Sexual Health STDs Diagnosis Print Urine Testing for Sexually Transmitted Diseases Medically reviewed by Medically reviewed by Susan Olender, MD on June 09, 2017 Susan Olender, MD, is an assistant professor of medicine at Columbia University College of Physicians and Surgeons in New York City. Learn about our Medical Review Board Susan Olender, MD Written by facebook twitter linkedin Written by Elizabeth Boskey, PhD Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases. Learn about our editorial policy Elizabeth Boskey, PhD Updated on November 25, 2019 Sexually Transmitted Diseases Overview Symptoms Causes Diagnosis Treatment Prevention Science Photo Library / Getty Images In This Article Table of Contents Expand Purpose Urine Test vs. Bacterial Culture Risks and Contraindications Before the Test During and After the Test Results Limits of Urine Testing Other STD Urine Tests A Word From Verywell View All Urine testing for STDs is becoming increasingly available. These days, several STDs can be detected using urine testing. Urine chlamydia tests and gonorrhea tests are a lot more pleasant than urethral or cervical swabs and are quickly becoming standard practice. It may be more difficult to find urine testing for other STDs, such as trichomoniasis or HPV. Purpose of Urine Testing for STDs It used to be that STD testing, particularly for bacterial STDs, was very uncomfortable. Men who thought they might have a bacterial STD like chlamydia or gonorrhea got tested by having a swab inserted into their urethra. Women had to undergo a pelvic exam. During that exam, a cervical swab would be taken and tested for bacteria. The fact that STD testing was uncomfortable and invasive made it less likely that people would undergo regular STD screening. That probably contributed to what is sometimes known as the hidden epidemic of asymptomatic STDs. Because many STDs have no symptoms, the only way to detect them is through testing. When people aren't tested regularly, they can spread STDs to their partners without even knowing it. Urine testing, as opposed to swab testing, makes it easier for people to undergo STD testing as part of their regular medical care. (However, STD testing is still not a standard part of most annual exams.) Urine Testing vs. Bacterial Culture for Bacterial STDs Urine testing is currently primarily used to detect bacterial STDs. Chlamydia and gonorrhea urine tests are widely available. Trichomoniasis urine tests are also available, but they are less common. The gold standard for diagnosing bacterial STDs, such as chlamydia and gonorrhea, used to be bacterial culture. That involved attempting to grow bacteria out of samples that were taken directly from the cervix or urethra. These days, bacterial DNA testing is considered a better option. It works differently than bacterial culture. Instead of trying to grow bacteria, these tests just look for bacterial DNA. This can be done using a process called LCR (ligase chain reaction) or with other DNA amplification techniques. These types of testing are sensitive to even very small amounts of bacterial DNA. Even better, they do not require a live bacterial sample. As such, they can be run on urine samples, not just urethral or cervical swabs. For most people, the thought of getting gonorrhea urine test or chlamydia urine test is a lot less intimidating than the thought of needing a physical exam. Risks and Contraindications Urine testing is completely safe. You will provide a urine sample, that you collect yourself, to the doctor. Then they will use special tests to identify whether it contains bacterial DNA. There are no contraindications for urine STD testing. Before the Test You do not need any special preparation for a urine STD test. However, before you are given any urine STD test, it is good to talk to your doctor about what STDs you are going to be tested for. You should discuss why the specific tests have been chosen. You may also want to ask for additional testing if you are at risk for other STDs that your doctor is not planning to test for. Finally, you should ask how long the results will take to come back and whether the doctor's office will call you if the results are negative. Some offices only call for positive test results. During and After the Test When you have a urine STD test, it is usually during a regular appointment. You will be asked to pee into a sample collection cup or tube. That tube will be given to one of the medical staff. Your urine sample will then be sent out to a lab, or tested at the clinic. You can leave as soon as you are done giving the sample or when your appointment is finished. Interpreting Results Urine STD test results are usually available in 5-7 days. However, that will depend on where your urine sample was sent for testing. A positive test result means that you are infected with that STD and should be treated. A negative test means there