Aa
Long term worries for partner
Dr
I had NSU diag. at GUM a no. of yrs ago. All other tests were neg. I was given 1g Zithro.
Since then it's returned on/off no. of times despite been retreated with Doxy & Metrodiz & no new exposures. I asked GUM about Myco Genit but they'd no test for it. I know MG responds to 5days Zithro or Moxy. I'd none of these.
My NSU was recurrent on/off with treat. consisting purely of:
1g Zitro & Clear on retest. Recurred & given 1g Zitro & clear on retest.
Recurred again & given standard doxy with metrodiz. No retest.
Approx. 6months later I was given 1g Zithro with Doxy. Retested & still there so had another dose of Doxy with Metrodiz.
Suddenly it just went away for THREE YEARS.
1. Did the NSU recur initially (i.e. prior to been absent for 3yrs) because it was due to MG & become resistant to standard 1g Zitro / standard Doxy? If it was MG it stands to reason it wouldn't have gone away for 3yrs without the Moxy or prolonged Zithro as it seemed to be resistant to the standard meds. But the fact it DID go away for 3yrs WITHOUT these doses - Does it rule out MG?
2. In one case I was given 1g Zithro & told to return after 3wks to retest. I waited for 8wks to ensure a more "full proof" result. This test showed no NSU but a test after 13wks showed NSU. Would the clear result after 8wks rule out MG?
3. NSU initially MAY have been contracted from 1 night stand in Mar 07. I tested Jul 07 & NSU showed up. I was given 1g Zitro BUT NOT RETESTED. 1month AFTER the initial 1g Zitro I received unprotect oral from the partner I'm still with now. Could I have passed something on via that unprotected oral bearing in mind I had taken the prescribed 1g Zitro a month prior? 5days after unprotect oral I tested for NSU & it was CLEARED. All our sex since has been protected. All repeated doses have been taken with no new exposures.
4. Is MG passed via oral sex? Has the unprotected oral affected my partner?
5. IS MG damaging to partners?
I had NSU diag. at GUM a no. of yrs ago. All other tests were neg. I was given 1g Zithro.
Since then it's returned on/off no. of times despite been retreated with Doxy & Metrodiz & no new exposures. I asked GUM about Myco Genit but they'd no test for it. I know MG responds to 5days Zithro or Moxy. I'd none of these.
My NSU was recurrent on/off with treat. consisting purely of:
1g Zitro & Clear on retest. Recurred & given 1g Zitro & clear on retest.
Recurred again & given standard doxy with metrodiz. No retest.
Approx. 6months later I was given 1g Zithro with Doxy. Retested & still there so had another dose of Doxy with Metrodiz.
Suddenly it just went away for THREE YEARS.
1. Did the NSU recur initially (i.e. prior to been absent for 3yrs) because it was due to MG & become resistant to standard 1g Zitro / standard Doxy? If it was MG it stands to reason it wouldn't have gone away for 3yrs without the Moxy or prolonged Zithro as it seemed to be resistant to the standard meds. But the fact it DID go away for 3yrs WITHOUT these doses - Does it rule out MG?
2. In one case I was given 1g Zithro & told to return after 3wks to retest. I waited for 8wks to ensure a more "full proof" result. This test showed no NSU but a test after 13wks showed NSU. Would the clear result after 8wks rule out MG?
3. NSU initially MAY have been contracted from 1 night stand in Mar 07. I tested Jul 07 & NSU showed up. I was given 1g Zitro BUT NOT RETESTED. 1month AFTER the initial 1g Zitro I received unprotect oral from the partner I'm still with now. Could I have passed something on via that unprotected oral bearing in mind I had taken the prescribed 1g Zitro a month prior? 5days after unprotect oral I tested for NSU & it was CLEARED. All our sex since has been protected. All repeated doses have been taken with no new exposures.
4. Is MG passed via oral sex? Has the unprotected oral affected my partner?
5. IS MG damaging to partners?
MEDICAL PROFESSIONAL
Thanks for the kind words. I'm glad to have helped.
Thanks again Doctor. Your replies have been extremely detailed & very helpful. Recently I have gone to a private specialist & I explained my concerns. His advice was in keeping with your own. I just wanted another opinion. Again, thanks for your help on this matter. The service provided through this forum is a very professional one.
MEDICAL PROFESSIONAL
This information doesn't change my opinions or advice. Regardless of how this started out, it is very unlikely you currently have an active STD or any other infection that would harm your wife in any way.
1) Most recurrent NGU (or prostatitis symptoms) are not due to new infections, but to relapse of symptoms of unknown cause.
2) I cannot judge whether or not you currently have M. genitalium. If you do, most likely it will not be harmful. However, you could speak with your doctor about taking a course of moxifloxacin in the hope it will stop your symptoms from recurring. (Sorry I misread and thought you had been treated with it in past years.)
3-6) If I were in your situation, I would continue unprotected sex with my wife without concern for her health or my own. I suggest you do the same. There are no data on the likely timing of PID, in the event your wife were to acquire MG. Most likely within a few weeks, but I can't say more. MG has not been associated with any complications of pregnancy.
