Most men who test positive for chlamydia or gonorrhea did not feel unwell beforehand. They came in because a former partner sent them a message, because something looked slightly off for a day or two, or because they were having bloodwork done anyway and decided to add it on. A smaller group arrives with the textbook picture — burning with urination and a discharge that is difficult to ignore — and those men tend to come in quickly, because the symptoms are genuinely uncomfortable.
That gap is the whole problem. Both infections are common, both are bacterial, and both are curable with a short course of antibiotics. What causes harm is the stretch of time between acquiring one and finding out, because in men that stretch is frequently silent and can run for weeks or months while the infection is still transmissible.
How They Present, and How Often They Do Not
When symptoms do appear, they usually show up within a couple of weeks of exposure. The common ones are a burning or stinging sensation when passing urine, a discharge from the penis that may be clear, cloudy or yellowish, and sometimes a dull ache or tenderness in one testicle. Infection acquired through anal or oral sex often produces nothing noticeable at all, which is one reason throat and rectal swabs are offered alongside a urine sample rather than instead of it.
A meaningful proportion of men carry either infection with no symptoms whatsoever. This is not unusual or a sign that the infection is mild. Untreated chlamydia or gonorrhea can move up the urinary and reproductive tract and cause epididymitis, an inflammation of the tube behind the testicle that is painful, occasionally severe, and in some cases affects fertility. Gonorrhea in particular has become more resistant to older antibiotics over the past two decades, which is why confirmed diagnosis rather than guesswork now matters more than it once did.
What Testing Involves
Testing is far less involved than most men expect. For chlamydia and gonorrhea the standard test is a nucleic acid amplification test, which for urethral infection is done on a urine sample. You are asked to hold your urine for a period beforehand and then provide the first part of the stream. There is no swab inserted into the urethra in routine testing — that practice is long out of date, though the belief that it is standard still keeps men away.
Where oral or anal exposure is relevant, a throat or rectal swab is used, and these can usually be self-collected in the exam room if you prefer. A sexual health visit will typically also include blood tests for syphilis and HIV, since these infections travel in the same circles and screening for one without the others leaves obvious gaps. Nothing about the visit requires an explanation of your personal life beyond what is clinically relevant to deciding which tests to order.
Treatment and What Comes After
Both infections are treated with antibiotics. Chlamydia is generally treated with an oral course, and gonorrhea is now usually treated with an injection, often combined with an oral antibiotic, because of resistance patterns. Treatment is short and the infection clears in the great majority of cases.
Two things after treatment matter as much as the antibiotic itself. The first is avoiding sexual contact for the period your physician specifies, so the infection is not passed back and forth. The second is partner notification — recent partners need to be told so they can be tested and treated, and in Alberta public health can carry out that notification anonymously on your behalf if you would rather not do it yourself. Reinfection from an untreated partner is one of the most common reasons a man ends up back in the office with the same result a month later.
Dr. Raymond Nash provides confidential STI testing and treatment at Grande Prairie Men’s Medical Clinic. Appointments can be arranged at gpmm.clinic or by calling (587) 416-8296. This article is general information and is not a substitute for an individual medical assessment.