STI and STD tests at OpenMed Warsaw
Tests for sexually transmitted infections make it possible to detect an infection even when it is not yet causing any symptoms. Diagnostics use, among others, PCR/NAAT tests from a swab or urine and serological blood tests. The type of sample and the range of tests are matched to the specific pathogen, the site of possible exposure and the time that has passed since sexual contact.
At OpenMed Warsaw you can discuss symptoms, a risky encounter or an abnormal result and agree on the right scope of diagnostics.
STI and STD tests in Warsaw
STI diagnostics may include either a single test for a specific infection or a panel that detects several pathogens at once. When bacterial and parasitic infections such as Chlamydia trachomatis, Neisseria gonorrhoeae or Trichomonas vaginalis are suspected, molecular PCR tests or other nucleic acid amplification methods - NAAT - are often used.
The sample may be, among others:
- a vaginal swab,
- a cervical canal swab,
- a urethral swab,
- first-catch urine,
- a throat swab,
- a rectal swab.
For infections such as HIV, syphilis and hepatitis B or C, on the other hand, the key role is played by appropriately chosen blood tests.
The sampling site matters. Gonorrhoea or chlamydia may, for example, be present only in the throat or rectum and at the same time be absent from the sample taken from the genitourinary tract. The scope of diagnostics is therefore worth matching to the type of sexual contact as well.
Doctors who consult on intimate infections and STI test results
Doing a laboratory panel on its own does not always answer the question of which tests are really needed and whether a detected microorganism requires treatment. During the consultation the doctor can take into account the type of sexual contact, the time since exposure, current symptoms, previous infections and any treatment used. This makes it possible to decide whether a test for a single pathogen, a PCR panel, samples from several sites or extended diagnostics with blood tests are needed.
What are sexually transmitted infections?
STI - sexually transmitted infections - refers to infections passed on mainly during sexual contact. The older term STD - sexually transmitted diseases - refers more to the diseases that develop as a result of infection.
The distinction matters in practice. You can be infected and have no symptoms or diagnosed disease at all. This applies in particular to chlamydia, gonorrhoea, HPV and some cases of HIV infection.
The most commonly diagnosed STIs include:
- Chlamydia trachomatis,
- Neisseria gonorrhoeae - gonorrhoea,
- Trichomonas vaginalis - trichomoniasis,
- Mycoplasma genitalium,
- Treponema pallidum - syphilis,
- HIV,
- HPV,
- HSV - the herpes virus,
- HBV - the hepatitis B virus.
The microorganisms can be passed on during vaginal, anal and oral sex. Some infections can also be transmitted through contact with skin or mucous membranes, through blood or from mother to child.
When is it worth being tested for STIs?
It is worth being tested not only when symptoms appear. Many sexually transmitted infections can remain asymptomatic for a long time.
Testing is worth considering in particular:
- after sex without a condom with a new partner,
- after a condom has broken or slipped off,
- after sexual contact with a person diagnosed with an STI,
- before starting sex without a condom in a new relationship,
- when having sex with multiple partners,
- when unusual discharge from the vagina or urethra appears,
- with pain or burning when passing urine,
- with bleeding after sex or between periods,
- with lower abdominal pain or pain during intercourse,
- with ulcers, blisters or lesions in the genital area,
- with recurrent inflammation of the cervix or urethra.
Testing is also justified if there are no symptoms but there has been contact that may carry a risk of infection.
Chlamydia, gonorrhoea and trichomoniasis - PCR diagnostics from a swab
Chlamydia trachomatis is one of the most common bacterial sexually transmitted infections. In women the infection may be asymptomatic or cause discharge, lower abdominal pain, bleeding after sex and cervicitis. Left untreated, the infection can spread to the upper reproductive tract.
The basic laboratory method for detecting chlamydia today is molecular NAAT/PCR testing. In women the sample may be a vaginal or cervical swab, and in men, among others, first-catch urine or material from the urethra.
Gonorrhoea is caused by Neisseria gonorrhoeae. It can cause purulent discharge, burning when passing urine, inflammation of the cervix or urethra, but it can also be asymptomatic. The infection may affect the genitals, the rectum and the throat.
Molecular tests are used to detect the infection. In certain situations a gonococcal culture is also needed, especially when the sensitivity of the bacteria to antibiotics has to be assessed.
