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Bacterial STI Curable

Nongonococcal Urethritis (NGU)

Nongonococcal urethritis (NGU) is inflammation of the urethra not caused by gonorrhea. It's a syndrome with several possible causes, from chlamydia to Mycoplasma genitalium, and in about half of cases no specific organism is ever found. Urethral discharge, burning when you pee, or itching inside the urethra are what put NGU on a clinician's list. It's curable with antibiotics, and testing for the underlying cause is widely available.

Find nongonococcal urethritis (NGU) testing near you When can nongonococcal urethritis (NGU) be detected?
Curable?
Yes
With oral antibiotics
Main symptom
Urethral discharge
Plus painful urination
First-line
Doxycycline
100 mg twice daily, 7 days
Cause identified
~50%
Often no organism found

Understanding nongonococcal urethritis (NGU)

What is nongonococcal urethritis (NGU)?

NGU is urethritis that isn't caused by gonorrhea. Rather than a single infection, it's a clinical syndrome with several possible causes. The most common identifiable culprit is Chlamydia trachomatis, followed by Mycoplasma genitalium. Less often, Trichomonas vaginalis, herpes simplex virus (HSV), or adenovirus are responsible. Importantly, in roughly half of all NGU cases, no organism is ever identified: the inflammation is real and treatable, but the cause remains unknown.

Because NGU is defined by what it isn't (gonorrhea) as much as by what it is, diagnosis hinges on two things: objective evidence that the urethra is inflamed, and laboratory testing to rule in or out the treatable causes. This two-part approach is why clinicians don't simply treat on symptoms alone: confirming urethritis and running NAAT testing for chlamydia, gonorrhea, and (in persistent cases) M. genitalium guides the right treatment and partner care.

NGU mainly presents in men, which reflects how urethritis is recognized and tested. The same pathogens cause infection in partners of any sex, but in women they more often present as cervicitis or remain silent. That's a key reason partner notification and treatment matter so much: an untreated partner can carry chlamydia that leads to pelvic inflammatory disease (PID) and infertility, even when the person diagnosed with NGU recovers fully.

Treatment is straightforward and effective for most people. The CDC's recommended regimen is doxycycline for seven days, chosen over single-dose azithromycin because of better outcomes and less resistance selection. NGU is curable: but persistent or recurrent cases need re-evaluation, because M. genitalium, which doxycycline alone clears in only about a third of cases, is a frequent reason symptoms come back.

Where to get tested

Find nongonococcal urethritis (NGU) testing near you

Choose your test and enter your city: we'll take you straight to local nongonococcal urethritis (NGU) testing: nearby clinics and labs, prices, hours and county rates.

Test from home

At-home STD testing in the U.S.

if you'd rather skip the trip, an at-home kit ships to the U.S., you collect the sample privately, and mail it back to a CLIA-certified lab. Results come online in days, with a clinician available if anything is positive. Same labs as a clinic, no waiting room, and you can read how accurate at-home STD tests are before you order.

Want a free option first? The CDC-supported TakeMeHome program mails free at-home HIV self-test kits, and, in many areas, free STI kits, to your door, with no insurance or payment needed. The paid kits below add broader panels and faster turnaround.

  • In-home collection

    Quest Diagnostics

    Quest Diagnostics

    $79 & up

    Panel:
    8-infection panel incl. chlamydia, gonorrhea, HIV, syphilis, hepatitis & herpes: single tests too
    Sample:
    Quest Mobile: a phlebotomist collects your sample at home
    Results:
    1–3 days, online: physician-reviewed
    • In-home sample collection
    • Nationwide Quest lab network
    • Physician-reviewed results
    • FSA/HSA eligible
    Order online Quest Diagnostics review

  • Best range: couples & full panels

    myLAB Box

    myLAB Box

    $79 & up

    Panel:
    Up to 14 infections, incl. HIV, syphilis, chlamydia, gonorrhea, hepatitis & herpes
    Sample:
    Self-collect: swab, urine, finger-prick
    Results:
    2–5 days, online
    • Free phone consult if positive
    • CLIA-certified labs
    • Couples & subscription options
    • Discreet packaging
    Order online myLAB Box review

  • Best for simplicity & support

    LetsGetChecked

    LetsGetChecked

    $89 & up

    Panel:
    5–6 common STIs incl. chlamydia, gonorrhea, HIV, syphilis & trichomoniasis
    Sample:
    Finger-prick + urine/swab
    Results:
    2–5 days, online
    • 24/7 nurse support
    • Prescription for positives
    • CLIA-certified labs
    • Free shipping both ways
    Order online LetsGetChecked review

Every kit uses CLIA-certified labs. At-home testing is for screening; a reactive result should be confirmed and treated by a clinician. Prices and panels shown are illustrative and change often, confirm current details on the provider's site.

Symptoms

What are the symptoms of nongonococcal urethritis (NGU)?

