Gonorrhea: Signs, Symptoms & Diagnosis

Most women who have gonorrhea feel no symptoms. If symptoms do result, they can appear within days or take up to a month to develop. By the time gonorrhea in women has progressed to the upper reproductive tract as pelvic inflammatory disease (PID), the symptoms from the original infection site (for example, the cervix) may have disappeared.

Gonorrhea symptoms in women may include:

• Pain or burning during urination
• Abnormal discharge from the vagina
• Pain during intercourse
• Bleeding after intercourse
• Rectal pain
• Itching (genital or anal)
• Sore throat (after oral sex)
• Red eyes (if the eyes are infected)

Indications of advanced gonorrhea could include nonmenstrual vaginal bleeding, pelvic pain, vomiting or fever. The appearance of these symptoms may indicate the development of PID. (Or it may point to other conditions, including other sexually transmitted diseases [STDs] or a urinary tract infection.) To find out the cause, it is important to see your doctor.

Men are more likely than women to experience symptoms, which may include burning during urination or unusual discharge from the penis.

Diagnosis of gonorrhea

In order to diagnose gonorrhea, your doctor will need to determine that the gonorrhea bacteria are present in your body. To do this, she will likely review your medical history, including a history of sexual partners, and then perform a physical and pelvic exam.

Gonorrhea is diagnosed through one or more laboratory tests, including:

• Nucleic acid amplification test (NAAT). A sample of urine or discharge from the infected area is tested for the gonorrhea bacteria.
• Culture test. Swabs from the cervix, urethra, rectum or throat are taken for a culture, which is allowed to grow for at least 48 hours. Culture tests are more accurate than some other tests but take more time to diagnose. However, they also provide information about drug-resistant strains of bacteria, which can help determine which antibiotic to use for treatment.
• Gram stain test. Swabs of cells from the infected area are stained with dye, allowing gonorrhea-causing bacteria to be identified under a microscope. Although this test is rapid, it is reliable in only about 50 percent of women with gonorrhea.
• Enzyme-linked immunosorbent assay (ELISA) test. Using a sample of discharge from the infected area, the ELISA detects antibodies (substances that fight the infection) to the bacteria. It is not as accurate as the culture test for gonorrhea.
• DNA probe test. A sample of discharge is taken from the infected area to test for the genetic material (DNA) of the bacteria. Results are 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.