Non-Gonococcal Urethritis (NGU): Causes, Symptoms, and Treatment in Singapore

Non-gonococcal urethritis (NGU) is inflammation of the urethra caused by an infection that is not gonorrhoea. The urethra is the tube that carries urine out of the body. NGU is most commonly diagnosed in men but can occur in women too. It is usually caused by a sexually transmitted infection, though it can occasionally have non-sexual causes such as urinary tract irritation or trauma.

NGU is caused by various infections of the urethra, most commonly Chlamydia trachomatis (the bacterium that causes chlamydia). Other common causes include Mycoplasma genitalium, Ureaplasma urealyticum, Trichomonas vaginalis, and herpes simplex virus. Less common causes include adenovirus, urinary tract irritation, or trauma to the urethra. Identifying the underlying cause is important for choosing the right treatment.

Symptoms in men may include white, cloudy, or watery penile discharge, burning or pain when urinating, irritation or itching at the tip of the penis, or occasional testicular discomfort. Symptoms tend to be milder than gonorrhoea. Some people have no symptoms at all. Because of overlapping symptoms with other STIs, testing is needed to identify the specific cause.

NGU symptoms, when they occur, may appear days to several weeks after exposure, depending on the underlying cause. Some people remain asymptomatic. Because timing varies, STI testing is recommended after potential exposure, with symptoms, or with new or multiple partners, even if symptoms are mild.

Yes. NGU is curable with appropriate treatment prescribed by a doctor based on the underlying cause. Most cases respond well to prescription antibiotics. Untreated NGU may persist or worsen. Sexual partners should also be tested and treated to prevent reinfection. Follow-up testing may be recommended to confirm the infection has cleared, especially if symptoms persist.

NGU is treated with prescription antibiotics. Your doctor will choose the appropriate antibiotic and dosing based on the suspected or confirmed underlying cause, your situation, allergies, and current clinical guidance. Complete the prescribed course even if symptoms resolve. Avoid sexual activity until treatment is completed as advised and recent partners have been treated. If symptoms persist after treatment, return for further evaluation.

Untreated NGU may lead to complications, depending on the underlying infection. In men, it may cause epididymitis, prostatitis, or reactive arthritis. In women, related infections may contribute to cervicitis or pelvic inflammatory disease. Untreated infection can also increase the risk of passing infection to partners.

NGU risk can be reduced by using condoms consistently during vaginal, anal, or oral sex, having regular STI screenings (especially with new or multiple partners), maintaining a mutually monogamous relationship with a tested uninfected partner, and ensuring sex toys are cleaned or covered with a fresh condom between partners. Open conversations with partners about STI status also support prevention.

Yes. Although "NGU" is most commonly used to describe urethral inflammation in men, women can be infected with the same organisms, such as chlamydia, mycoplasma, ureaplasma, or trichomoniasis. In women, these infections may appear as cervicitis, vaginitis, urinary symptoms, or pelvic discomfort. Women whose partners have NGU should consider testing.

You can get tested at Mediway through our STD testing service. Testing may include a urine NAAT test and/or urethral swab in men, depending on symptoms and exposure. Testing checks for the underlying organisms (chlamydia, mycoplasma genitalium, ureaplasma) so the right treatment can be prescribed. Learn more on our STD testing in Singapore page, or speak to our team for a confidential consultation.