Trichomoniasis is caused by the parasite Trichomonas vaginalis. In women it can cause heavy discharge, an unpleasant odour, itching, burning and vaginal irritation. In men the infection often causes no clear symptoms. A molecular test can detect the genetic material of the parasite even when only a small number of organisms is present.
Which infections does an STI panel detect?
The scope of the panel depends on the test used. The smallest sets may cover three basic pathogens:
- Chlamydia trachomatis,
- Neisseria gonorrhoeae,
- Trichomonas vaginalis.
Extended molecular panels may additionally include, for example, Mycoplasma genitalium, and some commercially available sets also Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum.
This does not mean, however, that the more targets a test covers, the better it automatically is. Results for Ureaplasma spp. and Mycoplasma hominis need particularly careful interpretation, because these microorganisms can be present in the genitourinary tract without causing disease.
Mycoplasma genitalium should be treated differently, as it is a genuine sexually transmitted pathogen and can cause inflammation of the urethra or cervix.
Nor does a PCR panel automatically cover all STIs. HIV, syphilis and viral hepatitis require other diagnostic methods.
A single-infection test or an STI panel - which to choose?
A single test makes sense when there is a specific reason to check one pathogen - e.g. a partner has received a positive chlamydia result or the doctor suspects gonorrhoea.
A panel covering several infections is particularly useful when:
- there has been unprotected contact and the status of the partner is unknown,
- there are non-specific symptoms that may have several causes,
- there has been contact with a new partner,
- the patient wants broader preventive testing,
- one STI has already been diagnosed, but other infections may coexist.
Detecting one infection does not rule out another. Chlamydia and Neisseria gonorrhoeae infections, for example, can coexist.
At the same time, a large panel covering a dozen or more microorganisms does not always have an advantage over targeted diagnostics. The results should reflect the actual risk, the symptoms and the possible clinical consequences.
STI tests from a swab versus blood tests
There is no single test that detects all sexually transmitted diseases.
From a swab or urine it is possible to diagnose mainly infections affecting the mucous membranes of the genitourinary tract, e.g.:
- Chlamydia trachomatis,
- Neisseria gonorrhoeae,
- Trichomonas vaginalis,
- Mycoplasma genitalium.
Depending on the risk, the sample may also come from the throat or rectum.
From blood, on the other hand, the tests performed include:
- HIV tests,
- syphilis diagnostics,
- HBsAg and other tests related to HBV,
- anti-HCV antibodies and further HCV diagnostics.
This is why a fuller set of tests after potentially risky contact may require both a swab or urine sample and a blood sample.
A blood test does not replace PCR for chlamydia or gonorrhoea, and a normal PCR result from a swab does not rule out HIV or syphilis.
Where is the sample for an STI test taken from?
The sampling site should correspond to the site of possible infection.
In women, a vaginal swab is often used to diagnose chlamydia and gonorrhoea. The sample may also be taken from the cervical canal.
In men, the commonly used sample is first-catch urine, i.e. the first portion of urine passed, and in certain situations also a urethral swab.
After oral contact, a throat infection is possible, especially with Neisseria gonorrhoeae and Chlamydia trachomatis. In such a situation a throat swab can be taken.
After anal contact, the sample may need to be taken from the rectum. Infection at this site can be completely asymptomatic.
This is exactly why a vaginal swab or a urine test alone is not always enough after exposure involving several different types of sexual contact.
How to prepare for an STI swab test?
The exact preparation depends on the type of sample and the specific test, but before a test from the genitourinary tract it is worth following a few practical rules.
Before a swab it is usually recommended to:
- avoid vaginal pessaries, creams, gels and antiseptics for about 24-48 hours, unless the doctor advises otherwise,
- where possible, abstain from intercourse for about 24-48 hours,
- avoid vaginal douching,
- tell the doctor about any antibiotics taken recently.
When material is collected from the urethra or first-catch urine is tested, it is usually recommended not to pass urine for about 1-2 hours before the sample is taken.
For the urine test, the classic "midstream" sample used in a general urine test is not collected. Chlamydia and gonorrhoea diagnostics require the first portion of urine, because it contains material flushed out of the urethra.
For throat or rectal swabs, separate rules apply, depending on the test used by the laboratory.
How is a swab taken in women and men?
In women, the sample for an STI test can be taken with a swab from the vaginal walls or from the cervical canal. Sampling from the cervix is done during an examination with a speculum. The procedure itself usually takes a few dozen seconds and does not require anaesthesia.
