Syphilis, a genital ulcerative disease, causes significant complications if untreated and facilitates the transmission of HIV. Untreated early syphilis in pregnant women results in perinatal death in up to 40% of cases and, if acquired during the four years preceding pregnancy, may lead to infection of the fetus in 80% of cases.1
Incidence of Syphilis: An estimated 70,000 sexually transmitted infections with Treponema pallidum, the cause of syphilis, occur each year in the United States. (Source: excerpt from Sexually Transmitted Diseases Statistics, NIAID Fact Sheet: NIAID)
What are the symptoms of syphilis?
Can syphilis be cured? How is syphilis treated?
What should I do if I have syphilis?
Can syphilis cause problems during pregnancy?
See also…
What is syphilis?
Syphilis (pronounced siff-ill-iss) is a sexually transmitted disease (STD) caused by a bacteria (germ). It progresses in stages and without treatment, can lead to death.
How is syphilis spread?
Syphilis can be spread during vaginal, anal, or oral sex through contact with an open sore or contact with a skin rash. The bacteria can enter the body through the penis, anus, vagina, mouth, or through broken skin. An infected pregnant woman can also pass the disease to her unborn child. Syphilis is not spread by contact with toilet seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing, or eating utensils.
What are the symptoms of syphilis?
Each stage of syphilis has different symptoms. Syphilis can be spread during the first two stages of the disease.
Primary Stage
A single, painless sore, called a chancre (shan-ker), appears in the first, or primary stage, about 10 days to 90 days after infection. The sore can appear on the vulva, vagina, cervix, tongue, lips, or other parts of the body, including inside the body. Twenty-one days after infection is the most common time frame in which the sore appears. The sore heals with or without treatment. In this stage, syphilis can be passed to others through contact with an open sore during vaginal, anal, or oral sex. If the infection is not treated, it moves to the next, or secondary, stage.
Secondary Stage
In the secondary stage, which starts three to six weeks after the sore appears, some or all of these symptoms can appear:
- skin rash with rough, red or reddish-brown spots both on the palms of the hands and bottoms of the feet. The rash usually does not itch. Rashes with a different appearance may occur on other parts of the body.
- sores on the throat, mouth, or cervix
- fever
- sore throat and swollen lymph glands
- patchy hair loss on the head and other parts of the body
- headaches and muscle aches
- weight loss
- tiredness
During vaginal, anal, or oral sex, contact with open sores or contact with the rash can spread the infection to others. The symptoms of secondary syphilis will resolve with or without treatment. But without treatment, the infection will progress to the latent and late stages of disease.
Latent Stage
The next stage is called the latent or hidden stage. This stage can start from two years to over thirty years after initial infection. After symptoms from the secondary stage disappear, a relapse of the second stage of syphilis can happen, when those symptoms come back. If a relapse happens, the disease can be passed to others. Otherwise, the disease cannot be passed to another person. Even without treatment, some people with latent syphilis do not go on to develop late stage syphilis. But others will go on to develop late stage syphilis.
Late Stage
In the late stage of syphilis, some people suffer damage to the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Complications may include small bumps or tumors on organs, blindness, insanity, or paralysis. This stage can last for years. Some people may die from the disease. You will only reach this stage if you have not received treatment earlier. If you have syphilis, get treated as soon as possible to avoid these problems.
How is syphilis diagnosed?
A doctor can diagnose syphilis in a number of ways:
- Recognizing its signs and symptoms and taking the correct tests.
- Looking at the fluid from a syphilis sore or swollen lymph node under a microscope. This can only be done during primary and secondary syphilis when a patient has sores.
- Testing the patient’s blood.
Can syphilis be cured? How is syphilis treated?
Yes, syphilis can be cured. Penicillin is the preferred drug to treat syphilis at all stages. The dose and length of treatment depends on the stage of syphilis and symptoms of the disease. If a person can’t take penicillin, another medicine may be available. But in late syphilis, damage already done to body organs cannot be reversed. You can get syphilis again after being cured if you are exposed to it. Taking antibiotics does not protect you from getting syphilis again.
