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Syphilis Symptoms in Men & Women

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Syphilis Symptoms in Men & Women

writtenByWritten by: Andy Wong
Andy Wong

Andy Wong

Andy is the Chief Marketing Officer at PlushCare. He's passionate about advancing healthcare solutions and improving access to care via health technology.

Read more posts by this author.

August 23, 2017 Read Time - 7 minutes

Syphilis Symptoms in Men & Women

According to a 2015 report by the Center for Disease Control, around 15 of every 200,000, or .0075% of men and women in the United States report contracting syphilis, a rare but potentially devastating sexually transmitted disease. Left untreated, syphilis can have unalterable and fatal repercussions, but with the proper care and management, is completely treatable.  Syphilis is a bacterial genital ulcerative disease that develops in stages, which are characterized by their symptomatic manifestations, or by their latency.  Syphilis is always symptomatic, but symptoms may take months or even years to appear, so it is possible to acquire or transmit the disease without knowledge of its existence.

The largest variance in syphilis in men and women is its rate of transmission, though mild differences may occur in its symptomatic expression.

Syphilis Transmission in Men & Women

According to a 2015 CDC report, men are far more likely to contract syphilis in their lifetime than women.  In 2015, men from ages 15-19 experienced 8 cases per 100,000 individuals, compared to women of the same age range, who reported 2.8 cases per 100,000.  That is a 286% higher likelihood of 15-19 year old men to contract syphilis.  Men aged 20-24 reported 35.7 cases per 100,000, compared to women who reported 5.1 cases per 100,000, 700% more likely for men!

Within the male population, MSM, or men who have sex with men are more likely to contract syphilis than MSW, men who exclusively have sex with women.

Unprotected sex and having multiple partners is also a large risk factor for syphilis.

How Do You Get Syphilis?

Syphilis is transmitted via direct contact with the open sores or bodily fluids of an infected person.  The T. pallidum spirochetes enter the contracting host’s body through microscopic cracks in the skin and through the mucus membranes along the penis, vagina, mouth, and anus.

Syphilis Risk Factors

According to a 2015 CDC report, men are far more likely to contract syphilis in their lifetime than women.  In 2015, men from ages 15-19 experienced 8 cases per 100,000 individuals, compared to women of the same age range, who reported 2.8 cases per 100,000.  That is a 286% higher likelihood of 15-19 year old men to contract syphilis.  Men aged 20-24 reported 35.7 cases per 100,000, compared to women who reported 5.1 cases per 100,000, 700% more likely for men!

Within the male population, MSM, or men who have sex with men are more likely to contract syphilis than MSW, men who exclusively have sex with women.

Unprotected sex and having multiple partners is also a large risk factor for syphilis.

What are the Symptoms and Stages of Syphilis in Men and Women?

Symptoms of syphilis in men and women are for the most part identical.  The main difference is the typical location of primary stage chancre sores.  For men, the chancre is most likely to develop on the penile head or shaft.  For women, the initial chancre is most likely to develop on the vulva, in the vagina, or on the cervix.  Both men and women may see chancres on the anus, buttocks, and upper thighs.  Due to the potential internal growth, and the chancre’s tendency to be painless, primary symptoms of syphilis in women will often go by unnoticed, unlike syphilis on the penis.  This may contribute to why physicians report fewer cases of primary syphilis in women than men.

The first symptoms of syphilis can occur from as soon as 10 days to as long as 3 months after acquisition.  The average onset of syphilis symptoms is 21 days.  So, what should you look for?

Primary Syphilis

The first, or primary stage of Syphilis is mild and can go by unnoticed, even when symptomatic.  The first sign of syphilis is the appearance of one or multiple chancre sores at the primary site of infection.  Chancre sores are typically firm, round, and painless.  Syphilis chancres start as pustules, spots with hard sloping edges with a fluid filled center, capable of bursting when pressure is applied.

