Gonorrhoea Test

If you don’t have any symptoms, you can take your own sample, often using a home testing kit. This will be a urine sample (people with a penis) or a swab from the entrance of the vagina (people with a vagina). 

If you have symptoms, a doctor or nurse may need to examine you. They will take a swab from inside the vagina or from the end of the penis. Tell your doctor or nurse about any antibiotics you have taken in the past 2 weeks, as these may affect the result. Tell your doctor or nurse about the use of vaginal creams or douches within the past 24 hours, as these can also affect results. 

If a urine sample is needed, you should wait 1 hour after you last urinated before providing the sample. This ensures there are enough bacteria (germs) in the urine for the test to be reliable. Follow any instructions given to you by the clinic or testing service.

What the test measures 

Gonorrhoea is caused by the bacterium (germ) Neisseria gonorrhoeae. The test looks for this bacterium in samples taken from potentially infected areas. Several types of test are used, depending on the clinical situation. 

The most widely used test is a nucleic acid amplification test (NAAT). This looks for the genetic material (DNA) of the bacteria in a swab or urine sample. It is highly accurate and is the standard test used by NHS sexual health clinics, online testing services and laboratories. Results are usually available within a few days, although rapid tests are available at some clinics. 

A culture test grows the bacteria from a swab sample in a laboratory. It takes longer than a NAAT but provides extra information: it allows the laboratory to test which antibiotics the infection is resistant or sensitive to. This is important given rising rates of antibiotic resistance in gonorrhoea. Culture samples are taken before antibiotics are given and are usually done alongside or following a positive NAAT. 

A Gram stain test looks at a sample under a microscope for the characteristic appearance of the bacterium. It can give a rapid result in some clinic settings, particularly for men with a urethral discharge, but it is not accurate enough for all sample types and is not used on its own to confirm or rule out infection. 

What your results mean 

A negative result 

A negative NAAT result means that gonorrhoea was not found in the test. This is reassuring, but it does not completely rule out infection if you tested very soon after possible exposure. 

If you have symptoms that suggest gonorrhoea but your test is negative, your clinician will consider other possible causes and may arrange further tests. A negative test result should always be interpreted alongside your symptoms and history. Do not assume a negative result means you do not have any infection. 

A positive result 

A positive result means that gonorrhoea was not detected in your test. This means you have a gonorrhoea infection that needs treatment. Treatment is effective and the infection can be cleared with antibiotics. 

You will usually be offered treatment at the same appointment as your result, or as soon as possible after. Your sexual health clinic will also ask about your recent sexual partners so that they can be contacted and offered testing and treatment. This is called partner notification, can be carried out confidentially, and is an important step in stopping the infection from spreading. 

If you test positive for gonorrhoea, your clinic will also recommend testing for other STIs, including chlamydia, syphilis and HIV. STIs often occur together, and a full sexual health screen gives you the most complete picture of your health.

If you are pregnant and have gonorrhoea, it is important that it is diagnosed and treated promptly. Untreated gonorrhoea in pregnancy is associated with a higher risk of miscarriage, preterm birth, and premature rupture of the membranes. During birth, the infection can also be passed to your baby, causing a serious eye infection, which can lead to blindness if not treated quickly. Your midwife or doctor will arrange for any newborn exposed to gonorrhoea to be assessed and treated. 

If your result is positive 

If you receive your test result during your appointment, you will receive antibiotic treatment at that visit. 

If you get your positive gonorrhoea test result after your appointment, you will need to have a follow up appointment to receive antibiotic treatment. If you only had NAAT testing done at your first visit, you will also have samples for culture taken. This is to provide information on which antibiotics will treat your infection, but you will not need to wait for these results before you are given treatment. 

In the UK, the current recommended treatment is typically an antibiotic injection — this is the standard first-line approach and is highly effective. The specific antibiotic used is reviewed regularly in response to resistance patterns and your sexual health clinic will follow current British Association for Sexual Health and HIV (BASHH) guidelines and give you the most appropriate treatment. 

You will be asked to return to the clinic after treatment to check that the infection has cleared only if: 

• You have persistent symptoms 
• You had a positive result on a throat swab 
• Antibiotic sensitivity results (to see if the antibiotic used is effective) are not known or show the infection is resistant to the first-line treatment 
• You were not treated with the first-line antibiotic 
• You are pregnant 

This is called a test of cure and is important to confirm treatment has worked. If you need a test of cure, , you should avoid sex (including oral or anal sex) until your test of cure confirms the infection has gone. This will prevent passing the infection on. 

Your sexual health clinic can help you notify recent sexual partners, either directly or confidentially through a process called contact tracing. Partners who are notified can access testing and treatment without being told who named them, if you prefer. 

If your result is negative but symptoms continue 

Your clinician will investigate other causes of your symptoms. This may include testing for chlamydia, Mycoplasma genitalium, trichomonas, or other infections. Do not self-treat before getting a clear diagnosis — different infections need different treatments.

Recent antibiotic use can reduce the amount of bacteria in your sample and lead to a false negative result. If you have taken antibiotics recently, tell your clinician before testing. 

For vaginal samples, using vaginal creams or douches in the 24 hours before testing can also affect results by washing bacteria from the sampling site. 

Testing too soon after exposure may give a false negative result if the infection has not yet established in enough quantity to be detected. Most sexual health clinics suggest testing at least 2 weeks after a possible exposure, though NAAT tests may detect infection earlier than culture tests. Your clinician will advise on the best time to test in your situation. 

For urine samples, not waiting long enough after last urinating can dilute the sample and make it harder to detect the bacteria. The recommendation to wait at least 1 hour before providing a urine sample helps to avoid this.

A full sexual health screen is recommended alongside gonorrhoea testing, as STIs often occur together. This typically includes: 

• chlamydia test — chlamydia is the most common STI in the UK and is often present alongside gonorrhoea 
• syphilis test — a blood test to check for syphilis 
• HIV test — gonorrhoea infection increases the risk of HIV transmission, and HIV testing is offered alongside all STI screens 
• hepatitis B and hepatitis C tests — particularly recommended for men who have sex with men and people who inject drugs 

Gonorrhoea is an STI caused by bacterium Neisseria gonorrhoeae. It can infect the genitals, rectum, and throat and in rare cases can cause eye infections or spread to other areas of the body. If untreated, it can cause serious complications including pelvic inflammatory disease, infertility, and — rarely — spread to the bloodstream. It is curable with antibiotics, although antibiotic resistance is a growing concern. For more information, visit the BASHH: gonorrhoea patient information leaflet.