Gonorrhoea testing at home

What gonorrhoea is

Gonorrhoea is an infection caused by the bacterium Neisseria gonorrhoeae. It passes between people during vaginal, anal and oral sex, and it can infect the urethra, cervix, anus, throat and eyes. In Australia it’s most often diagnosed in men who have sex with men, but it’s becoming more common across the wider population, especially among women of reproductive age. Having had it before doesn’t protect you from getting it again.

Symptoms depend on where the infection is

Gonorrhoea in the throat or anus causes no symptoms in most people, and around 80% of vaginal infections cause none either. Gonorrhoea in the penis is the exception – 85–90% of those infections do cause symptoms. That’s why routine testing matters most for the sites that stay silent: you can’t rely on your body to tell you.

When symptoms do appear, they can include:

• discharge from the penis, vagina or anus
• burning or stinging when you pee
• pain during sex, or bleeding between periods or after sex
• anal irritation, or pain when you poo
• a red, sore eye with discharge.

Why it’s worth finding early

Left untreated, gonorrhoea can travel further into the reproductive tract and cause pelvic inflammatory disease, which can lead to chronic pelvic pain, ectopic pregnancy and infertility. It can also cause a painful, swollen testicle and, rarely, spread through the bloodstream to the skin and joints. An untreated infection also keeps passing to partners. Most of that is avoidable when the infection is picked up on a routine test.

How gonorrhoea is tested

The most common test for gonorrhoea in Australia is a nucleic acid amplification test (NAAT) – usually PCR – which looks for the bacterium’s genetic material in a sample. It’s highly sensitive, and it’s the same lab method whether your sample was collected in a clinic or at home.

Gonorrhoea only shows up at the site it has infected, so the lab needs a sample from each site that may have been exposed:

Collecting your own samples isn’t a compromise. People without symptoms can collect most samples themselves – vaginal, anal and throat swabs included – and many clinics ask patients to do exactly that. Throat and anal infections are the ones most likely to be missed, because they’re only found when those sites are tested. The lab tests the same samples for chlamydia at the same time.

There’s a second kind of test, a gonorrhoea culture, which clinics use when someone has symptoms and before treatment. It grows the bacterium from a swab to check which treatments will work against it.

When to test

After a recent exposure

The window period for gonorrhoea – the time between an exposure and when a test can reliably detect an infection – is around 2 weeks. You can test sooner, but a negative result inside the window isn’t a guarantee, so test again once you’re outside it.

As a routine

For many sexually active adults, a yearly test is a sensible baseline. Testing as often as every 3 months is recommended for people at higher risk, such as men who have sex with men with new or casual partners. A change of partner is also a good prompt.

After treatment

If you’ve recently been treated for gonorrhoea, wait until 2 weeks after finishing treatment before a routine test – genetic material from the treated infection can linger and produce a positive result. Reinfection is common, so a retest at 3 months is recommended.

How at-home testing works with Prickly

Prickly is an Australian at-home STI testing service for people without symptoms. It tests for chlamydia, gonorrhoea and HIV.

• Request online. Complete a five-minute online request. A doctor then reviews your answers and confirms that at-home STI testing is suitable for you.
• Receive your equipment. Collection equipment tailored to your exposures usually ships the next business day in an unmarked mailer box with Australia Post tracking.
• Collect at home. Follow the included STI testing self-collection guide – swabs and urine for the lab, and a fingerprick HIV self-test you read at home in 15 minutes.
• Post to the lab. Post your lab samples back the same day using the included prepaid return label – at any Australia Post Office, red street posting box or Parcel Locker.
• Get your results. A doctor reviews every lab test result and emails you privately. Telehealth follow-up included – with help accessing treatment and telling partners, if needed.

Our NATA-accredited partner lab tests your samples for chlamydia and gonorrhoea using PCR, and your results arrive 3–8 business days after you post your lab samples back.

The same steps are on the home page under How it works, and fees are under Pricing.

If your result is positive

A positive gonorrhoea result is very manageable. With Prickly, a telehealth follow-up appointment is included at no extra charge. Gonorrhoea needs treatment given in person, so your doctor will talk you through the result and send a formal referral to a local sexual health clinic (opens in new tab), GP clinic (opens in new tab) or urgent care clinic (opens in new tab).

A few things to expect:

• Another sample before treatment. Gonorrhoea is becoming harder to treat in Australia, so the clinic will usually take a swab for culture before treating you, to check the treatment will work. Treatment goes ahead the same day – there’s no waiting on that result.
• A short break from sex. Avoid sex, including with a condom, for 7 days after treatment, and until your partners have been tested and treated if needed.
• Telling partners. Partners from the last 2 months should be told so they can test too – it also protects you from getting it straight back. Your doctor will talk you through it at your telehealth follow-up, and we can help you tell them if you’d like.
• A retest at 3 months. This checks for reinfection. A test of cure after treatment isn’t usually needed – your doctor will tell you if it applies to you.
• Notification. Gonorrhoea is a notifiable condition, so confirmed positive results are reported to your state or territory health department, as they are by every clinic and lab in Australia.

Lowering your risk

• Condoms and dams. Used for vaginal, anal and oral sex, they lower the chance of gonorrhoea passing between you and a partner.
• Testing as a routine. Most infections cause no symptoms, so regular testing is how they get found and stopped – yearly for many people, and as often as every 3 months at higher risk.
• Partners tested and treated. After a positive result, holding off sex until your partners have been tested, and treated if needed, is what stops gonorrhoea coming straight back.
• A conversation with a clinic. If infections keep coming back, or you’d like to do more than condoms and testing, a sexual health clinic (opens in new tab) or GP clinic (opens in new tab) can talk you through other ways to protect yourself, including options that involve medication.

When at-home testing isn’t right

See someone in person at a sexual health clinic (opens in new tab), GP clinic (opens in new tab) or urgent care clinic (opens in new tab) instead if you have symptoms or if you’re under 16. And if you may have been exposed to HIV in the last 72 hours, don’t wait for a test – visit www.getpep.info (opens in new tab) or go to a sexual health clinic (opens in new tab) or emergency department (opens in new tab) as soon as you can. If something happened without your consent, 1800RESPECT (opens in new tab) is also available 24/7 for free, confidential support.