How is Gonorrhea Tested & Diagnosed?

Gonorrhea Testing

The diagnostic process for any health condition is often covered in many issues – particularly within the side of the patients where there are several doubts that tend to cloud their judgement regarding the necessity of these procedures.

While there may be some merit in their doubts as healthcare is associated with ridiculous costs that are often too much for some to handle on their own, particularly when they do not have any insurance to cut the costs to a percentage of its original price point. Due to this, several conditions are left undiagnosed and unreported – making it harder for health institutions to track the progression of diseases within the community and employ the proper interventions to minimize its transmission. In addition to its impact within policy-making bodies, another issue arises when it comes to the health of the people affected by these conditions as the lack of a proper diagnosis and intervention typically results in the progression of the condition, along with the development of its complications that are often harder to treat or cannot be treated at all. This then translates into further expenses and additional health problems – one which is, in fact, counterintuitive to the original reservations of the community with regards to the expenses associated with denying a doctor’s visit for their initial presentations.

A particular infection that can be categorized under this specific problem is known as Gonorrhea – a condition caused by a bacteria that then results in damages to the internal structures of the genitalia once the condition is allowed to progress and develop into its later stages. While the condition itself causes evident symptoms, specifically, pain, the condition itself is sometimes left undiagnosed as it is asymptomatic for the better part of its duration, resulting in most diagnoses being performed during its more advanced staged, albeit certain treatment options are still available for the patient at this point. It is a sexually transmitted condition that can easily transfer from one person to another through contact with bodily fluids during intercourse – making it more important that early diagnosis is performed to minimize the risk of transmission among those who are not aware of their own or their sexual partner’s health status. With such a widely prevalent condition being mainly asymptomatic yet highly contagious given the right conditions, it is apparent that the proper recognition of its symptoms is made, and the proper avenues for its diagnosis is disseminated to the public for them to be aware of their options to be protected against the severe manifestations of this condition.

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Gonorrhea Infections: An Overview

As discussed, gonorrhea is a sexually transmitted condition caused by the bacteria known as Neisseria gonorrheae, a bacterial species that primarily targets the mucosal areas of the human body such as the genitalia, anal region, mouth, and throat, and eyes. For genital cases of gonorrhea infections, the primary target of the causative microorganism is often the cervix, uterus, and fallopian tubes in women, while the urethra serves as a common ground between men and women who are infected by this condition. Perinatal transmission may likewise occur wherein the condition is transmitted by a pregnant mother to their baby during childbirth, but this can be prevented through routine STD screening of pregnant women and the provision of prophylactic antibacterial to the baby following birth if the mother’s infection was not cleared out prior to their labor.

The Presentation of an Infection

Gonorrhea infections are mainly asymptomatic for the most part of its lifecycle – making it harder to diagnose unless the patient is either undergoing routine STD screening, or the condition has been diagnosed accidentally while looking for another disease entirely that likewise affects the genitalia. However, in instances where the condition becomes symptomatic, it may present with the following signs and symptoms:

  • Urinary frequency
  • Dysuria or producing a pus-like discharge (drip)
  • Swelling and redness of the genitalia
  • Swelling and pain in the testicles
  • Persistent sore throat
  • Watery, creamy, or slightly green vaginal discharge
  • Bloody stool
  • Heavier period flows or “spotting”
  • Painful sensation when having sex
  • High intensity pain within the lower areas of the abdomen
  • Fever
  • Itchiness within the genital or anal region

Due to the bacteria’s increased affinity with the mucosal regions of the body, extragenital infections may likewise occur – primarily being observed in the rectum, eyes, and throat.

The Complications of its Progression

Gonorrhea as an infection is mainly asymptomatic – resulting in several problems when the condition is left undiagnosed without any intervention to stop its progression. When this happens, the bacteria is then able to cause damages to the structures of the genitalia, causing complications such as:

  • Pelvic Inflammatory Disease
  • Epididymitis
  • Increased susceptibility to HIV/AIDS

The Treatment Following Diagnosis

The common treatment approach for gonorrhea is the use of antibacterial agents, albeit the recommended antimicrobial varies depending on the diagnosis of the physician, and depending on the health status of the patient being treated for the condition.