was no evidence that you were infected with that STD at the time of the test. A positive urine chlamydia test means you have chlamydia.A positive urine gonorrhea test means you have gonorrhea.A negative urine chlamydia test means you do not have chlamydia.A negative urine gonorrhea test means you do not have gonorrhea. Even with a negative test, it is important to undergo regular STD testing if you are sexually active and not in a mutually monogamous relationship. Depending on your number of sexual partners you may want to be screened once a year, or more often. Urine STD testing is not a one-time thing. You could get infected in your next sexual encounter. Comparing Urine STD Tests to Other STD Tests Some people still question whether urine testing is as effective at detecting bacterial STDs like chlamydia and gonorrhea. These questions usually focus on the efficacy of the tests in women. Why? The most common site of female infection (the cervix) is not on the pathway that urine travels out of the body. In contrast, urine passes through the most common site of infection (the penile urethra), in men. A 2015 study that examined 21 studies of the relative effectiveness of using different types of samples to detect chlamydia and gonorrhea found that: For chlamydia testing in women, the sensitivity and specificity were 87 percent and 99 percent for urine samples compared to cervical samples.For chlamydia testing in men, the sensitivity and specificity were 88 percent and 99 percent for urine samples compared to urethral samples.For gonorrhea testing in women, the sensitivity and specificity were 79 percent and 99 percent for urine samples compared to cervical samples.For gonorrhea testing in men, the sensitivity and specificity were 92 percent and 99 percent for urine samples compared to urethral samples. By and large, these results are relatively consistent across studies. Interestingly, self-collected vaginal swabs were closer in effectiveness to cervical swabs than urine testing. For some women, those may be a more acceptable alternative to a pelvic exam if urine testing isn't available. Tests on urine samples detect fewer STDs than tests on vaginal or cervical swabs. However, science suggests that urine testing still does a pretty good job of finding most infected individuals. That is great news for people who want to be tested for gonorrhea and chlamydia in a less invasive way. However, some other STD tests still do require either a physical examination or a blood draw. Limits of Urine Tests for Gonorrhea and Chlamydia Chlamydia and gonorrhea are the two most common notifiable diseases in the United States. In 2017, over 1.7 million cases of chlamydia were reported to the CDC in addition to more than 550,000 cases of gonorrhea. Most infections with gonorrhea and chlamydia are asymptomatic. The fact that many people have no symptoms means that the only way to detect and treat these infections is through screening. In men, these diseases most commonly infect the urethra, and in women the cervix. However, it is possible to get both of these diseases in the throat, from oral sex. Anal sex can also lead to rectal chlamydia and rectal gonorrhea infections. Neither rectal nor oral/throat infections will be detected by urine testing. It is therefore important to let your doctor know if you have unprotected oral or anal sex. Testing should be done separately for those sites. Currently, it is recommended that men who have sex with men undergo urine, throat, and anal screening once a year. Other people who regularly have unprotected oral or anal sex should consider a similar screening regimen. People who only engage in vaginal intercourse can get by with urine testing alone for gonorrhea and chlamydia. Other STD Urine Tests Currently, only gonorrhea and chlamydia are commonly tested for using urine samples. However, there are other STDs that can be tested for this way. Trichomoniasis urine tests are becoming more widely available. Like gonorrhea and chlamydia, trichomoniasis is a very common, curable STD. As such, it makes a lot of sense for doctors to test for it at the same time. Urine testing is one option for doing that. As with chlamydia and gonorrhea, some research suggests that urine testing may not be as effective as doing similar tests on a vaginal swab. HPV is another STD that can be detected using urine tests. As with trichomoniasis, urine tests for HPV are not yet widely available. However, research suggests that testing first-void urine is just as effective as testing vaginal smears. That said, when compared to Pap smears, urine HPV tests have the same problem as other HPV tests—many HPV infections go away on their own. Therefore, it may be more useful to know if there are problematic cervical changes rather than whether someone has HPV. You can only do that with a Pap smear or VIA test. There are no commercial urine tests available for