Hello, About 2 Months Ago I Had STD Symptoms Like
Recurrence of infection may happen- further details below
Detailed Answer:
Hello and welcome to "Ask a Doctor" service.
Red urethra might be due to urethritis, which is inflammation in the area and this maybe due to recurrence of the infection or complication with Candida infection from antibiotic use.
It is common for the tests for STD to come out negative (normal) so empiric treatment is done.
Normally treatment of STD should include treatment of the partner/s of the patient at the same time with the patient and sexual abstinence during treatment. If this did not happen reinfection is likely and you will need to repeat treatment. treatment in females lasts 2 weeks for doxycycline and 1 week in case of males.
Trichomonas is also an STD to consider and treatment with metronidazole for a week might be advisable.
It symptoms persist or you get itchiness locally with white secretions, Candida infection is likely and one fluconazole 200 mg orally is sufficient.
To conclude:
- recurrence of infection is likely if the treatment is not done as mentioned above. I would treat partners as well, treat you with doxy for 10-14 days for better results and possibly I would add metronidazole for a week as well other than cefixime or ceftriaxone single dose (partners single dose ceftriaxone or cefixime+ doxycycline for a week + /- metornidazole for one week).
- if still red and irritated you can take fluconazole 200 mg single oral dose for Candida.
I hope this answers your query. Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj
It may be due to yeast infection but need to be sure there is no STD
Detailed Answer:
Hello,
If you were not sexually active the previous 3 months before starting with symptoms then very likely this is not an STD but if you were sexually active those 3 monthd (even in the early days of the 3 month period) then an STD is to be considered.
This is very important because STD generally do not cause much symptoms but may cause chronic changes due to chronic inflammation in a woman and bear sequela if not treated well and on time (may cause chronic pelvic pain and problems with fertility in the future). This is why we have a low threshold suspecting and treating it.
Yeast infection of the urethra and vulva might cause urethritis and discomfort there as well so if it is unlikely to be an STD (you were not sexually active the previous 3 months) then you can choose between these two treatments (depending on if you are allowed access)
1. clotrimazole cream 2-3 times a day locally on the vulva for 8-10 days (this is more likely to be accessed over the counter)
2. fluconazole tablet 200 mg single oral dose (this is very convenient but may be difficult to access over the counter)
Having some probiotics daily and yogurt is found to help with yeast infection as well.
I hope this answers your query. Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj
Explanations on the causes
Detailed Answer:
Hello,
I understand your concern that you already got treated and the tests come out negative. On the other hand Doxycycline ( is a very good antibiotic for chlamydia but does not cover gonorrhea or trichomonas) and doxycyline is used for 7-14 days (average of 10 days) for chlamydia- so I am not sure you ever got the optimal treatment for the symptoms.
- If I were your doctor I would have prescribed Doxycyline twice a day for at least 10 days (chlamydia) + single dose Ceftriaxone 250 mg intramuscular (gonorrhea) and probably would add metronidazole twice a day for a week (trichomonas). This would be the full treatment to cover all the possible STDs empirically.
- Another alternative is to take azithromycine 500 mg, 4 tb at a time single dose (covers both gonorrhea and chlamydia) and the next day start metronidazole 500 mg twice a day for a week (covers trichomonas)
- Candida is sometimes difficult to diagnose or rule out with tests (as it happens with the rest of the infections) so it is worth trying a local cream (clotrimazole) twice a day for 7-10 days- it is not costly and it is effective if candida is the case. ( I am not surprised if you have candida as well because you have been using antibiotics, which make you prone to candida but candida is not dangerous and we do not worry for its development, we treat it empirically as well if we suspect it)
You may choose to start first with the cream for candida twice a day locally and if you see no improvement with the treatment in 3-4 days you might need to start oral treatment for the rest of the infections while you continue with cream for candida infection.
Try to avoid chemicals locally in the private area, sometimes local reactions to these washing soaps (even though they might say- sensitive) might be the reason for the irritation so wash a few times a day with warm water and no soaps or any chemicals.
I hope this helps answer your query. Let me know if I can assist you further.
This is why treatment for yeast infection can be tried first as a likely cause
Detailed Answer:
Hello,
That is why it might be a good idea just to try the antifungal cream first twice a day (in case this is due to local overgrowth of Candida due to the antibiotics, tests not always find it). Avoid local chemicals as well and wear cotton underwear.
Only after 3-4 days of treatment with the antifungal, and avoidance of any possible local irritants, if you do not notice any improvement it will be clear that the symptoms are not from yeast infection. The risk for recurrence of STD in such case is likely (or not complete cure).
I hope this helps answer your query.
Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj
Some patients may get itchiness, some get local irritation or burning sensation
Detailed Answer:
Hello,
Many patients with yeast infection do get itchiness while some patients might feel it as local irritation, some may get a local burning feeling, it all depends on how patients sense it.
I hope this answers your query.
Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj,
General and Family Physician
I would first recommend the antifungal cream locally
Detailed Answer:
Hello,
I would first recommend you to try the cream locally (Clotrimazole cream) twice a day for 7-10 days and avoid any chemicals in the genital area. This would take care of candida and local reactions as the cause of the symptoms.
If you do not notice much of improvement with this treatment in 3-4 days I would recommend you to consider one of these treatment options:
1. Doxycycline twice a day for at least 10 days (chlamydia) + single dose Ceftriaxone 250 mg intramuscular (gonorrhea) and probably would add metronidazole twice a day for a week (trichomonas). This would be the full treatment to cover all the possible STDs empirically.
2. Another alternative is to take Azithromycin 500 mg, four tabs at a time single dose after lunch (covers both gonorrhea and chlamydia) and the next day start Metronidazole 500 mg twice a day after food for a week (covers trichomonas)
I would advise you to discuss these with your doctor and to obtain the necessary prescription for the same. You can decide together which you would like to choose between these two regiments, they are both effective.
I hope this answers your query. Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj,
General and Family Physician