Gonorrhea Infections: Significance of Testing and Diagnosis

Importance of Taking the Tests

Gonorrhea is a sexually transmitted bacterial infection that primarily targets the genitalia – mainly remaining asymptomatic for a major part of its lifespan before it induces severe complications due to the damages that it has caused within the internal structures of the organ. As such, it is of considerable importance that proper testing is performed for patients who have similar presentations to ensure that disease progression is prevented and no damages, which are sometimes irreversible and may cause impotence and sterility, will be caused by an infection that was left unmonitored with no particular intervention at hand to resolve its presentations.

Timeline of Taking the Tests

The Centers for Disease Control and Prevention recommends a yearly screening for gonorrhea for all sexually active women aged 25 years old and above, including those who with significant risk factors, new or multiple sex partners, and those with a partner who has a concurrent sexually transmitted infection.

In general, regular screening is recommended for individuals who are sexually active as symptomatic cases are often diagnosed only during the later stages of the infection.

Expectations When Taking the Tests

Gonorrhea tests are often performed by initially extracting a sample from the requesting patient. The sample would depend on the test being performed as a urine test would require a urine sample from the patient, while a genital swab will include the use of cotton swabs to extract skin samples from the external, and in some cases, the inner areas of the genitalia. For the extraction of a urine sample, the physician may usually instruct you to wait for 2 hours from your last urination to obtain the sample. On the one hand, genital swabs would typically entail an inquiry as to whether genital creams have been used prior to extraction as these would interfere with the analysis of the extracted sample. Overall, some discomfort may be observed due to the nature of extraction for the swab sample, but no prior preparation is usually required of the patients for testing.

Available Tests and their Distinction

The following table provides a summary of the tests available for the diagnosis of gonorrhea infections:

Nucleic Acid Amplification Test (NAAT)

Gram Stain and Culture

Sample Required

Urine Sample or Genital Swab

Genital Swab

Waiting Time

1-4 days

Approximately 2-3 days

Tool Used

Urogenital Swab, Urine Cup

Urogenital Swab


Initial diagnosis for gonorrhea infection

Initial diagnosis for gonorrhea infection

Gonorrhea Diagnosis: Tests Available for Diagnosis

To properly diagnose an underlying gonorrhea infection, the following procedures are typically employed depending on the availability of the test in the testing facility. Do note, however, that while these procedures can be requested through anonymous testing sites, a prior physician prescription is necessary for the proper management of the condition. Self-medication with antimicrobial agents is highly discouraged to prevent antimicrobial resistance tendencies.

Nucleic Acid Amplification Test (NAAT)

Mechanism of Action

A nucleic acid amplification test or NAAT initially works by replicating a sample’s genetic material. This is first performed through the collection of an appropriate sample, either through a urogenital swabbing process, or by obtaining a clean urine sample, obtained at least 2 hours from the previous urination instance of the patient. Once the genetic material from the sample has been sufficiently amplified, certain markers are then used for the test which contains materials that could form complexes with the genetic material in the sample. If a complex is formed through this interaction, a visible determinant will be produced to identify the presence of the bacteria’s genetic material, and further test may examine the intensity of this outcome to determine the amount of genetic material procured from the sample.

Timeline Expected for Processing

On average, it takes 1 to 4 days to obtain a sample through NAATs.

Sample Required

Considering that the genetic material of the bacteria is the only indicator needed for the test, a urine sample or genital swab may suffice as an appropriate sample.

Price and Expenses

Nucleic acid amplification tests for gonorrhea are typically priced at around $14 when paid with out-of-pocket expenses.

Insurance Coverage

Yes. Since gonorrhea is a commonly recognized STD, most insurance policies would cover gonorrhea testing costs.

Sensitivity and Specificity

The following are the sensitivity and specificity rates of gonorrhea NAAT tests for each of the possible samples:

  • Urine: 55.6% sensitivity, 98.7% specificity
  • Swab: 94.2% sensitivity, 99.2% specificity

Gram Stain and Culture

Mechanism of Action

Gram staining and gonorrheal cultures were previously known as the gold standard for the testing of gonorrhea. However, due to the ease of access to other tests, along with the speed through which their results are typically produced, the use of these procedures went into decline.