syphilis or herpes. While the FDA did approve an HIV urine test in the 1990s, it is rarely if ever used. Oral and blood samples are far more likely to be used for HIV testing. There is even a home test for HIV that uses saliva samples. A Word From Verywell For a long time, research suggested that cervical and urethral testing were slightly more effective than urine testing for STDs. However, newer studies suggest that some urine tests may actually be better at picking up certain infections. Even when they're not superior, FDA approved urine tests are more than good enough in most circumstances. Furthermore, the tests continue to get better with time. For most people, it's far more important to get tested for STDs than to worry about getting the best STD test. Getting tested on a urine sample may not be quite as efficient as getting tested using a doctor collected swab. However, it is much better than not getting tested at all. Therefore, if urine STD tests or self-swabs are less scary for you, ask for them. You can even call your doctor's office before your appointment to make certain that urine tests are available. If they aren't, you can always choose to get tested somewhere else. It can be scary wondering if you have an STD. However, most people discover that it's better to know. That's particularly true for bacterial STDs, which are treatable with a simple course of antibiotics. It may be stressful to learn about an infection. Still, you'll feel better once you know it's gone. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Van der pol B, Ferrero DV, Buck-barrington L, et al. Multicenter evaluation of the BDProbeTec ET System for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine specimens, female endocervical swabs, and male urethral swabs. J Clin Microbiol. 2001;39(3):1008-16. doi:10.1128/JCM.39.3.1008-1016.2001 Shoveller JA, Knight R, Johnson J, Oliffe JL, Goldenberg S. 'Not the swab!' Young men's experiences with STI testing. Sociol Health Illn. 2010;32(1):57-73. doi:10.1111/j.1467-9566.2009.01222.x Singer M, De waaij DJ, Morré SA, Ouburg S. CpG DNA analysis of bacterial STDs. BMC Infect Dis. 2015;15:273. doi:10.1186/s12879-015-1016-7 Mcree AL, Esber A, Reiter PL. Acceptability of home-based chlamydia and gonorrhea testing among a national sample of sexual minority young adults. Perspect Sex Reprod Health. 2015;47(1):3-10. doi:10.1363/47e2715 Lunny C, Taylor D, Hoang L, et al. Self-Collected versus Clinician-Collected Sampling for Chlamydia and Gonorrhea Screening: A Systemic Review and Meta-Analysis. PLoS ONE. 2015;10(7):e0132776. doi:10.1371/journal.pone.0132776 Centers for Disease Control and Prevention. Reported STDs in the United States, 2017: High Burden of STDs Threatens Millions of Americans. 2018. Haugland S, Thune T, Fosse B, Wentzel-Larsen T, Hjelmevoll SO, Myrmel H. Comparing urine samples and cervical swabs for Chlamydia testing in a female population by means of Strand Displacement Assay (SDA). BMC Womens Health. 2010;10:9. doi:10.1186/1472-6874-10-9 Sabeena S, Bhat P, Kamath V, et al. Detection of Genital HPV Infection Using Urine Samples: a Population Based Study in India. Asian Pac J Cancer Prev. 2016;17(3):1083-8. doi:10.7314/apjcp.2016.17.3.1083 Shafer MA, Moncada J, Boyer CB, Betsinger K, Flinn SD, Schachter J. Comparing first-void urine specimens, self-collected vaginal swabs, and endocervical specimens to detect Chlamydia trachomatis and Neisseria gonorrhoeae by a nucleic acid amplification test. J Clin Microbiol. 2003;41(9):4395-9. doi:10.1128/jcm.41.9.4395-4399.2003 Additional Reading Coorevits L, Traen A, Bingé L, Van Dorpe J, Praet M, Boelens J, Padalko E. Identifying a consensus sample type to test for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and human papillomavirus. Clin Microbiol Infect. 2018 Mar 17. pii: S1198-743X(18)30223-4. doi: 10.1016/j.cmi.2018.03.013. Lunny C, Taylor D, Hoang L, Wong T, Gilbert M, Lester R, Krajden M, Ogilvie G. Self-Collected versus Clinician-Collected Sampling for Chlamydia and Gonorrhea Screening: A Systemic Review and Meta-Analysis. PLoS One. 2015 Jul 13;10(7):e0132776. doi: 10.1371/journal.pone.0132776. Maged AM, Saad H, Salah E, Meshaal H, AbdElbar M, Omran E, Eldaly A. Urine test for HPV genotypes as a predictor of precancerous cervical lesions and for cervical cancer screening. Int J Gynaecol Obstet. 2018 Jan 31. doi: 10.1002/ijgo.12453. Marangoni A, Foschi C, Nardini P, D'Antuono A, Banzola N, Di Francesco A, Cevenini R. Evaluation of the new test VERSANT CT/GC DNA 1.0 assay for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine specimens. J Clin Lab Anal. 2012 Feb;26(2):70-2. doi: 10.1002/jcla.21485. Situ SF, Ding CH, Nawi S, Johar A, Ramli R. Conventional versus molecular detection of Chlamydia trachomatis and Neisseria gonorrhoeae among males in a sexually transmitted infections clinic. Malays J Pathol. 2017 Apr;39(1):25-31. Continue Reading