At a glance

Why get tested?

To screen for Neisseria gonorrhoeae, which causes the sexually transmitted disease gonorrhoea

When to get tested?

If you have symptoms of gonorrhoea or are pregnant

Sample required?

A swab of secretion or discharge from the infected area or alternatively the first portion of urine

Test preparation needed?

None

What is being tested?

The test is looking for evidence of the bacterium Neisseria gonorrhoeae, which causes the sexually transmitted disease gonorrhoea. Gonorrhoea is easily treated but can cause severe reproductive and health problems if left untreated.

How is the sample collected for testing?

A swab is used to get a sample of secretion or discharge from the infected area such as the cervix, urethra, penis, anus or throat. The swab should be inserted into the urethra at least 2 cm. The swab then may be rolled onto a slide (not smeared) to better preserve morphological characteristics. Cotton or wooden swabs should not be used because they may be toxic to fastidious organisms. The first portion of a urine sample is used in some tests. Many doctors will take a sample from more than one body site to increase the likelihood of finding the bacteria.

Is any test preparation needed to ensure the quality of the sample?

Neisserias are relatively fastidious bacteria therefore efforts should be made to minimise the transportation time between clinic and a laboratory. A black top swab with charcoal transport media are recommended for culture.

The Test

How is it used?

The test is used in two ways:

  • to diagnose the cause of symptoms, and
  • to screen sexually active people for sexually transmitted diseases.

A definitive diagnosis is important because gonorrhoea can resemble chlamydia and the two disorders require different treatment.

When is it requested?

A doctor may request the test if you have symptoms such as (for women) a yellow or bloody vaginal discharge, bleeding associated with vaginal intercourse or burning/painful urination; or (for men) pus discharging from the penis or a burning sensation during urination.

What does the test result mean?

Looking for reference ranges?

Several tests can be performed:

  1. Gram stain for Neisseria gonorrhoeae is a quick and inexpensive test that works by detecting incomplete phagocytosis of Gram-negative diplococci (the gonorrhoea bacteria) under a microscope.
  2. Bacterial culture remains the ‘gold standard’ for diagnosis of gonococcal infection. The drawback of this method is slow turn-around time (48-72 hours). Blood culture is important when disseminated infection is clinically suspected.
  3. Nucleic acid amplification based techniques (polymerase chain reaction (PCR), ligase chain reaction (LCR) and others. They are sensitive, quick and less affected by delays in the transportation of specimens to a laboratory.
  4. A positive test indicates an infection that requires treatment with a course of antibiotics. A negative test means only that there is no evidence of disease at the time of the test. It is important for those who are at increased risk of infection to have screening tests performed on a regular basis to check for possible exposure.

Is there anything else I should know?

While many men with gonorrhoea will experience symptoms, most women do not or they are mistaken for a bladder or other vaginal infection. For men, symptoms usually appear within 2 to 5 days of infection, but can take up to 30 days; for women, those who have symptoms usually experience them within 10 days of infection. Symptoms include, for females, burning or painful urination, increased vaginal discharge and sometimes bleeding between menstrual periods or brought on by vaginal intercourse. For men, symptoms include a white, yellow or green discharge from the penis, a burning sensation when urinating and sometimes painful or swollen testicles. Symptoms of rectal infection include discharge, itching and painful bowel movements. If you test positive for gonorrhoea, you should also be screened for other sexually transmitted diseases and your sexual partner(s) should be tested and treated as well.

If you are infected, your risk of contracting other sexually transmitted diseases increases, including HIV, the virus that causes AIDS.

The diagnosis of a sexually transmitted disease should not be ruled out if the test is negative; patients' clinical symptoms and history should also be considered.

Common Questions

What are the symptoms of gonorrhoea?

For women, early symptoms (which are often mistaken for a bladder or vaginal infection) include bleeding brought on by vaginal intercourse, burning/painful urination and a yellow or bloody vaginal discharge. For men, early symptoms include a discharge of pus from the penis, pain in the penis and a burning sensation when urinating. Symptoms of rectal infection include discharge, itching and painful bowel movements with blood on the faeces.

The symptoms usually appear 2 to 10 days after sexual contact with an infected partner. The early symptoms can be mild and most women and many men can be infected without showing any symptoms.

What will happen if I don’t get treated?

Untreated gonorrhoea can lead to severe complications. Women can develop pelvic inflammatory disease (PID), an infection that spreads from the vagina and cervix to the uterus and fallopian tubes. PID can cause scarring of the fallopian tubes, which can lead to ectopic (or tubal) pregnancy or sterility. The symptoms of PID include heavier periods with more cramps, abnormal mucus discharges, pain in the lower abdomen, weakness, fever, vomiting and pain during intercourse.

Other long-term complications include abscesses and infection around the liver. In men, the infection can lead to an inflammation of the testicles that can result in sterility. The bacteria can also spread to the bloodstream and infect the joints, heart valves or brain, resulting in long-term or permanent organ damage.

How is gonorrhoea transmitted?

It is generally transmitted through sexual contact (oral, vaginal or anal) with an infected partner. An infected mother can spread the disease to her baby during childbirth.

How is it treated?

Gonorrhoea can be treated with a course of antibiotics.

How can it be prevented?

For information on prevention, see Safe sex and Staying healthy.

Last Review Date: September 16, 2010