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Sexually Transmitted Diseases


What Is It?

Syphilis (pronounced: SIFF-ill-iss) is a sexually transmitted disease (STD) caused by a type of bacteria known as a spirochete (through a microscope, it looks like a corkscrew or spiral). It is extremely small and can live almost anywhere in the body.

The spirochetes that cause syphilis can be passed from one person to another through direct contact with a syphilis sore during sexual intercourse (vaginal, anal, or oral sex). The infection can also be passed from a mother to her baby during pregnancy. You cannot catch syphilis from a towel, doorknob, or toilet seat.

In the 1990s there was a decrease in the number of people infected with syphilis. However, more recently there has been a steady increase in reported cases of syphilis, especially in young adults and in men who have male sexual partners.

In its early stages, syphilis is easily treatable. However, if left untreated, it can cause serious problems — even death. So it’s important to understand as much as you can about this disease.

What Are the Symptoms?

Syphilis occurs in several different stages:

Primary Syphilis

In the first stage of syphilis, red, firm, painless and sometimes wet sores appear on the vagina, rectum, penis, or mouth. There is often just one sore, but there may be several. This type of sore is called a chancre (pronounced: SHANG-ker). Chancres appear on the part of the body where the spirochetes moved from one person to another. Someone with syphilis may also have swollen glands during this first stage.

After a few weeks, the chancre will disappear, but the disease doesn’t go away. In fact, if the infection hasn’t been treated, the disease will continue to get worse.

Syphilis is highly contagious during this first stage. Unfortunately, it can be easy to miss because the chancres are painless and can appear in areas that may not be easy to see, like in the mouth, under the foreskin, on the cervix, or on the anus. This means that people may not know that they are infected, and can pass the disease on to others without realizing it.

Secondary Syphilis

If syphilis hasn’t been treated yet, the person will often break out in a rash (including the soles of the feet and palms of the hands). The infected person may also get flu-like symptoms, such as fever and achiness. This can happen weeks to months after the chancre first appears. Sometimes the rashes associated with syphilis can be very faint or look like rashes from other infections and, therefore, may not be noticed. Sores sometimes appear on the lips, mouth, throat, vagina, and anus — but many people with secondary syphilis don’t have sores at all.

The symptoms of this secondary stage will go away with or without treatment. But if the infection hasn’t been treated, the disease can continue to progress. Syphilis is still contagious during the secondary stage.

Latent Syphilis

If syphilis still hasn’t been treated yet, the person will have a period of the illness called latent (hidden) syphilis. This means that all the signs of the disease go away, but the disease is still very much there. Even though the disease is “hiding,” the spirochetes are still in the body. Syphilis can remain latent for many years.

Tertiary Syphilis

If the disease still hasn’t been treated at this point, some develop tertiary (or late-stage) syphilis. This means the spirochetes have spread all over the body and can affect the brain, the eyes, the heart, the spinal cord, and bones. Symptoms of late syphilis can include difficulty walking, numbness, gradual blindness, and possibly even death.

How Long Until Symptoms Appear?

A person who has been exposed to the spirochetes that cause syphilis may notice a chancre from 10 days to 3 months later, though the average is 3 weeks. If the syphilis is not treated, the second stage of the disease may occur anywhere from about 2 to 10 weeks after the original sore (chancre).

It’s important to keep in mind that many people never notice any symptoms of syphilis. This means it is important to let your doctor know that you are having sex, so that he or she can test you for syphilis even if you don’t have any symptoms.

What Can Happen?

Syphilis can be very dangerous if left untreated. In both guys and girls, the spirochetes can spread throughout the whole body, infecting major organs. Brain damage and other serious health problems can occur, many of which can’t be treated.

A woman who is pregnant and hasn’t been effectively treated is at great risk of putting her baby in danger. Untreated syphilis also can cause major birth defects. Syphilis also increases the risk of HIV infection because HIV can enter the body more easily when there’s a sore present.

How Is It Treated?

If you think you may have syphilis or if you have had sexual contact with someone who might have syphilis, see your doctor or gynecologist right away. It can sometimes be difficult to spot chancres. So it’s important to get checked on a regular basis, especially if you have had unprotected sex and/or more than one sex partner.

Depending on the stage, the doctor can make a diagnosis by examining the discharge from chancres under a special microscope or by doing a blood test to look for signs of infection. Let the doctor know the best way to reach you confidentially with any test results.

Early stages of syphilis are easily cured with antibiotics. Someone who has been infected for a while will need treatment for a longer period of time. Unfortunately, damage to the body from the late stage of syphilis cannot be treated. However, even in the late stage, it is important to get treatment. This can prevent further damage to the body. Anyone with whom you’ve had unprotected sex also should be checked for syphilis immediately.

How Is Syphilis Prevented?

The best way to prevent any STD is to not have sex. However, for people who decide to have sex, it’s important to use protection and to have as few sexual partners as possible. Latex condoms are effective against most STDs; however, if there are any sores or rashes, avoid sex until the person has seen a doctor for treatment.

Reviewed by: Nicole A. Green, MD
Date reviewed: May 2013