Gonorrhea is a sexually transmitted infection. That means it is spread through sexual contact. It does not always cause symptoms.
Tests used to find a gonorrhea infection include:
- Nucleic acid amplification tests (NAAT). NAATs find the genetic material (DNA) of gonorrhea germs. These tests are very accurate. They can be done on urine samples or samples of body fluid from the area where the infection is suspected.
- Gonorrhea culture. This test is done on a sample of body fluid collected from the area where the infection is suspected, such as the cervix, urethra, eye, rectum, or throat. The sample is combined with substances that help the gonorrhea germs grow. This test can also tell if the gonorrhea germs are resistant to antibiotics.
Why It Is Done
Tests for gonorrhea are done to:
- See if a gonorrhea infection may be causing symptoms such as painful urination, anal itching or bleeding, vaginal bleeding after intercourse, or abnormal discharge from the penis or vagina.
- Screen women who are at high risk for a gonorrhea infection. Because gonorrhea does not always cause symptoms, screening is important. The U.S. Preventive Services Task Force (USPSTF) recommends routine gonorrhea screening tests for:1
- Check for infection in a newborn whose mother had gonorrhea at the time of delivery.
How To Prepare
Do not urinate for 2 hours before a urine sample is collected.
Women should not douche or use vaginal creams or medicines for at least 24 hours before having a gonorrhea test.
How It Is Done
In a direct smear, a sample of body fluid is taken from the area where gonorrhea is suspected. In adults, this may include the urethra, the cervix, the rectum, or the eye.
- For a sample from the cervix, you will take off your clothes below the waist and drape a paper or cloth covering around your waist. You will then lie on your back on an exam table with your feet raised and supported by stirrups. This allows the doctor or nurse to examine your vagina and genital area. Your doctor or nurse will insert a special tool with curved sides (speculum ) into your vagina. The speculum gently spreads apart the vaginal walls so the inside of the vagina and the cervix can be examined. Samples are collected from the cervix with a swab or small brush.
- For a sample from the urethra or rectum, your doctor or nurse will insert a swab into the opening of your urethra or rectum.
- For a sample from your eye, your doctor or nurse will gently brush the insides of your lower and upper eyelids with a swab.
If you have a urine test, do not urinate for 2 hours before the test. Do not wipe the genital area clean before you urinate. Collect the first part of your urine stream, just as you begin to urinate.
There are home test kits you can use to collect a swab or urine sample and bring it to the lab for testing.
How It Feels
Collecting a sample of fluid from the urethra, the anus, or the rectum may cause mild discomfort or pain.
Collecting a sample from the cervix may cause mild discomfort. Most women find that the procedure feels similar to a Pap test or pelvic examination. Some women feel slight cramping while the speculum is inside the vagina.
Collecting a sample from the eye is usually painless unless the eyelids have sores on them.
Collecting a urine sample does not normally cause any discomfort.
There is very little risk of serious problems from having a sample of fluid collected from the cervix, the urethra, the anus, the eye, or the throat. Women may have a small amount of bleeding from the vagina if a sample is collected from the cervix.
There are no risks linked with collecting a urine sample.
Gonorrhea tests tell if a person has this disease. They look for the bacterium, or germ, that causes gonorrhea. Testing is done on body fluid or urine samples.
No signs of gonorrhea bacteria are found. If a culture is done, no gonorrhea bacteria grow in the culture. More testing for other sexually transmitted infections may be needed to find the cause of any symptoms.
Signs of gonorrhea bacteria are found. If a culture is done, gonorrhea bacteria grow in the culture.
What Affects the Test
You may not be able to have the test, or the results may not be helpful, if:
- You urinate 2 hours or less before collecting a urine sample.
- A sample from the rectum is contaminated with stool.
- You are a woman and you douche or use vaginal cream or spray within 24 hours before the test.
- You take antibiotics before the test.
What To Think About
- If a gonorrhea infection is suspected, don't have sex until the test results have come back. If the test shows that you have gonorrhea, don't have sex for 7 days after the start of treatment. Your sex partner must also be treated for gonorrhea to avoid passing the infection back to you or to others.
- If you have gonorrhea, all of your sex partners from the last 60 days should be tested and treated. And you may need to have tests for other sexually transmitted infections, including HIV.
- A gonorrhea culture may be done after a positive nucleic acid amplification test (NAAT) if your doctor or nurse is concerned that you may have antibiotic-resistant gonorrhea.
- In the United States, your doctor or nurse must report to the state health department that you have gonorrhea.
To learn more about testing for sexually transmitted infections, see:
U.S. Preventive Services Task Force (2014). Chlamydia and gonorrhea screening: Final recommendation statement. U.S. Preventive Services Task Force. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/chlamydia-and-gonorrhea-screening. Accessed October 14, 2014.
Other Works Consulted
Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Specialist Medical ReviewerPeter Shalit, MD, PhD - Internal Medicine
Current as ofSeptember 26, 2014