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:^{footnote 1}
  • All sexually active women ages 24 and younger.
  • Women older than 24 who are at higher risk for STIs.
  • Pregnant women who have an increased risk for a gonorrhea infection. Treating a pregnant woman who has gonorrhea can prevent an infection in her newborn.
• Check for infection in a newborn whose mother had gonorrhea at the time of delivery.

In some cases, the test is done to see how well treatment is working. This isn’t usually needed unless gonorrhea has occurred during pregnancy or a sex partner was not treated.

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

Direct smear

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.

Urine test

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.

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

• 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.