Gram staining typically involves the extraction of a sample from the genitalia of the patient, i.e., through genital swabbing. Once this sample is obtained, it will then be exposed to various dyes to visualize any available microorganisms within the sample – indicating through examination under a microscope as to whether the causative microorganism of gonorrhea, Neisseria gonorrheae, is present in the patient’s genitalia.

Cell culture, on the one hand, involves the collection of a sample through urogenital swabbing, along with its transfer to an appropriate medium that will allow the growth of the bacteria to occur. After a few days, once cultures of Neisseria gonorreae were found to be present, a positive diagnosis for the patient is then confirmed.

Timeline Expected for Processing

Gram staining and cell culture relies on the proper swabbing technique and growth of bacteria obtained from the sample. As such, it takes around 2-3 days for results to be produced through this method.

Sample Required

A urogenital or cervical swab is required to perform gram staining and cell culture.

Price and Expenses

Gonorrhea kits may be priced at around $3.00.

Insurance Coverage

Yes. Since gonorrhea is a commonly recognized STD, most insurance policies would cover gonorrhea testing costs.

Sensitivity and Specificity

For symptomatic patients, gram staining and cell culture has a 90-98% sensitivity, and 95-98% specificity. However, asymptomatic patients may only receive a sensitivity rate of around 60% due to the low amount of bacteria present within the genitalia.

Gonorrhea Diagnosis: Overall Summary of Available Tests

Nucleic Acid Amplification Test (NAAT)

Gram Stain and Culture


Around $14.00

Around $3.00

Insurance Coverage



Frequently Asked Questions (FAQs)

Is testing for gonorrhea likewise recommended for patients with HIV?

Yes. In fact, regular screening is recommended for those with HIV as a poor immune system is a significant risk factor for contracting the infection.

Why is regular screening for heterosexual men not recommended?

This is because urogenital swabbing is typically very invasive and uncomfortable to patients. Furthermore, swabbing may likewise induce some damages to the structures of the genitalia, however accidentally, and may not be worth the risk for such populations that are not considered high-risk for the infection.

What is the common identifying symptom for gonorrhea in most patients?

The most common symptom observed among symptomatic gonorrhea patients is the present of a green or yellowish thick discharge from their genitalia.

Is retesting for gonorrhea recommended once the antimicrobial therapy is completed?

Yes. Retesting is recommended for patients 3 months after they completed their antimicrobial therapy.

Are there at-home testing kits available for gonorrhea?

Yes. There are several at-home testing kits available for gonorrhea that you can avail if you are concerned about the privacy and confidentiality of your inquiry.


Center for Disease Control and Prevention

American Journal of Preventive Medicine

BMJ Open

  • American Academy of Pediatrics. (n.d.). Gonorrhea. Retrieved June 2021
  • American Sexual Health Association. (n.d.). Gonorrhea: Fast Facts. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Antibiotic-Resistant Gonorrhea. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Antibiotic-Resistant Gonorrhea Basic Information. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Epididymitis. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Gonorrhea – CDC Fact Sheet (Detailed Version). Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Gonorrhea – CDC Fact Sheet. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Gonorrhea Statistics. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Gonorrhea Treatment and Care. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Gonorrhea. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). National Overview – Sexually Transmitted Disease Surveillance, 2019. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Pelvic Inflammatory Disease (PID) – CDC Fact Sheet. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). STDs during Pregnancy – CDC Fact Sheet. Retrieved June 2021
  • Centers for Disease Control and Prevention. (n.d.). Update to CDC's Treatment Guidelines for Gonococcal Infection, 2020. Retrieved June 2021
  • Healthline. (2020). Gonorrhea. Retrieved June 2021
  • Healthline. (2020). Side Effects of Antibiotics: What They Are and How to Manage Them. Retrieved June 2021
  • Pan American Health Organization. (n.d.). Sexually Transmitted Infections. Retrieved June 2021
  • Planned Parenthood. (n.d.). Gonorrhea. Retrieved June 2021
  • San Francisco Department of Public Health. (2020). Gonorrhea Health Advisory: New Guidelines for Treatment of Gonococcal Infection. Retrieved June 2021

Written by Mark Riegel, MD

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