Gonorrhea Testing

Gonorrhea is one of the most common sexually transmitted diseases (STDs) in the United States. Gonorrhea testing looks for evidence of a gonorrhea infection. Testing for a gonorrhea infection is used to screen for and diagnose gonorrhea.

Purpose of the test

The purpose of gonorrhea testing is to detect a gonorrhea infection. A gonorrhea test is performed in two different situations:

• Screening: Screening tests look for diseases when a person isn’t experiencing symptoms in order to detect the disease earlier. When doctors screen for gonorrhea, they may also screen for other STDs at the same time.
• Diagnosis: While not everyone with a gonorrhea infection will develop symptoms, some people experience signs such as pain and burning during urination. Gonorrhea testing can diagnose or rule out gonorrhea as the cause of a person’s symptoms. Because gonorrhea has similar symptoms to chlamydia, another common STD, doctors often test for both gonorrhea and chlamydia at the same time.

What does the test measure?

Gonorrhea testing detects evidence of infection with the bacteria Neisseria gonorrhoeae. There are several types of gonorrhea tests:

• Gonorrhea nucleic acid amplification (NAAT) testing: NAAT testing detects the genetic material (DNA) of the gonorrhea bacteria and is considered the optimal test for gonorrhea infection. This type of test can be performed on a urine sample or a swab taken from a site of potential infection.

• Gram stain: Gram stains look for certain types of cells that are characteristic of a gonorrhea infection under a microscope. This test is performed on urethral swabs and is used primarily in men who are experiencing urinary symptoms.

• Gonococcal culture: Gonococcal cultures attempt to grow the gonorrhea bacteria from swabs taken from sites of potential infection. Cultures are the only tests that detect the infection’s susceptibility to antibiotics. Doctors may order a gonococcal culture if they suspect that a patient has an antibiotic-resistant strain of gonorrhea.

• Rapid gonorrhea tests: While rapid testing for gonorrhea isn’t common, several tests are being developed to allow health care professionals to give same-day gonorrhea testing results.

When should I get a gonorrhea test?

Because many people who are infected with gonorrhea do not have any noticeable symptoms, a number of health organizations recommend regular gonorrhea screening for certain adolescents and adults between the ages of 15 and 65, including:

• • Women under 25: All sexually active women younger than age 25 should get yearly screening for gonorrhea.
  • Women 25 and older: Women 25 and older who have risk factors for gonorrhea infection should be screened yearly.
  • Pregnant women: Because gonorrhea can be passed from mother to child during childbirth, all pregnant women under 25 should be tested. Pregnant women 25 and older should be screened if at an increased risk of gonorrhea infection.
  • Men who have sex with men: Men who have sex with men should be screened annually for gonorrhea, or every 3 to 6 months if they are at an increased risk for contracting gonorrhea.

• People with HIV: People diagnosed with HIV should be screened for gonorrhea at least once per year.

Regular screening for gonorrhea in heterosexual men without symptoms is not generally recommended.

Risk factors that impact the frequency of gonorrhea screening include:

• A new sexual partner in the past 60 days
• Multiple sex partners
• Having an STD in the past or a sex partner recently treated for an STD
• Inconsistent condom use
• Trading sex for money or drugs
• Sexual contact with sex workers
• Meeting anonymous partners from the internet
• Residing in a correctional facility or juvenile detention center
• Illegal drug use

Anyone with signs or symptoms of gonorrhea should be tested for this infection. Gonorrhea testing should also be ordered when a sex partner has been diagnosed with gonorrhea. When present, signs and symptoms of gonorrhea include:

• Painful urination
• White, yellow, or green urethral discharge
• Pain in the testicles or scrotum.
• Increased vaginal discharge
• Vaginal bleeding between periods.
• Anal discharge or itching
• Anal soreness or bleeding
• Painful bowel movements
• Sore throat

After being treated for gonorrhea, it’s recommended to test for gonorrhea again three months after completing antibiotics.

Gonorrhea testing is performed on a urine sample or a swab from the site of potential infection, often the urethra, cervix, mouth, or rectum. Urine samples can be collected by the patient, while swab samples can be collected by either the patient or a medical professional.

Before the test

Patients should tell their doctor if they are taking any antibiotics before a gonorrhea test. Patients may be instructed to wait for one to two hours after they last urinated before collecting a urine sample.

Women may need to take additional precautions before a gonorrhea test. Women should tell their healthcare practitioner if they have recently used a vaginal douche or vaginal cream.

Before an at-home gonorrhea test, it’s important to read all of the instructions contained in the testing kit.

