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Thursday, October 1, 2020

Non-gonococcal Urethritis (NGU): Causes, Symptoms and Treatment

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Non-gonococcal Urethritis is an infection of the urethra caused by pathogenic microorganisms (germs) distinct from gonorrhea. This condition can be caused in men by irritation of the urethra by chemicals, such as additives to condoms, which can range from colors to Flavors, spermicides, and lubricants.

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In women, this may be caused by irritation as a result of rubbing or pressure on the genital area as a result of tight clothing, including underwear, sex, and other irritants like soaps, unhealthy practices like touching, spermicides, and reactions to condoms can be one of the causes of this infection.

It can also be a result of physical activity such as bicycle riding. In older women, the tissues of the urethra and bladder wear out and become drier and thinner after menopause, which is caused by the lack of estrogen (the female hormone); this is usually the cause of Urethritis in older women.

Several types of germs cause Non-gonococcal Urethritis, and the most common and severe is chlamydia. Chlamydia is prevalent in both males and females. The diagnosis of Non-gonococcal Urethritis is more commonly found in males than in females, primarily due to the anatomical differences.

Pathogens that can cause Non-gonococcal Urethritis to include but are not limited to:


There are many causes of Non-Gonococcal Urethritis, which is as a result of the different variation of organisms habiting the urinary tract. Mycoplasma genitalium, Ureaplasma, and urealyticum are some of the agents.

Non-Gonococcal Urethritis can also be associated with reactive arthritis, in which arthritis, conjunctivitis, and Urethritis are experienced.


The most common bacterial cause of Non-Gonococcal Urethritis is Chlamydia, but it can also be as a result of Ureaplasma urealyticum, Haemophilus vaginalis, Mycoplasma genitalium, Mycoplasma hominins, Gardnerella vaginalis, E.coli.


  • Herpes simplex virus, Adenovirus, Cytomegalovirus
  • Fungi
  • Candida Albicans
  • Parasitic include Trichomoniasis Vaginalis


Urethritis can be caused by injuries from a urinary catheter or a cystoscope, or by an irritating chemical such as antiseptics or some spermicides.
Modes of transmission


Most germs that cause Non-Gonococcal Urethritis can be
contracted during sex (vaginal, anal, or oral) that involves direct mucosal membrane contact with an infected person.

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These causes of Non-Gonococcal Urethritis include: the result of a process such as inserting a tube into the penis(catheterization), a narrowing or closing of the tube in the penis (urethral stricture), an inflamed prostate gland due to bacteria (bacterial prostatitis), a tightening of the foreskin whereby it will be difficult to pull back from the head of the penis (phimosa) and urinary tract infections.

Perinatal: During birth, infants can be exposed to the Non-Gonococcal Urethritis causing germs while passing through the birth canal, which can result in the baby developing infections in the ears and lungs(pneumonia) eyes (conjunctivitis).

Signs or symptoms of NGU?

The indicating symptoms of Urethritis can include pain or a burning sensation upon urination, a white or cloudy discharge, and a feeling that one needs to pass urine frequently.

For men, the signs and symptoms are :

  1. Discharge from the penis
  2. Burning sensation or pain when urinating,
  3. Itching, irritation, or tenderness around the tip of the penis

Women infected with Non-gonococcal Urethritis are usually asymptomatic in women. However, the infections causing organism can spread to other parts of the female reproductive system, for instance, the uterus or fallopian tubes, which connect the ovaries to the uterus.

If the infection spreads, the woman might develop Pelvic Inflammatory Disease (PID). Pelvic inflammatory disease is a severe health condition that can re sult in persistent pain and is usually linked to infertility in women.

Some symptoms can include:

  1. Pain around the pelvis or the lower abdomen
  2. Discomfort or pain during sexual intercourse that is felt deep inside the pelvic
  3. Bleeding between after sex and between periods.
  4. Pains During urination
  5. Painful and heavy periods
  6. Unusual vaginal discharge

Anal or oral infections can arise in both men and women, which can result in rectal discharge, itching, or pain during a bowel movement.

Oral infections may also occur, but a majority of these infections are usually asymptomatic, while some people might experience a painful experience sore throat.


A Non-gonococcal Urethritis diagnosis can be made when a person has arthritis ( which is the swelling of the urethra), but gonorrhea is ruled out as the possible cause of the soreness after tests have been conducted.

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Treatment can be based on the prescription and strict usage of the proper antibiotics depending on the strain of the Ureaplasma, which is a bacteria found in the urinary or genital tract.

Because of its multi-causative nature, initial treatment methods comprise using a broad-spectrum antibiotic that is active against chlamydia (such as doxycycline). It is crucial that both the patient and any sexual partner(s) be treated.

Women infected with non-gonococcal Urethritis may develop Pelvic Inflammatory Disease (PID). And after the administration of a broad spectrum of antibiotics, if symptoms persist, further consultation with a urologist may be vital in identifying the cause.

According to a research study, tinidazole used with doxycycline or azithromycin may treat cure. Non-gonococcal Urethritis more efficiently than when doxycycline or azithromycin is administered alone.

If Non-gonococcal Urethritis is left untreated, complications including epididymitis and infertility can materialize.

Seeking immediate, competent medical intervention, treatment, and attending followup appointments to ensure break up of the disease cycle. It is advisable for one to his or her partner(s) and careful consideration and open communication between partners may insulate all partners involved from contracting the infection.

Treatment and follow up for Non-gonococcal Urethritis?

The primary treatments for Non-gonococcal Urethritis are the antibiotics azithromycin and doxycycline. Other antibiotics are erythromycin and ofloxacin.

A woman who is pregnant, or believes she might be, should consult with a doctor, before and after treatment. This will guarantee that medications will be used that will not impair the development of the baby.

Full dosage of medications should be administered even if symptoms begin to clear before the end of treatment. Inform all partner(s) to Abstain from sex until 2weks after treatment.

Further consultation for evaluation by a health care provider should be considered if symptoms continue or if symptoms recur after the use of complete doses all the prescribed medicine.

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If untreated, the causative organism of Non-gonococcal Urethritis, especially chlamydia, can lead to severe complications. For men, these complications may include:

Epididymitis (inflammation of the epididymis, the long, cordlike structure found along the posterior wall of the testes), which can cause infertility if left unmonitored or treated.

  1. Reiter’s syndrome (arthritis): It can also lead to Sexually acquired reactive arthritis(SAAR): which can sometimes cause inflammation of the eyes (Conjunctivitis)
  2. Skin lesions
  3. Discharge from the penis

In women:

  1. Pelvic Inflammatory Disease (PID) which can result in ectopic (tubal) pregnancy.
  2. Infertility.
  3. Chronic and persistent pelvic pain
  4. Urethritis
  5. Vaginitis
  6. Mucopurulent cervicitis (MPC)
  7. Spontaneous abortion (miscarriage)
  8. For men or women, infections caused by anal sex may lead to severe proctitis (inflamed rectum) and Infants exposed to the germs causing Non-gonococcal Urethritis during passage through the birth canal may develop conjunctivitis (eye infection) and pneumonia.
Non-gonococcal Urethritis
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Disclaimer: This article is purely informative & educational in nature and should not be construed as medical advice. Please use the content only in consultation with an appropriate certified medical or healthcare professional.

Jennifer Aigbini
I am a language enthusiast, studying Linguistics at the University of Benin, in Nigeria.
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