7) With the new knowledge about MG and its role in some cases of NGU, and the possibility of potential problems in women, one has to acknowledge some level of potential risk for your wife. On the other hand, the general experience of STD specialists -- including my own over 40 years in this business -- is that we never see serious health problems (PID, infertility, etc) in the female partners of men with nonchlamydial NGU. If there is any risk, it is very low.
8) As noted above, you could speak with your doctor (preferably a GUM specialist) about both you and your wife having a course of moxifloxacin. Personally, if I were in your circumstance, I would not do this for either myself or my wife -- and as noted above, would continue unprotected sex without worry. By far the most likely scenario here is that you have (or have had) recurrent non-bacterial prostatitis, and no STD at all.
That will end this thread. Your situation is too complex for me to want to give any further advice about it. If you pursue it further at all -- the wisdom of which I question -- then I would suggest you print out this thread as a framework for discussion in person with a GUM specialist, then follow the advice you receive.
1) Most recurrent NGU (or prostatitis symptoms) are not due to new infections, but to relapse of symptoms of unknown cause.
2) I cannot judge whether or not you currently have M. genitalium. If you do, most likely it will not be harmful. However, you could speak with your doctor about taking a course of moxifloxacin in the hope it will stop your symptoms from recurring. (Sorry I misread and thought you had been treated with it in past years.)
3-6) If I were in your situation, I would continue unprotected sex with my wife without concern for her health or my own. I suggest you do the same. There are no data on the likely timing of PID, in the event your wife were to acquire MG. Most likely within a few weeks, but I can't say more. MG has not been associated with any complications of pregnancy.
7) With the new knowledge about MG and its role in some cases of NGU, and the possibility of potential problems in women, one has to acknowledge some level of potential risk for your wife. On the other hand, the general experience of STD specialists -- including my own over 40 years in this business -- is that we never see serious health problems (PID, infertility, etc) in the female partners of men with nonchlamydial NGU. If there is any risk, it is very low.
8) As noted above, you could speak with your doctor (preferably a GUM specialist) about both you and your wife having a course of moxifloxacin. Personally, if I were in your circumstance, I would not do this for either myself or my wife -- and as noted above, would continue unprotected sex without worry. By far the most likely scenario here is that you have (or have had) recurrent non-bacterial prostatitis, and no STD at all.
That will end this thread. Your situation is too complex for me to want to give any further advice about it. If you pursue it further at all -- the wisdom of which I question -- then I would suggest you print out this thread as a framework for discussion in person with a GUM specialist, then follow the advice you receive.
Thanks Dr,
To clarify:
I've been to public & private docs & none seem overly worried but not 100% sure. They told me to move on.
My partner is female & the possible incident which may have caused NSU was female.
I never had Moxiflox at any stage.
My urologist thinks prostatitis is/was an issue for me. He examined me in detail.
Full history:
Mar 2007 - Incident occured with a female during 1 night stand.
Jul 2007 - Tested & NSU present - 1g Zitro
Aug 2007 - Unprotect oral with new partner who is now my wife.
Condoms used since.
Sept 2007 - Retest - Clear result
Dec 2007 - NSU present - 1g Zitro
Mar 2008 - Retest - Clear result
April 2008 - NSU present - Doxy & Metrodiz - No retest
Dec 2008 - NSU present - 1g Zitro & Doxy.
Jan 2009 - Retest & NSU present - Doxy & Metrodiz
Oct 2012 - Retest & NSU clear.
May 2013 - Retest & NSU present.
From Oct 2012 - May 2013 sometimes after sex I took the condom off & would rub the outside onto the tip of my penis ensuring some vaginal secretions would end up on the tip of my penis.
1. Was May 2013 NSU due to my wife's normal bugs from the condom? She never had Chylm/Gonn.
2. Do the meds from July 2007-Jan 2009, but with NSU still recurring point against MG?
3. Concerned I've passed something to my now wife in Aug 2007 during the oral sex incident. However your reply says it isn't a concern, is that correct? Without research how can I be sure?
4. Is it now safe to start unprotect sex with my wife?
5. If I start unprotected sex would PID show symptoms in my wife relatively quickly, if the worst were to happen?
6. Pregnancy complications?
7. You said "NGU not due to chlamydia is rarely if ever serious. No complications are known, either in infected men or their female partners". But also said about MG "There is somewhat increased concern for female partners' health". Is this not contradictory?
8. Any final advice?
Thanks.
To clarify:
I've been to public & private docs & none seem overly worried but not 100% sure. They told me to move on.
My partner is female & the possible incident which may have caused NSU was female.
I never had Moxiflox at any stage.
My urologist thinks prostatitis is/was an issue for me. He examined me in detail.
Full history:
Mar 2007 - Incident occured with a female during 1 night stand.
Jul 2007 - Tested & NSU present - 1g Zitro
Aug 2007 - Unprotect oral with new partner who is now my wife.