Some NGU infections cause no symptoms at all, particularly when the underlying cause is chlamydia or M. genitalium. Silent infection is part of why partner testing matters, an asymptomatic partner can still transmit and develop complications. Symptoms typically appear days to a few weeks after exposure, depending on the underlying organism. That's exactly why testing matters: you can have it, pass it on, and never feel a thing.

Men (most common presentation)

  • Urethral discharge, mucoid (clear/cloudy) or purulent (pus-like)
  • Painful or burning urination (dysuria)
  • Itching or irritation inside the urethra
  • Symptoms may be mild and intermittent
  • Some men have no symptoms despite confirmed infection

Partners (any sex)

  • Often asymptomatic, especially with chlamydia
  • In women, the underlying cause may present as cervicitis rather than urethritis
  • Untreated chlamydia can progress silently
  • May develop complications of the underlying STI without urethral symptoms

Because the same organisms behave differently in different people, the absence of symptoms in a partner does not mean they aren't infected.

Left untreated

Why nongonococcal urethritis (NGU) is worth catching early

Treated early, nongonococcal urethritis (NGU) is curable and causes no lasting harm. Left untreated, it can cause serious complications:

Epididymitis

Inflammation of the epididymis behind the testicle, which can cause pain and swelling and, if untreated, affect fertility.

Prostatitis

Inflammation of the prostate gland, a recognized complication of NGU in men.

Reactive arthritis

An immune-mediated joint inflammation that can follow urethritis, sometimes alongside eye and skin findings.

Complications in partners

Partners can develop the complications of the underlying STI, notably chlamydia leading to pelvic inflammatory disease (PID) and infertility, which is why partner treatment is essential.

How testing works

How a nongonococcal urethritis (NGU) test works

How you test for nongonococcal urethritis (NGU) depends on the infection. The options below cover what each test looks for, how the sample is collected, and where you can get it: at a lab, a clinic, or at home.

When to test

Get evaluated when urethral symptoms appear, and seek re-evaluation if symptoms persist or return after treatment.

After treatment

Diagnosis is a two-step process: confirm urethritis (Gram stain or first-void urine WBC/leukocyte esterase) AND run NAAT for chlamydia and gonorrhea.

Gram stain of urethral secretions Confirms urethritis
Sample
Urethral swab
Results
Same visit (microscopy)

≥2 WBC per oil-immersion field with no gonococci confirms NGU.

First-void urine analysis
Sample
First-void urine
Results
Same day

Positive leukocyte esterase or ≥10 WBC per high-power field provides objective evidence of urethritis.

NAAT for chlamydia & gonorrhea Most accurate
Sample
Urine or urethral swab
Results
1–3 days

Identifies the most common causes and rules out gonorrhea.

NAAT for Mycoplasma genitalium
Sample
Urine or urethral swab
Results
Few days

Reserved for persistent or recurrent NGU to guide targeted treatment.

What a nongonococcal urethritis (NGU) test costs

Where What it costs
Private lab (self-pay)Varies by clinic and which tests are run; office visit plus NAAT testing.
Free / sliding-scale clinicMany public health and STI clinics offer low-cost or free evaluation and treatment.
With insuranceSTI testing and treatment are commonly covered; check your specific plan.

Compare STD testing costs across every option.

Screening guidance

Who should get tested for nongonococcal urethritis (NGU)?

Testing for nongonococcal urethritis (NGU) is usually guided by symptoms, a known exposure, or a partner's diagnosis rather than routine screening: so you test when you have a reason to, not on a fixed schedule.

  1. 1

    Men with urethral symptoms

    Discharge, burning with urination, or urethral itching should prompt evaluation for urethritis and testing for chlamydia, gonorrhea, and other causes.

  2. 2

    Sex partners of someone with NGU

    All partners from the prior 60 days should be evaluated, tested, and presumptively treated for chlamydia even without symptoms.

  3. 3

    People with persistent or recurrent symptoms

    If symptoms return after treatment, re-confirm urethritis and test for Mycoplasma genitalium, a common cause of treatment-resistant NGU.

  4. 4

    Anyone with a new diagnosis of chlamydia or trichomonas

    These are leading identifiable causes of NGU; a positive result explains the syndrome and guides partner care.

  5. 5

    Sexually active people with multiple or new partners

    Routine STI screening can catch chlamydia and other NGU causes before symptoms or complications develop.

If your result is positive

How is nongonococcal urethritis (NGU) treated?

NGU is curable with oral antibiotics. The CDC's recommended first-line regimen is doxycycline, chosen for better outcomes and lower resistance selection than single-dose azithromycin.

StageRecommended regimen
Initial NGUDoxycycline 100 mg orally twice daily for 7 days (or azithromycin 1 g single dose as alternative).
Persistent / recurrent NGURe-confirm urethritis and test for M. genitalium. If positive: doxycycline followed by moxifloxacin 400 mg daily for 7 days.

Treat partners

Refer all sex partners from the prior 60 days for evaluation, testing, and presumptive treatment effective against chlamydia.

Re-test after treatment

If symptoms persist or recur, return for re-evaluation rather than repeating the same treatment blindly.

