Symptoms of gonorrhea usually appear 2 - 5 days after infection, however, in men, symptoms may take up to a month to appear. Some people do not have symptoms. They may be completely unaware that they have caught the disease, and therefore do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person.

Symptoms in men include:

• Burning and pain while urinating
• Increased urinary frequency or urgency
• Discharge from the penis (white, yellow, or green in color)
• Red or swollen opening of penis (urethra)
• Tender or swollen testicles
• Sore throat (gonococcal pharyngitis)

Symptoms in women can be very mild or nonspecific, and may be mistaken for another type of infection. They include:

• Vaginal discharge
• Burning and pain while urinating
• Increased urination
• Sore throat
• Painful sexual intercourse
• Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area)
• Fever (if the infection spreads to the fallopian tubes and stomach area)

If the infection spreads to the bloodstream, fever, rash, and arthritis-like symptoms may occur. See: Disseminated gonococcemia

Gonorrhea can be quickly identified by staining a sample of tissue or discharge and then looking at it under a microscope. This is called a gram stain. Although this method is fast, it is not the most certain.

Gram stain tests used to diagnose gonorrhea include:

• Cervical gram stain in women
• Gram stain of urethral discharge in men
• Joint fluid gram stain

Cultures (cells that grow in a lab dish) provide absolute proof of infection. Generally, samples for a culture are taken from the cervix, vagina, urethra, anus, or throat. Cultures can provide a preliminary diagnosis often within 24 hours and a confirmed diagnosis within 72 hours.

Cultures used to diagnose gonorrhea include:

• Endocervical culture in women
• Urethral discharge culture in men
• Throat swab culture in both men and women
• Rectal culture in both men and women
• Culture of joint fluid
• Blood cultures

DNA tests are especially useful as a screening test. They included the ligase chain reaction (LCR) test. DNA tests are quicker than cultures. Such tests can be performed on urine samples, which are a lot easier to collect than samples from the genital area.