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Hello, About 2 Months Ago I Had STD Symptoms Like

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Posted on Thu, 18 Apr 2019
Question: Hello, about 2 months ago I had STD symptoms like alittle pain when urinating and some discharge. I took a dull STD test and everything came back negative but my doctor decided to still take a antibiotic called Doxycycline so I did and all symptoms went away besides one which was the tip of my uretha tip looks alittle red/irritated. I decided to take another STD test to make sure and once again everything came back negative. What could be the reason for the tip of my uretha to be irritated
doctor
Answered by Dr. Dr. Antoneta Zotaj (4 hours later)
Brief Answer:
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
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (2 hours later)
I was not sexually active when I was taking the doxcycline or the cefixime. I also dont have any other symptoms besides the irritated uretha tip. Could this just not be an STD and simply irritation
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Follow up: Dr. Dr. Antoneta Zotaj (9 minutes later)
I know you were saying I could have been reinfected but I havent been sexually active at all since I took any of the antibiotics
doctor
Answered by Dr. Dr. Antoneta Zotaj (4 minutes later)
Brief Answer:
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


Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (9 hours later)
I was also tested for a yeast infection which also came back negative!
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Follow up: Dr. Dr. Antoneta Zotaj (19 minutes later)
I was sexaully active 2 weeks before I got symptoms but since then I was on the doxycycline and have not been sexually active since and I have been tested for STDs 3 times which were all negative
doctor
Answered by Dr. Dr. Antoneta Zotaj (23 minutes later)
Brief Answer:
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.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (2 hours later)
The doxcycline did clear up the discharge and the burning when urinating thought
doctor
Answered by Dr. Dr. Antoneta Zotaj (20 minutes later)
Brief Answer:
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


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (46 minutes later)
do yeast infection not always itch?
doctor
Answered by Dr. Dr. Antoneta Zotaj (17 minutes later)
Brief Answer:
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
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (37 minutes later)
So what would your expert opinion to do
doctor
Answered by Dr. Dr. Antoneta Zotaj (19 minutes later)
Brief Answer:
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

Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 4435 Questions

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Hello, About 2 Months Ago I Had STD Symptoms Like

Brief Answer: 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