During the test

When gonorrhea testing is performed at a doctor’s office, a swab or brush may be used to take a sample from the site of potential infection, such as the cervix, urethra, mouth, or rectum.

For women, doctors may take a sample from your cervix for genital gonorrhea testing. During this procedure, you will lie on your back on an exam table with knees bent and feet resting in stirrups. Your doctor will use a speculum to open the vagina and access the cervix. A plastic spatula or soft brush is then used to collect the sample from the cervix. Women may experience mild discomfort during this procedure.

For men, a doctor may use a swab to collect a sample from the urethra, the tube within your penis that allows urine to flow from your bladder. This procedure may cause temporary discomfort.

Urine samples can be used to test both men and women. As you begin to urinate, the initial portion of your urine stream is collected in a container provided by the healthcare practitioner or laboratory.

During an at-home gonorrhea test, the initial portion of urine is collected in a container contained in the testing kit.

After the Test

There are no risks to having a gonorrhea test or restrictions on activities after the test is completed. If a sample was taken from the cervix, women may have temporary, minor vaginal bleeding or discharge.

After an at-home test is completed, the collection cup is packaged and sent to a laboratory for analysis.

Receiving test results

Results of gonorrhea testing may be reported during a follow-up appointment with your doctor, over the phone, or through online medical charts. Results of NAAT testing may be available as early as one or two days after completing the test. Gonococcal cultures may take several days before results are available.

It’s important to discuss gonorrhea test results with a healthcare professional. Your doctor can help you manage your risk for gonorrhea and other STDs and answer questions about test results.

If test results are positive for gonorrhea, it’s important to begin treatment as early as possible in order to reduce the risk of health complications and prevent spreading the infection to others. Healthcare professionals can also discuss the importance of talking to sexual partners who may be infected and advise patients about retesting that may be necessary after treatment is completed.

At-home gonorrhea test results often take additional time, as the samples must be sent to a laboratory by mail before testing begins. Once the test is completed, results may be reported by phone or through a smartphone application associated with the company performing the testing.

Interpreting test results

Gonorrhea test results are reported as positive or negative. A positive test result, sometimes called an abnormal result, indicates that you have an active gonorrhea infection that requires treatment. If your gonorrhea test result is positive, your sexual partner(s) should be tested and treated as well.

A negative test result means that there is no evidence of infection at the time of the test. Depending on the type of test, it can take days or weeks for a person infected with gonorrhea to test positive. For this reason, a negative result does not rule out a gonorrhea infection if the test is taken too soon after potential exposure.

If results from at-home gonorrhea testing are positive, it’s important to contact your doctor as soon as possible. Timely treatment for gonorrhea reduces the risk of health complications and helps avoid spreading the infection to others.

• STD Testing
• Chlamydia Testing
• Herpes Testing
• HIV Tests
• Human Papillomavirus (HPV) Test
• Syphilis Tests
• Trichomonas Testing
• Gram Stain

The following resources offer additional information on gonorrhea risk, detection, and treatment:

• CDC Fact Sheet: Gonorrhea
• MedlinePlus Medical Encyclopedia: Gonorrhea
• Healthfinder.gov: Get Tested for Chlamydia and Gonorrhea

Sources

A.D.A.M. Medical Encyclopedia. Gonorrhea. Updated March 28, 2019. Accessed April 7, 2021. https://medlineplus.gov/ency/article/007267.htm

Centers for Disease Control and Prevention. Screening recommendations and considerations referenced in treatment guidelines and original sources. Updated June 4, 2015. Accessed April 7, 2021. https://www.cdc.gov/std/tg2015/screening-recommendations.htm

Centers for Disease Control and Prevention. Gonorrhea: CDC fact sheet (detailed version). Updated January 19, 2021. Accessed April 7, 2021. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm

Ghanem KG. Clinical manifestations and diagnosis of Neisseria gonorrhoeae infection in adults and adolescents. In: Marrazzo J, ed. UpToDate. Updated June 17, 2020. Accessed April 7, 2021. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-neisseria-gonorrhoeae-infection-in-adults-and-adolescents

Ghanem KG, Tuddenham S. Screening for sexually transmitted infections. In: Marrazzo J, ed. UpToDate. Updated December 4, 2020. Accessed April 2, 2021. https://www.uptodate.com/contents/screening-for-sexually-transmitted-infections

MedlinePlus: National Library of Medicine. Gonorrhea test. Updated December 3, 2020. Accessed April 7, 2021. https://medlineplus.gov/lab-tests/gonorrhea-test/

MedlinePlus: National Library of Medicine. Health screening. Updated April 23, 2020. Accessed April 7, 2021. https://medlineplus.gov/healthscreening.html