Depending on the test, separate samples may be taken from different sites, e.g. from the vagina and throat or from the vagina and rectum.
In men, a first-catch urine test is often performed instead of a urethral swab. If a sample has to be taken directly from the urethra, a thin swab is placed in its opening for a short time.
A throat swab is similar to the standard sampling done for throat infections. For a rectal swab, material is collected from the mucous membrane of the rectum.
The test should correspond to the site of exposure - a sample taken from one site gives no information about the others.
Symptoms that may indicate a sexually transmitted disease
STIs can cause a wide range of complaints. The more common ones include:
- unusual vaginal discharge,
- purulent or mucous discharge from the urethra,
- pain and burning when passing urine,
- bleeding between periods,
- bleeding after intercourse,
- lower abdominal pain,
- pain during intercourse,
- pain or swelling of the testicles,
- itching or burning in the genital area,
- ulcers, blisters or other skin lesions,
- pain, discharge or bleeding from the anus,
- throat complaints after oral contact.
The symptoms are non-specific. Similar complaints can occur with vaginal thrush, bacterial vaginosis, urinary tract infections or irritation of the mucous membranes.
This is why the appearance of the discharge or the nature of the pain alone does not reliably show whether the cause is chlamydia, gonorrhoea or another STI.
Is it worth having an STI test without symptoms?
Yes. The absence of symptoms does not mean the absence of infection.
Chlamydia infection is very often asymptomatic. Gonococcal infections of the throat and rectum, as well as some genital infections, can also be asymptomatic.
This is one of the reasons why STIs can be passed on to further partners by people who do not know they are infected.
Testing without symptoms makes particular sense after a change of partner, after sex without a condom, after learning that a partner is infected, or before giving up protection in a stable relationship.
This does not, however, mean that every available test has to be done routinely. The scope is worth matching to the actual risk.
When should you get tested after risky sexual contact?
A test done too early may give a negative result despite infection. This is due to the so-called window period - the time between infection and the moment when a given method can reliably detect it.
In practice, for molecular tests for chlamydia and gonorrhoea, about 14 days after contact is often considered an appropriate time for screening. If symptoms appear or a partner has a confirmed infection, however, do not wait two weeks to see a doctor - the doctor may recommend earlier testing and then a repeat test.
For HIV, the timing depends on the test used. A laboratory 4th generation Ag/Ab test from venous blood can usually detect infection from about 18 to 45 days after exposure. Tests based on antibodies alone have a longer window period.
In syphilis diagnostics, antibodies also do not appear immediately. A test done very early may need to be repeated after a few weeks and, in some situations, also about 3 months after exposure.
So there is no single time, such as "7 days after contact", that would be right for the whole STI panel.
STI test results - when should you see a doctor?
A positive PCR result means that the genetic material of the tested microorganism has been detected. It should not, however, be the basis for choosing an antibiotic or antiparasitic drug on your own.
A consultation is particularly advisable when:
- Chlamydia trachomatis has been detected,
- Neisseria gonorrhoeae has been detected,
- Trichomonas vaginalis has been detected,
- Mycoplasma genitalium has been found,
- an HIV or syphilis test result requires confirmation,
- there are severe complaints despite a negative panel,
- infections keep coming back,
- the patient is pregnant,
- there is fever together with severe lower abdominal pain.
With gonorrhoea, an additional problem is the growing resistance of Neisseria gonorrhoeae to antibiotics. If treatment failure is suspected, the doctor may order a culture and a drug susceptibility test - PCR alone cannot show which antibiotics the bacterium is sensitive to.
Once an STI has been diagnosed, testing sexual partners also matters. Without it, reinfection may occur after treatment has been completed.
Should a partner be tested too?
When chlamydia, gonorrhoea, trichomoniasis or another STI is confirmed, sexual partners may need testing and, in certain cases, treatment as well.
This matters even when the other person has no symptoms. An asymptomatic infection may persist and lead to repeated transmission after one of the partners has completed treatment.
The partner does not need an identical set of tests. It depends, among other things, on the pathogen detected, the type of sexual contact and the site of possible infection.
Until the management recommended by the doctor has been completed, it may be necessary to abstain from sex for a time or to use protection consistently.
Discreet and confidential STI testing at OpenMed
Privacy concerns should not stand in the way of testing. Information about your sex life, the tests performed and the results forms part of your medical records and is covered by medical confidentiality.
