anything, but intermittent discomfort of the sort you have now had twice is consistent with prostatitis. Unfortunately, my only suggestion is that you find a way to see a knowledgeable health professional about it. In the meantime, I suggest avoiding sex and not taking any of the antibiotics you have on hand:  the main effect of doing so is likely to be to obscure the eventual diagnosis and make evaluation more difficult.

I'm sorry I can't do more, but this is not a diagnostic service; we never try to diagnose or recommend treatment for anything, but to give more general advice about STIs and their symptoms. Please find a way to get direct clinical care as soon as you can. If you cannot be in contact with your primary care provider, I have to believe there are ways for you to find care wherever you are.

Thanks for your understanding. Let me know if anything isn't clear.

HHH, MD

As it happens, my symptoms of burning during and after urination cleared up on their own again. They lasted about three days and disappeared.  No discharge or urethral redness.  Same as last May.

I'm assuming no STI would have cleared this fast even factoring in the antibiotics. In other words,  if the antibiotics had cleared an infection it would have resolved more slowly.

This is all my way of saying I think your hunch is correct that this was not an infection. And, I am inclined to seek evaluation but not worry about it from the point of view of STIs. But if you think I'm being too quick in moving on from STI possibility, please let me know.

Thanks again for your help with this annoying problem.

Sorry I can't come up with a clear answer, but it seems very likely that you have no infection and can safely continue your current sexual lifestyle without putting partners at risk. However, you might consider assuring use of condoms that do not include spermicidal lubricant, or perhaps no lubricant at all; a separate sexual lubricant, if needed, might be better.