Gonorrhoea testing in the UK: who should test, what the tests involve and what happens next

Gonorrhoea is a sexually transmitted infection passed on through unprotected sex, and the NHS says it is treated with antibiotics. The difficulty is that it does not always announce itself. The NHS says not everyone gets symptoms, and that when symptoms do appear they usually start around 2 weeks after infection, although they sometimes do not appear until many months later.

Testing therefore does two jobs. It finds infections that cause no symptoms, and it confirms the cause when symptoms are present. Finding and treating the infection early matters because, as the NHS explains, untreated gonorrhoea can cause serious problems including an eye infection, pelvic inflammatory disease that can lead to infertility, and infection in the testicles or prostate.

The NHS advises going to a sexual health clinic or seeing a GP if you or a sexual partner think you might have gonorrhoea, if you or a partner have had sex without a condom, or if you are pregnant or planning to get pregnant and think you might have it. The NHS also lists getting tested once a year, or when you have a new sexual partner, among the ways to prevent gonorrhoea and spread it to others.

The main NHS page on sexually transmitted infections gives a wider list for attending a sexual health clinic: if you think you may have an STI, if a sexual partner has symptoms, if you are worried after sex without a condom or dental dam, if you are pregnant with symptoms, or if you are having sex with new partners.

• Symptoms in the genitals: yellow or greenish discharge, burning when you pee, lower abdominal pain, sore testicles.

• Symptoms elsewhere: pain, itching and discharge from the anus, a sore throat, or red, painful or discharging eyes.

• No symptoms but a recent condomless sexual contact, a new partner or a partner with an STI.

• Pregnancy, where the NHS stresses getting tested and treated before the baby is born.

The NHS says that at an appointment the doctor or nurse will ask about your symptoms and sexual partners and may need to check your penis or vagina. You can ask for a chaperone when you book. They may use a swab, which is like a large cotton bud, to take a sample of fluid from the penis or vagina, and you may be able to do the swab yourself. You might also be asked for a urine sample. A swab of the bottom, throat or eyes may be taken if those areas are affected.

You may also be offered tests for other sexually transmitted infections at the same time. The NHS STI page lists urine tests, blood tests and swabs from the urethra, vagina or anus as the usual kinds of sample across STIs, and notes that some clinics offer home testing kits for some infections.

Sexual health clinics are described by the NHS as places where you do not usually need a GP referral or an appointment, although it advises contacting the clinic first. You do not need to give your real name or the name of your GP surgery, and no information about your visit will be shared outside the clinic unless you ask for it to be.

The NHS says that if you do not have symptoms but want a test, you can use a self-test kit for gonorrhoea at home and send it to a lab. If the test shows you have gonorrhoea you will be contacted and told what to do next. Free kits may be available from a sexual health clinic or some pharmacies, and kits can also be bought from some pharmacies.

The NHS framing is that self-test kits are for people without symptoms. If you have symptoms, or have been told by a partner that they have gonorrhoea, the NHS advice is to go to a sexual health clinic or GP. If you have eye symptoms, a high temperature, joint pain or a rash, the NHS says to ask for an urgent GP appointment or get help from NHS 111.

The NHS STI page says that STIs can take up to 7 weeks after unprotected sex to show up on a test, and that if you do not have symptoms it is best to wait 7 weeks before getting tested. It points to Brook for more on how long to wait before an STI test. If you have symptoms, or know you have been in contact with someone who has gonorrhoea, you should not simply wait; seek an assessment and the clinic will advise on timing and on whether to treat before results.

The NHS also says that you can start gonorrhoea treatment before getting test results, which is a practical reason to attend a clinic early after a known contact.

The NHS says gonorrhoea is treated with a single dose of antibiotics, which can be an injection or tablets. You should go back to the GP surgery or sexual health clinic about a week after starting treatment to be tested again. Until you and any partner have completed treatment and tests show the infection has gone, the NHS advises not having vaginal, anal or oral sex.

Your current and any recent sexual partners will also need to be tested. The NHS says a sexual health clinic can help you contact them, or contact them for you, and that this can be done without naming you.

The NHS adds that the MenB vaccine can give some protection against gonorrhoea and may be offered to men who have sex with men and are at higher risk, for example those who currently have or recently had gonorrhoea or another bacterial STI, or who have had multiple sexual partners in the last 3 months.

The NHS lists gonococcal conjunctivitis (an eye infection that can follow touching infected fluid and then the eyes), pelvic inflammatory disease and infection of the testicles or prostate as possible complications of untreated infection. It says the sooner treatment is started, the easier these are to treat.

In pregnancy the NHS says gonorrhoea can increase the risk of premature birth and low birth weight, and can spread to the baby's eyes during birth, which can cause blindness if not treated with antibiotics. For this reason it recommends being tested and treated before the baby is born.

NHS sexual health clinics provide testing and treatment for gonorrhoea free of charge and usually without a GP referral. Some people prefer private testing for convenience or speed; if you do, check that the service uses laboratory tests for the sites you need tested (genital, throat and anus can be separate), that results are accompanied by clear advice on treatment and that there is a route to antibiotics and retesting. A negative private result does not remove the need to attend an NHS clinic if you have symptoms.