Physicians begin diagnosis by taking a complete medical history, including a history of sexual partners. The physician will also conduct a physical examination and, for women, a pelvic examination.

Several laboratory tests are available to diagnose gonorrhea, including:

• Nucleic acid amplification test (NAAT). This test takes a urine sample or a sample of discharge from the infected area and detects genes from the gonorrhea bacteria.
  
  
• Culture test. Requires swabs from the cervix, urethra, rectum or throat for a culture. The sample is placed in culture media and allowed to grow for at least 48 hours. Culture tests are more accurate than some other tests, but take more time.
  
  
• Gram stain test. Involves taking swabs of cells from the infected area. The cells are stained with dye and the bacteria can be identified under a microscope. Although this test is rapid, it is reliable in only about 50 percent of women with gonorrhea.
  
  
• Enzyme linked immunoabsorbent assay test (ELISA test). This test uses a discharge sample from the infected area. It detects antibodies (substances that fight the infection) to the bacteria. It is more sensitive than the gram stain test but not as accurate as the culture test.
  
  
• DNA probe test. Uses a discharge sample from the infected area and tests for the genetic material (deoxyribonucleic acid [DNA]) of the bacteria. It is less accurate for samples collected from the throat. The DNA probe test may also identify chlamydia, a sexually transmitted disease that frequently occurs with gonorrhea.

Physicians may use two of the above tests to confirm the diagnosis. The NAAT urine test is becoming more widely used. It is more accurate than the Gram stain test and faster than culturing specimens. However, the culture test provides information about drug-resistant strains of bacteria, which can help determine which antibiotic to use for treatment.

In addition, there have been pilot studies on the use of home tests for the diagnosis of gonorrhea. Early research has indicated that self-collected vaginal swabs are as effective as doctor’s cervical examinations for diagnosing STDs. Researchers plan to continue work on the development of home test kits for the general public.

All diagnosed cases of gonorrhea must be reported to the Centers for Disease Control and Prevention (CDC) and usually to local and state health agencies as well. CDC monitoring of certain “notifiable” diseases assists with control and prevention. An infected woman should notify her sexual partners of the diagnosis so they may seek medical testing and treatment. All sexual contacts from 60 days prior to the appearance of symptoms or the medical visit should be notified. If the infected person does not notify partners, the local health agency will attempt to do so.