What should I do if I have syphilis?
- Avoid having any sexual activity while you are being treated for syphilis. Don’t have sexual contact until the syphilis sores are completely healed.
- Be sure to tell your sexual partners, so they can be tested and treated if necessary.
- After you have completed treatment for syphilis, get retested after six months and 12 months. Some doctors recommend more frequent follow-up tests.
Can syphilis cause problems during pregnancy?
Yes. Pregnant women can pass syphilis to their babies during pregnancy and childbirth. It can cause miscarriage, stillbirth, or death soon after birth. An infected baby may be born without signs of disease. However, if not treated right away, the baby may have serious problems within a few weeks. Babies born with syphilis may develop skin sores, rashes, fever, jaundice (yellow skin), anemia (a blood problem), or a swollen liver and spleen. Untreated babies may become developmentally delayed, have seizures, or die.
All pregnant women should be tested for syphilis. Pregnant women with syphilis are treated right away with penicillin. For women with an allergy to penicillin, there is no alternative medicine that has proven effective for treatment. Penicillin will prevent passing syphilis to the baby, although treatment during the second half of pregnancy may not eliminate the risk for premature labor and fetal distress.
How is syphilis prevented?
There are things you can do to protect yourself from syphilis:
- Don’t have sex. The best way to prevent syphilis or any STD is to practice abstinence, or not having vaginal, oral, or anal sex.
- Be faithful. Have a sexual relationship with one partner who has been tested for syphilis and is not infected is another way to reduce your chances of getting infected. Be faithful to each other, meaning that you only have sex with each other and no one else.
- Use condoms. Protect yourself with a condom EVERY time you have vaginal, anal, or oral sex. For vaginal sex, use a latex male condom or a female polyurethane condom. For anal sex, use a latex male condom. For oral sex, use a dental dam. A dental dam is a rubbery material that can be placed over the anus or the vagina before sexual contact.
- Know that some methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from STDs. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sex.
- Talk with your sex partner(s) about STDs and using condoms. It’s up to you to make sure you are protected. Remember, it’s YOUR body! For more information, call the Centers for Disease Control and Prevention at (800) 232-4636.
- Talk frankly with your doctor or nurse and your sex partner(s) about any STDs you or your partner have or had. Talk about any sores in the genital area. Try not to be embarrassed. Being honest could save your lives.
- Have regular pelvic exams. Talk with your doctor about how often you need them. Many tests for STDs can be done during an exam. Ask your doctor to test you for syphilis and other STDs. The sooner an STD is found, the easier it is to treat.
- If you are pregnant, get tested for syphilis. Get tested as soon as you think you may be pregnant.
For More Information . . .
You can find out more about syphilis by contacting the National Women’s Health Information Center (NWHIC) at 800-994-WOMAN or the following organizations.
CDC Info, HHS
Phone: (800) CDC-INFO or (800) 232-4636
CDC National Prevention Information Network (NPIN), CDC, HHS
National Center for HIV, STD and TB Prevention, CDC, HHS
National Institute of Allergy and Infectious Diseases
Phone: (301) 496-5717
American Social Health Association
Phone: (800) 783-9877
Planned Parenthood Federation of America
Phone: (800) 230-7526
The syphilis FAQ was reviewed by the Division of STD Prevention, Centers for Disease Control and Prevention, May 2005.
All material contained in the FAQ is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women’s Health in the Department of Health and Human Services; citation of the sources is appreciated. The National Women’s Health Information Center is Sponsored by the Office on Women’s Health in the U.S. Department of Health and Human Service.
1 Ingraham NR. The value of penicillin alone in the prevention and treatment of congenital syphilis. Acta Derm Venereol 1951, 31 (suppl 24):60-88.
