Nongonococcal Urethritis (NGU): What It Is, How It Differs From Gonorrhea, and How to Treat It

Nongonococcal urethritis (NGU) is an infection of the urinary tract, or of the vaginal area in women. In the early stages it often causes few noticeable symptoms, but if it is not treated properly, symptoms can develop later on. Chlamydia is a common sexually transmitted infection (STI) in both women and men. It is caused by a bacterium called Chlamydia trachomatis, which can be passed on through sexual contact. The main cause of infection is unsafe sexual activity, such as having multiple partners, not using condoms for protection, or engaging in other risky behaviors.

Symptoms of nongonococcal urethritis

In men, symptoms of chlamydia often include pain, burning, or itching during urination, and there may be involuntary leaking of urine. In women, the symptoms can resemble those of a urinary tract infection, but sometimes there are no symptoms at all. Chlamydia can be spread through sexual contact with an infected person, including through the mouth, the vagina, or other routes. People who are infected with chlamydia may not have obvious symptoms.

This is because the bacteria can damage tissue without causing pain or itching. Even so, some people do have pain when passing urine, pain in the vagina, or vaginal bleeding. There may also be a rash or moistness around the infected genital area.

Nongonococcal urethritis in men

Symptoms of nongonococcal urethritis in men can include:

• Yellow or cloudy discharge from the tip of the penis
• A feeling of interrupted urination or irritation when passing urine
• Irritation and pain at the tip of the penis

This depends on the cause of the infection. Symptoms may appear several weeks or even several months after infection. However, if you develop symptoms just 1–2 days after having sex, they may not be due to a sexually transmitted infection, though it is still a good idea to get tested for STIs.

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Nongonococcal urethritis in women

Nongonococcal urethritis often does not cause noticeable symptoms in women. However, the infection that causes NGU can spread to other parts of the female reproductive system, such as the uterus or the fallopian tubes, which connect the ovaries to the uterus. If the infection spreads, a woman may develop pelvic inflammatory disease (PID).

Pelvic inflammatory disease (PID) is a condition in which the upper reproductive organs in women become inflamed, including the uterus, fallopian tubes, ovaries, and the peritoneum in the pelvic area. It usually results from a bacterial infection that spreads from the vagina or the cervix up into the upper reproductive organs. Causes of PID include:

• Sexually transmitted infections, such as gonorrhea, nongonococcal urethritis, and chlamydia
• Pelvic infection following gynecological procedures, such as an abortion or the insertion of an intrauterine device
• Pelvic infection from other infections, such as other sexually transmitted infections or an infection in the abdominal cavity

Symptoms of PID include:

• Lower abdominal pain
• Foul-smelling discharge, abnormal discharge, or yellow or green mucus
• Fever
• Pain when urinating, or difficulty urinating
• Bleeding after sex
• Pain when the genital area is touched
• If you have symptoms of PID, you should see a doctor promptly for diagnosis and appropriate treatment

Treatment of PID depends on the severity of the infection. It may include:

• Antibiotics
• Rest and recovery
• Surgery
• Antibiotics are the main treatment for PID, and are usually taken for 10–14 days

Complications of PID include:

• Infertility
• Ectopic pregnancy
• Infection in the abdomen

Diagnosing nongonococcal urethritis

Nongonococcal urethritis can be diagnosed in several ways, such as:

• Swab test – the most commonly used method. A swab is used to collect discharge samples from the cervix, the opening of the urethra, the anus, or the throat, which are then sent for staining and bacterial culture.
• Urine test – a convenient and quick method that uses a urine sample to detect bacteria, usually alongside a swab test. A swab test is more accurate than a urine test but may cause slight discomfort, while a urine test is convenient and quick but may be less accurate than a swab test.
• Blood test – to detect bacteria or viruses associated with nongonococcal urethritis.
• Endoscopic examination – to check for infection or other symptoms in the genital area.

