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Do Men and Women Have Different Syphilis Symptoms?

Men and women are both at risk of contracting syphilis, and both experience the same stages and symptoms. Syphilis is a bacterial infection spread primarily through sexual contact and is classified as a sexually transmitted infection that can be cured if it’s detected in its early stages. The number of syphilis symptoms experienced, as well as frequency and severity, can differ from person to person but are typically the same for both sexes.

After initial infection, syphilis can lay dormant for years and even decades, making it difficult to detect in men and women. Symptoms may be experienced differently from person to person as the infection progresses through its four different stages. Syphilis shows very few symptoms in the first stage but can cause serious complications if left untreated, which is why it’s so important to get tested regularly.

Stages of Syphilis

Primary syphilis: This is the first sign of syphilis infection and typically emerges as a small sore called a chancre (SHANG-kur). The sore indicates where the bacteria entered the body and is often missed because of its location on the anus, penis, vulva, vagina, or scrotum. Sores may develop deep inside the vagina, inside the rectum, under a fold of skin near the scrotum, or other places that make them hard to see.

During primary syphilis, chancres develop three weeks to three months after infection. The sores are not painful and may go unnoticed, especially if they can’t be seen. Sores typically go away on their own in three to six weeks, but the infection will remain. If left untreated, syphilis will progress to the secondary stage.

Secondary stage: In this stage, symptoms become more dramatic. Men and women generally experience the same type of symptoms although some individuals may not present all of the symptoms. Skin rashes are common but may be hard to see or notice because the rash doesn’t itch or the redness may be faint. Common symptoms reported in the secondary stage are:

  • A skin rash on palms of hands or soles of feet
  • Sores in the mouth, vagina, or anus
  • Flu-like symptoms
  • Sore throat
  • Fever
  • Swollen glands
  • Weight loss
  • Hair loss
  • Headache
  • Fatigue
  • Muscle aches

The secondary stage can last up to six weeks and symptoms usually go away by themselves. The infection can then reoccur every two years or so. Symptoms of syphilis are sometimes hard to detect because they mimic other illnesses, so regular testing is imperative. If left untreated, syphilis moves on to the late, more dangerous stages.

Latent stage: In this stage of syphilis, there are no signs or symptoms of the infection. The latent stage can last for years if the infection is not treated.

Tertiary stage: If left untreated, syphilis will advance to the most severe stage of the infection. This stage may not appear for decades after the initial infection and only approximately 30 percent of people infected with syphilis will enter this stage. At this point, even with treatment, any damage the infection has caused cannot be reversed.

Severe effects of syphilis are:

  • Stroke
  • Deafness
  • Personality changes
  • Heart valve disease
  • Aneurysm
  • Inflammation of blood vessels

Neurosyphilis and ocular syphilis can occur during any of the infection stages but are more typical of late-stage syphilis. The symptoms of neurosyphilis and ocular syphilis manifest as:

  • Severe headache
  • Difficulty coordinating muscle movements
  • Paralysis
  • Numbness
  • Dementia
  • Changes in vision or blindness

Syphilis and Pregnancy

Mothers with syphilis can pass the infection to the fetus through the placenta. Babies born with syphilis might not exhibit any symptoms or may have a faint rash on their palms or the soles of their feet. Later signs include deafness and seizures. The Center for Disease Control recommends getting tested before becoming pregnant and at least once during the pregnancy term. Contact your Nurx™ medical provider so we can help you and your partner get tested for syphilis and other STIs before getting pregnant to make sure your whole family is protected.

How to Stay Protected

Since syphilis is so difficult to detect, and because you or your partner might not know you’re infected, it is important to take precautions. Take steps to protect yourself from infection, and to prevent the spread of infection. Even if you’ve been treated for syphilis in the past, you can contract the infection again, so here are some preventative steps you can take.

  • Use protection. Latex condoms help reduce the spread of STIs like syphilis. Use a condom every time you have sex for protection against infections.
  • Get tested. Getting tested means you can begin treatment right away if your results are positive. Getting tested is relatively simple and may be covered by your insurance plan. Speak to a member of our medical team here at Nurx to learn how you can order a comprehensive STI test you can do at home.

Primary and Secondary Syphilis by the Numbers

A study done by the CDC in 2017 reported that the rates for new syphilis cases among men were considerably higher than the rates for women. Infection rates for both men and women have steadily increased over the years and the rate for primary and secondary syphilis among women doubled from 2013-2017. Here is the breakdown:

  • Men who have sex with men only (MWM) – 52 percent
  • Men who have sex with men and women (MSM,MSW) – 6 percent
  • Men who have sex with women only (MSW) – 15 percent
  • Women  – 12 percent

Further Reading

Syphilis CDC Fact Sheet Center for Disease Control, 2017

Syphilis Mayo Clinic

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