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This is now the commonest of all sexually transmitted diseases and can be very difficult to treat. It is mainly a disease of men (women can certainly carry it but often do not show any symptoms). There is considerable medical debate as to what organism causes NSU but whatever it is it can be difficult to find.

NSU develops seven to ten days after having sex with an affected person and the symptoms are similar to those of gonorrhoea. The discharge may be white, yellow, green, grey or streaked with blood and must be reported to your doctor. The first sign may be pain on passing water.

The STD clinic will do tests to rule out other types of venereal infection and you will be given a long course of antibiotic tablets. Repeated courses may be necessary as the disease can take months to clear. This makes it very wearing to suffer from as repeated visits to the clinic are essential.

One cause of NSU of increasing importance is Chlamydia but the organism is difficult to detect. In women it can inflame the cervix leading to bleeding after intercourse and occasionally to a discharge, but the infection causes no symptoms in two-thirds of women. In some, however, it leads to attacks of pain similar to acute appendicitis or gall-bladder disease. It can reach the tubes, especially if the woman has an IUD, leading to pelvic inflammatory disease (PID) with resultant damage which can cause ectopic pregnancies or even infertility. It is a more frequent cause of PID even than gonorrhoea.

As with trichomoniasis it is very important that if the man is diagnosed as having NSU his partner should also be treated. Otherwise, the detection of the infection depends on the GP suspecting its presence from symptoms and/or the appearance of the cervix. Unfortunately, men can carry the organism but have no symptoms. Treatment is with tetracycline or erythromycin by mouth.

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