If symptoms of gonorrhea develop, they usually appear within two to 10 days after sexual contact with an infected partner, although a small percentage of patients may be infected for several months without showing symptoms. More advanced symptoms, which indicate progression to PID, include abdominal pain, bleeding between menstrual periods, vomiting, or fever. Men are more often symptomatic than women. They usually have a discharge from the penis and a burning sensation during urination that may be severe. Symptoms of rectal infection include discharge, anal itching, and sometimes painful bowel movements.
Many doctors prefer to use more than one test to increase the chance of an accurate diagnosis.
The gram stain is quite accurate for men but is not very sensitive for women. Only one in two women with gonorrhea have a positive gram stain. The slide is examined under a microscope for the presence of the bacteria. More often, urine or cervical swabs are used for a new test that detects the genes of the bacteria. These tests are as accurate as culture and are used widely.