Physicians begin diagnosis of gonorrhea by compiling a complete medical history of the patient. This may include questions about the patient’s sexual activity and sexual partners. A physician will also perform a physical examination and, for women, a pelvic examination. In men, gonorrhea is determined by the presence of symptoms and a positive result of one or more laboratory tests. In women, because gonorrhea is often asymptomatic, several laboratory tests may be conducted to confirm a diagnosis of gonorrhea. 

Several laboratory tests are available to diagnose gonorrhea, including:

• 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. This quick test is the most effective way of confirming the presence of gonorrhea in men. However, it is reliable in only about 50 percent of women with gonorrhea. It is also not effective for testing for gonorrhea in the throat or the anus.
  
  
• Nucleic acid amplification test (NAAT). This test uses a urine sample or a sample of discharge from the infected area and is able to detect the presence of genes from the gonorrhea bacteria.
  
  
• Culture test. Requires swabs of sample tissue from the cervix, urethra, rectum or throat. The sample is placed in a culture media and allowed to grow for at least 48 hours. Culture tests are more accurate than some other tests, but take more time.
  
  
• 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 in women 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 genetic material of the gonorrhea bacteria. It is less accurate for samples collected from the throat. The DNA probe test may also identify chlamydia, a sexually transmitted disease (STD) that frequently occurs with gonorrhea.

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 in-home diagnostic tests for gonorrhea in women. 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. So far, there are no effective home testing methods for men.

Physicians are required to report all diagnosed cases of gonorrhea to the U.S. Centers for Disease Control and Prevention (CDC), and usually to local and state health agencies as well. CDC monitoring of certain “notifiable” diseases, including gonorrhea, assists with control and prevention of the disease. Anyone diagnosed with gonorrhea should notify their sexual partners of the diagnosis so they may seek medical testing and treatment. This should include all sexual partners from 60 days prior to the appearance of symptoms or the medical visit. If an infected person does not notify sexual partners of the diagnosis, a local health agency may attempt to do so.