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All About STIs: Syphilis

All About STIs: Syphilis Image

No one likes to think about sexually transmitted infections (STIs), but every sexually active person should understand which STIs are out there and whether he or she is at risk. For the next installment in our All About STIs series we’re going to talk about syphilis. Syphilis can develop into serious health problems if left untreated, so stay safe by arming yourself with the facts about this infection.

What is Syphilis?

Syphilis is an STI caused by the bacterium Treponema pallidum. This bacteria can get into your body when you have oral, vaginal, or anal sex. It often presents as one or more sores around your genitals, butt, mouth, or lips. Because syphilis is an infection that progresses, it’s divided into stages that help doctors understand how to manage it. These stages are:

  • Primary syphilis, or the first stage, which usually involves one or more sores at the original infection site
  • Secondary syphilis, or the second stage, when the infection causes symptoms beyond the original site, such as a skin rash 
  • Latent stage, when the bacteria becomes dormant and does not cause any symptoms
  • Tertiary syphilis, when the infection causes damage to vital organs of the body, such as the brain and heart

Syphilis can also cause one or more symptoms involving the neurologic system during any of the above stages. Syphilis causes the most significant damage to your body if you don’t get treatment.

What Are the Symptoms of Syphilis?

The symptoms of syphilis vary as the infection progresses. For primary syphilis, it will take 14 to 21 days after your exposure to the bacteria before you start showing symptoms, though the incubation period can extend to as long as three months following exposure. These symptoms include:

  • One or more ulcers or open sores that typically don’t hurt. They may heal in three to six weeks, even in the absence of treatment, though the infection will not yet be cured
  • Swollen lymph nodes around the sores

Four to eight weeks after these symptoms show up, an infected person will start seeing signs of secondary syphilis. These include:

  • A rash typically involving the chest, back, abdomen, and extremities, and often involving the palms and soles of the feet 
  • Warty patches around your genitals
  • Joint and muscle pain
  • Changes in vision
  • Not feeling hungry
  • Feeling ill overall

If untreated, syphilis typically then enters the latency stage, which can last for 10 to 30 years. After that, tertiary syphilis may occur. Although not every infected person experiences tertiary syphilis, those who do get to that stage encounter quite serious health problems, including:

  • Heart damage, such as aneurysms or valve disease
  • Skin, bone, or liver tumors
  • Problems with the central nervous system

Neurologic changes, such as imbalance, visual or hearing symptoms, or other related symptoms caused by swelling of the lining of the brain, among others, can occur at any stage of syphilis and can be severe. When neurologic changes occur, prolonged treatment with IV antibiotics is required.

Keep in mind that the genital sores caused by syphilis also put you at higher risk for transmitting or acquiring HIV, because the sores provide a portal of entry.

Who’s at Risk for Syphilis?

Syphilis is one of the few STIs that is more common in men than women. Overall, 24,000 people in the United States had first or second stage syphilis in 2015, and only 2,200 of those were women. In particular, it is more common among men who have sex with men. The age group most affected is people between 20 and 35.

Increasingly, however, syphilis is becoming more common in pregnant women, and it is important that such cases be recognized early in order to protect the fetus and ensure healthy development.

Anyone showing signs and symptoms of syphilis who recently had unprotected sex should be tested for syphilis. If you’re a woman, remember that taking birth control will not keep you safe from STIs. Whether you’re using NuvaRing, Depo-subQ Provera 104, or another contraceptive method, these are only intended to protect you from pregnancy.

How is Syphilis Treated?

Syphilis is treated with an antibiotic, often penicillin, though people who are allergic to penicillin have other options. The length of time you’ll have to take the antibiotics depends on the type of syphilis and the stage it’s reached when diagnosed. It’s vital that you continue taking your antibiotics until you finish your course or you may not completely treat the infection. You should also refrain from sex until your last dose is finished, as you don’t want to pass syphilis on to your partner.

Your doctor will probably recommend follow-up tests at three, six, 12, and 24 months after your infection to make sure it’s gone for good.

How Can You Prevent Syphilis?

Like all STIs, the best way to prevent syphilis is to use condoms during sex, even if you’re on birth control. Condoms can prevent the bacteria from getting inside your body and causing infection.

Always remember that even if you’ve already had syphilis and been completely cured, you can get it again if you have sex with a person who has the infection. That’s why it’s a good idea to ask your partners to get tested, and get tested regularly yourself. All three of the Nurx STI Home Test Kits include tests for syphilis.


This blog pro­vides infor­ma­tion about telemed­i­cine, health and related sub­jects. The blog content and any linked materials herein are not intended to be, and should not be con­strued as a substitute for, med­ical or healthcare advice, diagnosis or treatment. Any reader or per­son with a med­ical con­cern should con­sult with an appropriately-licensed physi­cian or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.

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