Clinicians should perform routine screening of all sexually active women at increased risk for gonorrhea, because of the high risk for pelvic inflammatory disease, ectopic pregnancy, and chronic pelvic pain associated with asymptomatic gonorrhea infection, according to the U.S. Preventive Services Task Force.
Those at risk include sexually active women under age 25 years, those with previous gonorrhea or other sexually transmitted infections, those with new or multiple sex partners, those who don't consistently use condoms, sex workers, and drug users. Pregnant women with these risk factors should be screened at the first prenatal visit, and those with ongoing or new risk factors should also be screened during the third trimester because gonorrhea increases the risk of preterm rupture of membranes, chorioamnionitis, and preterm labor (Ann. Fam. Med. 2005;3:263–7).
The task force recommended against routine screening in women and men at low risk for gonorrhea, and it found insufficient evidence to recommend for or against routine screening in men at high risk.