Non-gonococcal urethritis (NGU) can cause different symptoms in men and women. In some cases, NGU does not cause any symptoms at all.

Symptoms of NGU in men

The symptoms of NGU in men can include:

• a white or cloudy discharge from the tip of your penis
• a burning or painful sensation when you pee
• the tip of your penis feeling irritated and sore

Depending on the cause of NGU, symptoms may begin a few weeks or several months after an infection.

If NGU has a non-infectious cause, such as irritation or damage to the urethra, symptoms may begin after a couple of days.

Symptoms that start a day or 2 after sex are not usually caused by a sexually transmitted infection (STI), but testing for STIs is still recommended.

Read about the causes of NGU.

Symptoms of NGU in women

NGU usually causes no noticeable symptoms in women.

However, the infections that cause NGU in men can spread to other parts of the female reproductive system – for example, the womb or fallopian tubes, which connect the ovaries to the womb.

If the infection does spread, a woman may develop pelvic inflammatory disease (PID).

PID is a serious health condition that can cause persistent pain. Repeated episodes of PID are associated with an increased risk of infertility.

Some women with PID do not have symptoms. If there are symptoms, they include: 

• pain around the pelvis or lower part of your stomach (abdomen)
• discomfort or pain during sexual intercourse that is felt deep inside the pelvis
• bleeding between periods and after sex
• pain when you urinate
• heavy or painful periods
• unusual vaginal discharge – especially if it is yellow or green

A few women with PID become very ill with:

• severe lower abdominal pain
• high temperature
• feeling and being sick

Visit a GP or a sexual health clinic if you think you may have PID.

Non-gonococcal urethritis (NGU) can have a number of possible causes, such as an infection, irritation or damage to the urethra.

There are also many cases where no cause is found – this is sometimes known as non-specific urethritis (NSU).

Sexually transmitted infections (STIs)

If urethritis is caused by gonorrhoea, it is known as gonococcal urethritis.

NGU can also be caused by other sexually transmitted infections (STIs), such as chlamydia. Chlamydia is spread during unprotected sex (sex without a condom), including anal and oral sex.

Urethritis is more common among people who are at risk of STIs. This includes people who:

• are sexually active
• have had unprotected sex
• have recently had a new sexual partner

Other infections

A number of other infections can cause NGU. These are caused by other bacteria that usually live harmlessly in the throat, mouth or rectum.

These bacteria can cause NGU if they get into the urethra, which is the tube that carries pee from the bladder to the outside of the body. This can occur during oral or anal sex.

Infections that can cause NGU include:

• Trichomonas vaginalis – an STI caused by a tiny parasite
• Mycoplasma genitalium – tests for this condition have only recently been developed and are not available in all clinics yet; if you can't be tested, you will be treated as though you might have it
• a urinary tract infection
• the herpes simplex virus – this can also cause cold sores and genital herpes
• an adenovirus – usually causes a sore throat or an eye infection

Non-infectious causes

It's possible for NGU to have a non-infectious cause. This is when something else leads to the urethra becoming inflamed. 

Non-infectious causes of NGU include:

• irritation from a product used in the genital area – such as soap, deodorant or spermicide
• damage to the urethra caused by vigorous sex or masturbation, or by frequently squeezing the urethra – some men may do this if they're worried they have an infection
• damage to the urethra caused by inserting an object into it, such as a catheter – this can be done during an operation in hospital

Non-gonococcal urethritis (NGU) is usually treated with a short course of antibiotics to kill the bacteria that caused the infection.

The healthcare professionals at the sexual health clinic (also known as a GUM clinic) will arrange your treatment.

If your urethritis is caused by gonorrhoea, this may be treated differently.

Antibiotics

Treatment with antibiotics may be started before you receive your test results. Most people with NGU are prescribed antibiotic tablets or capsules.

This may be:

• azithromycin – taken just once as a single dose
• doxycycline – taken twice a day for 7 days

You will not usually need to return to the clinic as long as you've:

• taken your treatment
• made sure that any recent partners have been treated
• not had any sex until a week after everyone has been treated

It may sometimes take 2 or 3 weeks for your symptoms to disappear completely.

Do not have sex, including vaginal, anal and oral sex, until:

• you've finished your course of doxycycline, or it's been 7 days since you took azithromycin
• you have no symptoms
• your partner or partners have also been treated

Side effects

Antibiotics may cause some side effects, such as:

• feeling sick
• being sick
• diarrhoea

Informing partners

It's possible to pass on NGU during sex, so it's makes sense to treat all cases of NGU as a sexually transmitted infection (STI) and ensure all recent partners have been treated.

You also should not have any kind of sex until you're certain the condition has cleared up.

It's recommended that you inform any person you've had sex with in the last 3 months, but this timeframe can vary. The healthcare professionals at the sexual health clinic can advise you.

Some people can feel angry, upset or embarrassed about discussing STIs with their current partner or previous partners.

However, do not be afraid to discuss your concerns with the healthcare professionals at the sexual health clinic. They can advise you about who to contact and the best way to contact them.

With your permission, the clinic can arrange for a "contact slip" to be given to your former partner or partners.

The slip explains that they may have been exposed to an STI and advises them to have a check-up. It does not have your name on it, and your details will remain totally confidential.

Nobody can force you to tell any of your partners about your STI, but it's strongly recommended that you do. Without treatment, STIs such as chlamydia can have serious effects on a person's health, particularly for women.

Complications of untreated chlamydia include:

• infection of the testicles in men
• infection of the neck of the womb (cervix) in women
• pelvic inflammatory disease (PID) – this can increase the risk of infertility and ectopic pregnancy

Treatment failure

If you still have the symptoms of non-gonococcal urethritis (NGU) after you have finished your course of antibiotics, return to the sexual health clinic.

You may be asked if you took the medicine correctly and whether anyone with untreated NGU could have passed the infection back to you.

You may need further tests to confirm your diagnosis and check for any STIs.

In some cases, you may be given a new prescription for some different antibiotics to treat the NGU.