Can NGU be given to a female who performed oral sex?

[William2011]

I am a male. Approximately one week ago I had protected vaginal sex and received unprotected oral sex from a female. 2 days later I received unprotected oral sex from a different female. About 2 days ago I began to experience discomfort in my urethra and have to urinate more frequently than usual. So far there has not been any discharge. Today I got a full STD screening. I will get the results in 4 days. Based upon the research I have done, and my symptoms, I assume if anything, I either have gonorrhea or NGU. The test results will determine that. If it is gonorrhea what is the risk that I transmitted it to the second female who performed oral on me? And if it is NGU same question.
---William---

[Edward W Hook, MD]

Azithromycin in a dose of 1000 mg is one of the recommended therapies for NGU.  the other is doxycycline, 100 mg twice daily for 7 days.  

[William2011]

Thanks again,
     I will post when I get the results. Also what are the recommended medication treatments and dosages for NGU and gonorrhea? I have seen that 1000mg of Azithromyicin is commonly prescribed. Are the treatments and dosages different for males and females. Your expertise and advise is greatly appreciated!
---William---

[Edward W Hook, MD]

The 20-30% is for vaginal intercourse. there are no studies of oral sex but almost certainly the figure is lower.  

There is no way to guess based on symptoms however proportionately NGU is more likely.  Please let us know how yout tests turn out.  EWH

[Edward W Hook, MD]

Welcome to the Forum.  You ask good questions,

If you have gonorrhea, there certainly is a risk of you then transmitting it to a new partner. There is a risk of gonorrhea transmission for an infected male to an un-infected female is about 20-30% per episode of intercourse.  

If you have NGU the answer is less clear.  NGU in men following receipt of oral sex is thought to arise from the introduction of oral (mouth) bacteria into the urethra during oral sex. These bacteria, being foreign, then elicit an inflammatory response which manifest itself as NGU.  Whether the introduction of such bacteria into a female partner's vagina through sexual intercourse might have adverse health consequences for her is unknown but consensus is probably not.   there is no evidence that introduction of such bacteria into a partner's throat would have adverse effect.  

On the other hand, since so much is unknown, you are best off if you tell recent partners if you have NGU. You can tell them that the cause is unknown and but that to be on the safe side they need to know and to be treated.  

I hope this is helpful to you.  EWH

[Edward W Hook, MD]

No the soreness of your testicles is not suggestive of an STD in your situation.

I am glad to hear your urinary symptoms are improved.  

You are taking antibiotics in a dose not recommee for STDs for an STD you do not know you have.  At this time, I suggest you keep working with the doctor who is treating you and we end this thread here.   Take care.  EWH

[William2011]

Dr. Hook,
       I have been on the dosage of Erythromycin since Monday. I have not received the results of the STD screening yet, hopefully tomorrow. The frequent urination and discomfort in the urethra has mostly stopped. This evening my testicles began to be sore, they may be a little swollen, but they are definitely sore and more sensitive than usual. Does that symptom correlate to anything? I am seeking further guidance.
      Gratefully,
             William

[Edward W Hook, MD]

Erythromycin is as effective as azithromycin for chlamydia an NGU when take as 500 mg 4 times daily for 7 days, as is recommended.  There are no data to indicate how well twice daily dosing for five days would work.  

The utility of this regimen for gonorrhea is certainly less than 90%.  How much less is hard to know.  EWH

[William2011]

Dr. Hook,
        I took some preemptive measures and through my doctor obtained a regimen of Erythrocin (pink pill). I am allergic to Amoxicillin and the pharmacy was out of Azithromycin, so I was given this alternative treatment. Is this medication as effective in treating NGU and Ghonorrea as Azithromycin? The dosage directions say 1 500mg tablet twice a day, with a total of 9 tablets.

[William2011]

Thank you,
     It was helpful. The 20-30%, is that for oral or vaginal intercourse? I received unprotected oral from the second female. Does that effect the risk percentage? Also based upon my described symptoms is it more likely that I have one or the other?

---William---