Condoms used since.
Sept 2007 - Retest - Clear result
Dec 2007 - NSU present - 1g Zitro
Mar 2008 - Retest - Clear result
April 2008 - NSU present - Doxy & Metrodiz - No retest
Dec 2008 - NSU present - 1g Zitro & Doxy.
Jan 2009 - Retest & NSU present - Doxy & Metrodiz
Oct 2012 - Retest & NSU clear.
May 2013 - Retest & NSU present.
From Oct 2012 - May 2013 sometimes after sex I took the condom off & would rub the outside onto the tip of my penis ensuring some vaginal secretions would end up on the tip of my penis.
1. Was May 2013 NSU due to my wife's normal bugs from the condom? She never had Chylm/Gonn.
2. Do the meds from July 2007-Jan 2009, but with NSU still recurring point against MG?
3. Concerned I've passed something to my now wife in Aug 2007 during the oral sex incident. However your reply says it isn't a concern, is that correct? Without research how can I be sure?
4. Is it now safe to start unprotect sex with my wife?
5. If I start unprotected sex would PID show symptoms in my wife relatively quickly, if the worst were to happen?
6. Pregnancy complications?
7. You said "NGU not due to chlamydia is rarely if ever serious. No complications are known, either in infected men or their female partners". But also said about MG "There is somewhat increased concern for female partners' health". Is this not contradictory?
8. Any final advice?
Thanks.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
Nongonococcal urethritis, or NGU, is the same as nonspecific urethritis (NSU) -- different terms for the same disease. NGU is more commonly used in North America, which is why it's my habit.
NGU not due to chlamydia is rarely if ever serious. No complications are known, either in infected men or their female partners. You don't say the sex of your partners, but I'll add that MG isn't known to be sexually transmitted between men (although it hasn't been studied carefully). Since the relatively recent discovery of M. genitalium as an occasional cause (about 10-15% of cases), there is somewhat increased concern for female partners' health. However, even here the risk appears to be low. And most if not all cases would have been eradicated by one or more of the antibiotics you had, especially moxifloxacin. It is possible that testing for MG will become routine in the future, but not yet. To your specific questions:
1-3) Recurrences are common with NGU, but not usually for 3 years. I would guess you have had a prostate problem, rather than recurrent NGU per se. It is unlikely that your problem is due to persistent or recurrent M genitalium. Many cases of persistent or recurrent NGU or prostatitis probably are not infections at all, but non-infectious inflammation. In any case, it is almost impossible to accurately judge when and where such infections may have been acquired, if any infection is responsible for the problem.
4) MG is not known to be transmitted by oral sex. It hasn't been carefully studied, but my guess is that this is infrequent if it occurs at all.
5) See my comments above: There may be risk of PID (fallopian tube infection) in women with MG, but few if any complications in men.
My advice is that if and when you have continuing symptoms, you return to a GUM clinic for personal evaluation. The professional staff at most UK GUM clinics know as much about this stuff as I do. Alternatively, if you prefer the private sector and live in or near London, consider a visit to the Freedom Health Clinic -- an excellent sexual health service center. But in the meantime, don't be overly worried. It is unlikely anything serious is going on.
Best wishes-- HHH, MD
Nongonococcal urethritis, or NGU, is the same as nonspecific urethritis (NSU) -- different terms for the same disease. NGU is more commonly used in North America, which is why it's my habit.
NGU not due to chlamydia is rarely if ever serious. No complications are known, either in infected men or their female partners. You don't say the sex of your partners, but I'll add that MG isn't known to be sexually transmitted between men (although it hasn't been studied carefully). Since the relatively recent discovery of M. genitalium as an occasional cause (about 10-15% of cases), there is somewhat increased concern for female partners' health. However, even here the risk appears to be low. And most if not all cases would have been eradicated by one or more of the antibiotics you had, especially moxifloxacin. It is possible that testing for MG will become routine in the future, but not yet. To your specific questions:
1-3) Recurrences are common with NGU, but not usually for 3 years. I would guess you have had a prostate problem, rather than recurrent NGU per se. It is unlikely that your problem is due to persistent or recurrent M genitalium. Many cases of persistent or recurrent NGU or prostatitis probably are not infections at all, but non-infectious inflammation. In any case, it is almost impossible to accurately judge when and where such infections may have been acquired, if any infection is responsible for the problem.
4) MG is not known to be transmitted by oral sex. It hasn't been carefully studied, but my guess is that this is infrequent if it occurs at all.
5) See my comments above: There may be risk of PID (fallopian tube infection) in women with MG, but few if any complications in men.
My advice is that if and when you have continuing symptoms, you return to a GUM clinic for personal evaluation. The professional staff at most UK GUM clinics know as much about this stuff as I do. Alternatively, if you prefer the private sector and live in or near London, consider a visit to the Freedom Health Clinic -- an excellent sexual health service center. But in the meantime, don't be overly worried. It is unlikely anything serious is going on.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
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