Public Health

Syphilis - Women’s Health Guide

Syphilis is a sexually transmitted disease (STD) caused by bacteria. It has often been called "the great imitator" as so many of the signs and symptoms are like those from other infections.

How is it spread?

Women get syphilis from sexual contact with someone who has it. Anyone who has it can spread it to others. Sometimes sores or infection may not be visible and the person may not know that they have it. Syphilis can be spread between:

• Men and women
• Women and women
• Men and men

Contact with a syphilis sore can spread the infection. It can get into your body through the vagina, anus, mouth and throat, or broken skin. Pregnant women can pass the infection to their babies before they are born.

What are signs of syphilis in women?

There are four stages of syphilis. Each is defined by how long the person has had it. Signs vary in each stage.

1. Primary Stage: The first sign of syphilis is often a small, round, firm sore. These appear at the place where it entered the body such as the vulva, vagina, tongue, or lips. These signs may be inside the vagina. Most do not cause pain. There can also be more than one sore. Signs of syphilis often go away in about 3 to 6 weeks even without treatment. If not treated in this stage, it will progress into the other stages.
2. Secondary Stage: This stage can start with a rash over one or more areas of the body. These appear mostly on the palms of the hands and the bottoms of the feet. Other signs may be:
   • Sore throat
   • Swollen glands
   • Fever
   • Hair loss in patches
   • Head and muscle aches
   • Weight loss
   • Tiredness
   If not treated in this stage, signs will still go away. However, the syphilis bacteria are still in the body. The infection will progress into the latent stage.
3. Latent Stage: This stage is also called the hidden stage. It can last many years. Syphilis remains in the body with no signs of infection. After 10 to 20 years without treatment, syphilis can progress to the late stage.
4. Late Stage: Syphilis in this stage can cause:
   • Numbness
   • Problems with blood vessels
   • Damage to bones and joints
   • Difficulty walking
   • Blindness
   • Paralysis
   • Brain damage
   • Dementia
   • Heart disease
   • Death

How do you know if you have syphilis?

Your health care provider can examine and test you for syphilis. Blood or fluid from a sore can be tested.

How is it treated?

Syphilis can be cured with antibiotics in all stages of the disease. Always finish antibiotic treatment. Do not have sex until after treatment and all signs are gone. See your health care provider if your signs do not go away after finishing treatment. Some damage to your body caused by the disease may remain.

If you have syphilis

• Always finish all antibiotic treatment.
• Do not have sex with someone who has syphilis or has not finished treatment (to prevent re-infection).
• Tell current and recent sex partners of the infection so they can get checked.
• Know that it can raise the risk of getting and spreading HIV.
• Get tested again after 6 and 12 months. Only a health care provider can tell you when you no longer have it.

How can you avoid syphilis?

• Avoid sexual contact.
• Have safer sex:
• Reduce the number of sexual partners.
• Condoms, when used correctly, can reduce the risk of getting syphilis. Each time you have sex use a condom (male or female type):
• Before vaginal sex
• Before anal sex
• Before oral sex
• Have sex with only one partner who does not have sex with others and does not have syphilis.
• Know that other forms of birth control do not protect against syphilis.

For more information, see Safer Sex.

What about pregnancy?

All pregnant women should be tested for syphilis. If you are pregnant and have syphilis, you can pass the infection to your baby during pregnancy or birth. Syphilis during pregnancy can cause:

• Babies with skin sores, blood, liver and other problems
• Miscarriage
• Early birth
• A baby born dead
• A baby that dies soon after birth

Pregnant women and babies born to infected mothers must be treated to avoid problems.

For more on syphilis

• Centers for Disease Control and Prevention (CDC): Syphilis – CDC Fact Sheet
• National Institute of Allergy and Infectious Diseases (NIAID/NIH): Syphilis
• U.S. Department of Health and Human Services (HHS), Office on Women's Health: Syphilis Fact Sheet

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