diagnosed likely NSU (NGU) - doxcycline.

please can you help me.
i am a gay man in the uk and had oral sex 9 days ago and also 3 days ago with different partners.i always use condoms for penetrative sex.
this morning the tip of my penis was red and tender with a slight watery/grey discharge. the head of the penis is also a little tender and swollen.
I do not have pain urinating and there is no great discharge apart from slight weep.
i have never had this problem before so went to the std clinic this afternoon.
had swab taken and gave urine...the result today showed higher than normal white cell count.(i think that is what they said)
I was told that it is likely i have nsu (ngu ?) and was given 14 day course of doxycycline.(one capsule 2 times a day).
can you answer the 2 following questions?

is it possible i have gonnorrea and if it is..  would the doxycycline also clear it up?

i am due to go on a gay themed holiday in 6 days time and am concerned that i will still have the infection when i go. can you tell me if the doxycycline will kill the infection by the time i go in 6 days time.?... or will i need to wait 14 days before engaging in sex. I realise the course given to me is 14 days long.

thanks... knowledge appreciated

[H. Hunter Handsfield, M.D.]

Clearly you have urethritis.  It probably is NGU (the same thing as NSU, just different terminology between North America and the UK) and not gonorrhea.  It is probable your swab specimen was examined under the microscope, which easily picks up gonorrhea.

In the US, most experts treat NGU with 7 days doxycycline, but 14 days is common in the UK.  All experts recommend no sex until completing treatment, and ideally until several days have passed after the end of treatment.  Therefore, you should not plan on having sex during your upcoming holiday.  If temptations get the better of you, definitely use a condom if you top anybody or receive oral.

Another thought:  Most NGU doesn't cause penile tenderness and swelling, and mostly it doesn't cause redness and tenderness of the penile opening.  Those features suggest the possibility your NGU is due to a virus.  If so, you probably won't notice much improvement with doxycycline, which has no effect on any virus.  The most common viral causes are herpes and adenovirus, either can be acquired by oral sex.  Until the possibility of herpes is excluded, that's another reason to avoid sex the next 1-2 weeks.

Return to your provider if you develop other symptoms to suggest herpes, such as penile blisters or sores, or painful swelling in the groin; or if your symptoms are not very much improved after 3-4 days.

Sorry about the gay holiday, but you definitely have a responsibility to not put other persons at risk.  Cest la vie.

HHH, MD

[sparkeler]

You probably do have chlamydia and/or ghonnorrea.  The doxycycline will eradicate the infection.  I would advise that you finish your antibiotics before engaging in any further sexual activity.  14 days isn't a lifetime without sex.  Your health is more important.  Stay safe:)

[worried000]

thanks for advice....  woke up this morning with swollen foreskin which has a centimetre patch raised with tiny lesions ion it.. a little itchy too.  is this herpes??
the weeping from the penis is better.   still penis a little tender and swollen.

do i need to return to clinic ... and is there a cure ??

thanks

[H. Hunter Handsfield, M.D.]

Sounds like genital herpes.  Return to your provider ASAP.  The sooner fresh herpes lesions are examined, the more accurate the diagnostic tests, and treatment also is much more effective if started early.  If not certain your own GP is up to speed on STDs, consider a visit to your nearest GUM clinic.

Genital herpes can be treated, but not cured.  You can read about genital herpes at www.metrokc.gov/health/apu/std; www.ashastd.org; www.cdc.gov/std; and www.westoverheights.com.

[worried000]

thanks for your advice....
actually this evening the only symptoms are slightly swollen foreskin and a patch of red irritation. no real weeping from the penis and no pain on urination. I did notice very minute 'pin *****' ulcers this morning over a centimeter raised area on the foreskin but these seem to have gone. no ulcers now... i just have a slightlty red irritated and swollen foreskin...  
am still taking the doxycycline... maybe i have ngu and slight genital herpes.?

the earliest appointment i could get at the clinic is thursday evening. do you think this is too long to wait.?? i could take time off work tomorrow and hope the clinic would see me if i just turned up...?
thanks..