How Do I Get Tested For Gonorrhea?

Neisseria Gonorrhoeae
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Question: How Do I Get Tested For Gonorrhea?

Answer: Healthcare providers test for gonorrhea in one of two ways:

  • Swab Test: A swab is taken of the urethra (men) or cervix (women) to test for genital infection. A swab may also be taken from the throat, for people who have had oral sex. Sometimes, swabs are also taken from the eye and/or the rectum. Rectal swabs are primarily used for people who have receptive anal sex. For women, the cervical swab is taken as part of a pelvic exam done with a speculum. That allows the doctor to see the cervix so they can swab the correct place.
  • Urine Test: Some providers will also use a urine test to diagnose gonorrhea. 

Once a sample has been acquired, it is sent to a laboratory for testing. Depending on the sample and the lab, testing may involve:

  • growing gonorrhea from the sample
  • looking for bacterial DNA
  • using antibodies to identify whether or not the sample contains any bacteria.

Some providers can also do a test called a Gram stain in their office at the time of your visit. For this test, a sample taken from the urethra or cervix is stained with a special dye. The dye makes it easy to spot Neisseria gonorrhoeae, the bacterium that causes gonorrhea, under the microscope. This test can provide results faster than other forms of testing. However, it may not be as accurate. In addition,some doctors offices are not equipped to provide it.

Home Testing for Gonorrhea

There has been a movement towards home-testing for STDs. The hope is that the sense of privacy might encourage people to test more often.

One type of home test involves self-sampling for gonorrhea and chlamydia detection. (Self-sampling can also be done in the doctor's office.)

The quality of home tests varies. Research studies involving them have been few and not always favorable. However, it is certainly possible to do high-quality testing on self-collected samples.

As such, these tests are a good option for people who would not otherwise seek out regular screening or testing. It is just important for people to make certain that the tests are being run by a reputable lab. You'll want to check that before choosing to use these services. This can be particularly an issue with tests ordered online, as described here. One easy thing to look for is testing options that send you to the same labs your doctor would use. 

A Word from Verywell

Diagnostic testing always has trade offs. Sometimes you trade  the ability to identify as many cases as possible for the risk of over diagnosis. Other times you trade some accuracy for techniques that make people more willing to test. For example, current guidelines suggest that nucleic acid tests, usually run on urine samples, should be confirmed. However, sometimes a confirmation can leas to a false negative, which some doctors are concerned about. The truth is, it can be difficult to balance catching as many cases as possible and accidentally treating someone who is not infected.

 

A bigger issue, for gonorrhea, is checking that people follow through with treatment. The risk of antibiotic resistant gonorrhea is a real one. It's important to make certain that we do as much as possible to keep it from becoming a bigger problem than it already is. That means making certain people finish their antibiotics. It may also mean confirming that a treatment has worked, or running susceptibility tests before treatment is started. Susceptibility testing is used to identify which antibiotics can effectively attack any given infection. 

Sources:

Lunny C, Taylor D, Hoang L, Wong T, Gilbert M, Lester R, Krajden M, Ogilvie G. Self-Collected versus Clinician-Collected Sampling for Chlamydia and Gonorrhea Screening: A Systemic Review and Meta-Analysis. PLoS One. 2015 Jul 13;10(7):e0132776. doi: 10.1371/journal.pone.0132776.

McRee AL, Esber A, Reiter PL. Acceptability of home-based chlamydia and gonorrhea testing among a national sample of sexual minority young adults. Perspect Sex Reprod Health. 2015 Mar;47(1):3-10. doi: 10.1363/47e2715.

Owens SL, Arora N, Quinn N, Peeling RW, Holmes KK, Gaydos CA. Utilising the internet to test for sexually transmitted infections: results of a survey and accuracy testing. Sex Transm Infect. 2010 Apr;86(2):112-6. doi: 10.1136/sti.2009.037226.

Whiley DM, Lahra MM; National Neisseria Network. Review of 2005 Public Health  Laboratory Network Neisseria gonorrhoeae nucleic acid amplification tests guidelines. Commun Dis Intell Q Rep. 2015 Mar 31;39(1):E42-5.

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