Diagnosing nongonococcal urethritis is very important, because the infection can affect a person's health and sex life. So if you have any of the symptoms above, you should see a doctor for diagnosis and treatment as soon as possible.

How is nongonococcal urethritis treated?

Nongonococcal urethritis can be treated with antibiotics. The antibiotics most commonly used for treatment are:

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Azithromycin

Azithromycin is an antibiotic in the macrolide group. It is used to treat bacterial infections such as pneumonia, bronchitis, tonsillitis, sinusitis, and middle-ear infections, as well as sexually transmitted infections such as gonorrhea and nongonococcal urethritis. Azithromycin works by inhibiting bacterial growth: it binds to the bacteria's ribosomes so that they cannot make the proteins they need to survive.

Doxycycline

Doxycycline is an antibiotic in the tetracycline group. It is used to treat bacterial infections such as pneumonia, bronchitis, tonsillitis, sinusitis, and middle-ear infections, as well as sexually transmitted infections such as gonorrhea and nongonococcal urethritis. Doxycycline works by inhibiting bacterial growth: it binds to the bacteria's ribosomes so that they cannot make the proteins they need to survive.

Medication	How it is taken	Side effects
Azithromycin	A single dose of 1–2 grams (as prescribed by a doctor)	Nausea and vomiting Diarrhea Headache Dizziness Constipation Loss of appetite Altered taste Numbness or tingling of the skin Allergic drug reaction
Doxycycline	Taken twice a day for 7 days	Nausea and vomiting Diarrhea Headache Dizziness Constipation Loss of appetite Altered taste Numbness or tingling of the skin Allergic drug reaction

The alternative medications are erythromycin and ofloxacin. If a woman is pregnant, or thinks she may be pregnant, she should tell her doctor so that a medication that will not harm the baby can be used. Even if your symptoms improve once you start any of these medications, you should keep following the treatment until you have finished the medication completely. You should also tell your sexual partner so that both of you can be treated at the same time, and you should avoid sex until you have both recovered. If you still have unusual symptoms, or if the infection comes back after you have completed all of the medication, you should return to your healthcare provider for another diagnosis.

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How to prevent nongonococcal urethritis

• Use condoms for protection – using a condom every time you have sex helps reduce the risk of contracting nongonococcal urethritis.
• Avoid sex with strangers – having sex with people you don't know, with sex workers, or with someone you meet while out — when you don't know whether they carry the infection — increases the risk of contracting nongonococcal urethritis.
• Get an annual health check-up – yearly check-ups, including screening for HIV and all sexually transmitted infections, especially nongonococcal urethritis, help make treatment faster and can ultimately lead to a full recovery.
• Avoid oil-based lubricants – oil-based lubricants or gels can weaken a condom's protection or cause it to break, making it ineffective.
• Always keep clean – looking after the cleanliness of your genitals by bathing daily and washing both before and after sex helps reduce the risk of nongonococcal urethritis.

In summary, nongonococcal urethritis is most commonly caused by chlamydia, a common sexually transmitted infection caused by the bacterium Chlamydia trachomatis. It usually infects the genitals and urinary tract, but it can also infect the throat and the anus. Nongonococcal urethritis often causes no symptoms, but if it is left untreated it can lead to serious health complications, such as pelvic inflammatory disease, infertility, and ectopic pregnancy.

Testing for nongonococcal urethritis is very important, especially for people who have sex without a condom, so that it can be detected and treated in time. Prevention comes down to using condoms, testing regularly, and talking with your partner about sexual health.

Verified references

Links and relevance to the article’s main topic were reviewed on 13 August 2026. Each source supports only the scope stated in the original document and does not replace personalised medical, legal, or service advice.

1. CDC: About Gonorrhea Accessed 13 August 2026
2. CDC: STI Treatment Guidelines Accessed 13 August 2026
3. CDC: About Chlamydia Accessed 13 August 2026