Treatment & online care

Resistance note: Doxycycline alone cures only about 30–40% of M. genitalium. It is the recommended first-line agent for overall outcomes and lower resistance selection within sequential therapy, not because it cures M. genitalium well on its own.

Prevention

How to prevent nongonococcal urethritis (NGU)

  • Treat partners

    Refer all sex partners from the prior 60 days for evaluation, testing, and presumptive treatment against chlamydia.

  • Use condoms

    Condoms reduce transmission of the organisms that cause NGU.

  • Complete treatment fully

    Finish the full antibiotic course and avoid sex until you and your partner(s) are treated.

  • Return if symptoms persist

    Re-evaluation can identify M. genitalium and other treatment-resistant causes.

Who is most at risk

Who is most at risk for nongonococcal urethritis (NGU)?

Anyone who is sexually active can contract nongonococcal urethritis (NGU), but certain groups face significantly higher risk, and should test more frequently.

New or multiple sex partners
More partners increases exposure to chlamydia and other organisms that cause NGU.
Condomless sex
Vaginal, anal, and oral sex without condoms raises transmission risk.
Prior or current chlamydia
Chlamydia is the leading identifiable cause of NGU.
Partner with a recent STI diagnosis
Partners within the prior 60 days should be evaluated and treated.

Stats & rates

How common is nongonococcal urethritis (NGU) in the U.S.?

Where you test and what it costs vary by location, see the by-location links below for nongonococcal urethritis (NGU) testing where you live. Source: CDC, Urethritis & Cervicitis (STI Treatment Guidelines, 2021).

Browse by location

Nongonococcal urethritis (NGU) testing by state & city

Jump to local nongonococcal urethritis (NGU) testing, clinics and labs, prices and county rates, in your state or a popular city, or explore another test.

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Living with nongonococcal urethritis (NGU)

Questions to ask your provider about nongonococcal urethritis (NGU)

Nongonococcal urethritis (NGU) is treatable and nothing to be ashamed of. The most useful next step after a positive result (or before a first test) is a direct conversation with a clinician. Here are the questions that matter most:

  • Which underlying cause was found (chlamydia, M. genitalium, or other), and does it change my treatment?
  • What treatment options are available to me, and how long until I'm no longer contagious?
  • Should I notify my recent partners, and can your office help me do that confidentially?
  • How soon can I re-test to confirm the infection has cleared?
  • Are there other STIs I should test for at the same visit?
  • Can this affect my fertility, pregnancy, or long-term health if left untreated?

Good to Know

Nongonococcal urethritis (NGU) testing FAQs

Common questions about nongonococcal urethritis (NGU) and nongonococcal urethritis (NGU) testing, answered.

What is nongonococcal urethritis (NGU)?

NGU is inflammation of the urethra that is not caused by gonorrhea. It's a syndrome with several possible causes, including chlamydia, Mycoplasma genitalium, trichomonas, herpes, and adenovirus. In about half of cases, no specific organism is identified.

What causes NGU?

The most common identifiable cause is Chlamydia trachomatis, followed by Mycoplasma genitalium. Less often it's caused by Trichomonas vaginalis, HSV, or adenovirus. Around 50% of NGU cases have no organism identified at all.

What are the symptoms of NGU?

Typical symptoms include urethral discharge (mucoid or purulent), painful urination, and itching inside the urethra. It mainly presents in men, and some infections cause no symptoms at all.

How is NGU diagnosed?

Diagnosis requires objective evidence of urethritis, a Gram stain showing ≥2 WBC per oil-immersion field with no gonococci, or a positive leukocyte esterase or ≥10 WBC per high-power field on first-void urine, plus NAAT testing for chlamydia and gonorrhea (and M. genitalium in persistent cases).

Is NGU curable?

Yes. NGU is curable with oral antibiotics. The CDC's recommended first-line treatment is doxycycline 100 mg twice daily for 7 days, with azithromycin 1 g single dose as an alternative.

Why does my NGU keep coming back?

Persistent or recurrent NGU is often caused by Mycoplasma genitalium, which doxycycline alone clears in only about 30–40% of cases. If symptoms return, you should be re-evaluated to confirm urethritis and tested for M. genitalium, which may need doxycycline followed by moxifloxacin.

Do my partners need treatment?

Yes. All sex partners from the prior 60 days should be evaluated, tested, and presumptively treated with a regimen effective against chlamydia. This prevents reinfection and protects partners from complications like PID and infertility.

What complications can NGU cause?

In men, NGU can lead to epididymitis, prostatitis, and reactive arthritis. Partners can develop the complications of the underlying STI, notably chlamydia leading to pelvic inflammatory disease and infertility, which is why partner treatment matters.

Medically Reviewed · Updated

Reviewed by Dr. Ngozi Adeyemi, MD, MPH · Infectious Disease & Epidemiology

Board-certified in infectious disease with a focus on STI epidemiology and public-health screening programs. Leads testing, diagnosis and the data-driven 'state of STDs' reporting. Our editorial guidelines →

2 Sources

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