During the consultation it is worth giving the doctor the information that matters for choosing the tests - including when the contact took place, whether it was vaginal, oral or anal, and whether a condom was used.
This is not about judging the patient, but about choosing the right sample. For example, after oral exposure a throat swab may be needed, which a standard urine test cannot replace.
Price of STI tests and PCR panels
The price of a test depends mainly on the number of pathogens tested for and the diagnostic method used.
A single PCR test for Chlamydia trachomatis will cost differently from a panel covering, for example, Chlamydia, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium at the same time.
The final scope of diagnostics is also affected by:
- the number of pathogens tested for,
- the number of sites from which samples have to be taken,
- the need for a throat or rectal swab,
- adding blood tests for HIV, syphilis or viral hepatitis,
- the need for a culture and antibiogram, e.g. when resistant gonorrhoea is suspected.
If you are not sure whether a single test will be enough or a panel would be better, the scope can be agreed during a consultation. Current prices of individual tests are available in the OpenMed price list and from the clinic reception.
STI tests for couples and before a new relationship
Tests can also be done preventively before starting sex without a condom in a new relationship. The most important thing then is to establish when each partner last had potentially risky contact, because a test done too early may still fall within the window period.
Depending on the situation, diagnostics may include:
- chlamydia and gonorrhoea by PCR/NAAT,
- Trichomonas vaginalis,
- Mycoplasma genitalium in specific cases,
- HIV,
- syphilis,
- HBV,
- HCV.
Exactly the same panel is not always needed for both people - previous contacts, HBV vaccination, symptoms and tests already done all matter.
Frequently asked questions about STI and STD tests
Yes. Many infections, including chlamydia and some gonorrhoea infections, can be completely asymptomatic. The test can be done preventively after unprotected contact, a change of partner or before starting sex without a condom.
No. A PCR test from a swab may cover several of the most important pathogens of the genitourinary tract, but it does not replace blood tests for, for example, HIV or syphilis. The scope of a specific panel should always be checked before the test.
Yes. The infection is very often asymptomatic, especially in women. The absence of pain, discharge or burning when passing urine does not rule out infection.
No. Clear purulent discharge is a characteristic symptom, especially in some men, but the infection can also cause few or no symptoms. This applies in particular to infections of the throat and rectum and to some infections in women.
Not always. Chlamydia or gonorrhoea may be present in the throat despite a negative result from a genitourinary sample. If the exposure involved the throat, the doctor may recommend a swab from that site.
If there was a risk of infection in the rectum, such a swab may be indicated. A standard vaginal swab or urine test does not rule out a rectal infection.
For molecular tests, about 2 weeks after possible exposure is often considered a practical time for screening. If there are symptoms or a partner has a confirmed infection, see a doctor sooner - the doctor may do the test straight away and decide on a repeat test later.
It depends on the type of test. A laboratory 4th generation antigen/antibody test performed on venous blood can usually detect infection about 18-45 days after exposure. Tests based on antibodies alone require a longer period.
This cannot be assumed automatically. Ureaplasma urealyticum and Ureaplasma parvum can colonise the genitourinary tract also in people without disease. The result should not therefore be treated in the same way as a positive test for chlamydia or gonorrhoea, and treatment should not be started without a clinical assessment.
No. These are different bacteria with different clinical significance. Mycoplasma genitalium is a recognised sexually transmitted pathogen and can cause, among others, inflammation of the urethra and cervix. Mycoplasma hominis, on the other hand, can be present in the genitourinary tract without causing disease.
An antibiotic may affect the test result. If treatment is ongoing or has recently ended, tell the doctor. Do not, however, stop prescribed medicines on your own just to do the test.
This cannot be established from the result of one person alone, but the partner may need testing and, in certain cases, treatment. This matters even when there are no symptoms and helps to reduce the risk of reinfection.
No. A panel detects only the pathogens within its scope and in the sample taken from a specific site. Symptoms may also result from thrush, bacterial vaginosis, a urinary tract infection, irritation or an infection outside the scope of the test performed.
Yes. For some sexually transmitted infections the risk can be significantly reduced through appropriately chosen prevention, vaccinations, regular testing and the right management after exposure. At OpenMed we encourage a consultation with an infectious diseases specialist, who will assess your individual risk, choose the appropriate range of tests and discuss the available options for preventing sexually transmitted infections. A wide range of vaccinations is available, as well as HIV prevention.