Urine tests for STIs: chlamydia, gonorrhea & more

A simple urine test can do more than you might think – especially when it comes to your health. From chlamydia to gonorrhea: urine tests offer a fast, discreet, and reliable way to detect sexually transmitted infections (STIs) early and treat them appropriately. In this article, you will learn which STIs can be diagnosed through urine testing, how the tests are performed, which symptoms may indicate an infection, and whether they can be done conveniently at home.

Table of contents

• Which STIs can be diagnosed with a urine test?
• Common STI symptoms
• How is a urine test for STI diagnosis performed?
• What type of urine sample is required for an STI test?
• Can medication use affect the results of a urine STI test?
• Do you need to follow specific preparations such as fasting for a urine STI test?
• Summary

Which STIs can be diagnosed with a urine test?

Urine tests can be used to detect certain sexually transmitted infections (STIs). The following STIs can be diagnosed through urine testing:

• Chlamydia (Chlamydia trachomatis):The most common type of chlamydia test is the nucleic acid amplification test (NAAT). A NAAT detects the DNA of the bacteria that cause chlamydia infection.
• Gonorrhea (Neisseria gonorrhoeae):Gonorrhea can also be detected using NAAT, which identifies genetic material from the bacteriumNeisseria gonorrhoeae.
• Trichomoniasis (Trichomonas vaginalis):In addition to other testing methods, a urine sample can also be used to detect trichomoniasis.

Source:  Cleveland Clinic, 2024; Cleveland Clinic, 2024; MedllinePlus, 2023

Urine tests are used in both men and women to diagnose STIs. In addition to urine testing, other diagnostic methods include blood tests or swab samples. A study and recommendation by the Centers for Disease Control and Prevention (CDC) found that vaginal swabs are especially effective for detecting STIs such as chlamydia, gonorrhea, and/or trichomoniasis in women, as they offer higher sensitivity (Aaron, K. J., 2023).

Common STI symptoms

Many STIs are often asymptomatic and therefore remain undiagnosed and untreated. Below are some typical symptoms of chlamydia, gonorrhea, or trichomoniasis:

Chlamydia

Common symptoms in men:

• White, cloudy, or watery discharge from the tip of the penis
• Burning and itching around the testicles and penis
• Pain and swelling in the testicles
• Burning when urinating

Common symptoms in women:

• Vaginal discharge that is not normal for you
• Bleeding after sex or between menstrual periods
• Burning when urinating
• Lower abdominal pain

Gonorrhea

Common symptoms in men:

• Unusual discharge from the tip of the penis (white, yellow, or green)
• Pain or burning during urination
• Inflammation (swelling) of the foreskin
• Pain or tenderness in the testicles – rare

Common symptoms in women:

• Unusual vaginal discharge (thin or watery, green or yellow)
• Pain or burning when urinating
• Lower abdominal pain or tenderness – less common
• Bleeding between periods, heavier menstruation, or bleeding after sex – less common

Trichomoniasis

Common symptoms in men:

• Pain when urinating or ejaculating
• More frequent urination than usual
• Thin, white discharge from the penis
• Sores, swelling, and redness on the tip or foreskin of the penis

Common symptoms in women:

• Abnormal vaginal discharge (thick, thin, or frothy, yellow-green)
• Increased discharge with a strong fishy odor
• Pain, swelling, or itching around the vagina – sometimes also on the inner thighs
• Pain or discomfort during urination or sex

Source: NHS, 2024; NHS, 2024; NHS, 2021

How is a urine test for STI diagnosis performed?

A urine test for STI diagnosis begins with collecting a urine sample. The urine is collected in a sterile container and sent to a laboratory, where nucleic acid amplification tests (NAAT) are used to detect the genetic material of STI pathogens. The results are communicated to the patient, and if positive, the doctor can initiate targeted treatment (Queensland Health, n.d.).

Are there options for taking STI urine tests at home?

Homed-IQ offers home tests for sexually transmitted infections (STIs) that provide a discreet and reliable way to get a diagnosis. The Chlamydia and Gonorrhea Test screens specifically for these two common infections. If you’d like a more comprehensive overview of your sexual health, the Basic-4 STI Test also includes screening for Trichomoniasis and Mycoplasma genitalium. The sample is collected at home and analyzed in a certified laboratory. Results are usually available within a few days.

What type of urine sample is required for an STI test?

For an STI test, a first-catch urine sample is required, meaning the initial stream of urine when you begin to urinate. This part of the urine contains the highest concentration of pathogens such as Chlamydia trachomatis or Neisseria gonorrhoeae.

Before collecting the sample, the individual should avoid urinating for several hours to increase the test’s accuracy in detecting an STI. A sample can be collected at any time of day, but if possible, the first urine of the day is recommended.
Source: Queensland Health, n.d.

Can medication use affect the results of a urine STI test?

Certain medications can influence the results of STI tests, potentially leading to false positives or false negatives. For example, antibiotics may suppress signs of infection in some tests, while steroids may lead to false positives by affecting the immune response.

Before taking an STI test, talk to your doctor about any medications you are using, to ensure the right test and treatment plan are selected.
Source: (STD Check, 2024).

Do you need to follow specific preparations such as fasting for a urine STI test?

No – Fasting is not required for a urine test for sexually transmitted infections.
Source: Bundesstadt Bonn, n.d.

Summary

Urine tests are an effective method for diagnosing sexually transmitted infections such as chlamydia, gonorrhea, and trichomoniasis, as they detect pathogens in the first-catch urine using modern molecular testing methods (e.g. NAATs) in the laboratory. These tests are available in clinics as well as at home, through providers such as Homed-IQ. For best results, the individual should avoid urinating for about 1 hour prior to sample collection. Medications may affect the test results, so medical consultation is recommended. Fasting is not required, making the test easy and convenient to perform.