Since syphilis is a sexually transmitted infection, chancres can occur on, in, and around the genitals, on the anus, in the rectum, or on the upper and inner thighs.  Syphilis can also be contracted in the mouth or throat, with oral chancres typically located on the pharynx.  The chancre pustule then scabs over to become an ulcer, which takes about 3 to 6 weeks to heal fully, regardless of treatment or lack thereof.

Secondary Syphilis

The secondary stage of syphilis is markedly more severe and may overlap with the healing process of the primary stage.  The first sign of secondary syphilis is a reddish-brown rash upon several areas of the body.  The most characteristic area of syphilis rash is on the palms and the bottom of feet, but rashes like this and other skin inflammation may occur elsewhere on the body.

These body rashes often resemble those of other diseases and conditions, such as contact dermatitis, acne, chicken pox, etc.  This characteristic has lead to syphilis’s acquisition of the moniker, “The Great Pretender.”  Syphilitic rashes are not usually itchy or painful, and can be so faint that they might not even be noticeable.

Along the mucous membranes and warm, moist areas of the body, such as the mouth, throat, genitals, and anus, and underarms, large white or grey lesions appear.  These are known as Condyloma Lata, which contain vast amounts of infectious T. pallidum spirochetes, making them highly contagious.  These occur in about 33% of syphilitic individuals.

Other possible symptoms of secondary stage syphilis include:

  • Fatigue
  • Fever
  • Hair loss
  • Headaches
  • Myalgia (muscle pain)
  • Sore throat
  • Swollen lymph nodes
  • Weight loss

Just as in the primary stage, secondary symptoms will go away on their own accord with or without treatment. However, if untreated, the infection will progress to the next stage.

Latent Syphilis

Around 30% of those infected with syphilis are currently living in the latent, or dormant period of syphilis.  In the latent stage, there are no symptoms.  The bacteria reside in the spleen and lymph nodes, inactive for 3 to 30 years.  If untreated during the latent stage, the disease will develop into the tertiary stage.

Tertiary Syphilis

The tertiary stage of syphilis may take years or even decades to arrive, but around 30-40% of all seropositive individuals will progress to it, since the undiagnosed primary and secondary syphilis followed by a long, asymptomatic period can lead to a false sense of security.

Though at this stage in the infection the bacteria are typically no longer contagious, their effects on the body can be devastating.  The bacteria living inside have at this point congregated and multiplied in one or more organ systems of the body.  Common infections include those of the central nervous system, the cardiovascular system, the bones, and the skin.

  • Neurosyphilis
  • Cardiovascular Syphilis
  • Gummatous Syphilis

Further possible complications of syphilis

As with many viral infections, syphilis increases your risk of contracting other diseases.  Syphilis increases your susceptibility to STDs and other complications such as:

  • Chlamydia
  • Gonorrhea
  • HIV/AIDS
  • HPV
  • Trichomoniasis
  • HIVThose infected with syphilis have a 200-500% greater chance of developing HIV

For pregnant women infected with syphilis, there is a chance that it will be passed on to the baby; this is called congenital syphilis.

  • Congenital syphilis, or neonatal syphilis occurs when a pregnant, syphilitic woman transmits the infection to her unborn child.

If you or someone you know displays these symptoms and complications, consult immediate help from an urgent care center or doctor near you.

Syphilis Prevention

Preventing Syphilis Transmission

The only way to ensure you do not contract or transmit syphilis is by abstaining from vaginal, oral, and anal sex.  However, if you are sexually active, there are ways to prevent the spreading of syphilis from or to your sexual partner:

  • Maintaining a mutually monogamous sexual relationship with a partner who has been tested for STDs
  • Proper usage of condoms and dental dams during vaginal, anal, and oral sex; even gloves during manual stimulation can help prevent the proliferation of syphilis.

To learn about the methods of syphilis testing, click here.

For information on syphilis treatment, click here.

If you think you have symptoms of syphilis, call or book online with PlushCare to set up a phone appointment with a top U.S. doctor today, and/or order an STD test now.

Sources:

PlushCare is dedicated to providing you with accurate and trustworthy health information.

avert.org. Syphilis. Accessed on February 7, 2021 at https://www.avert.org/sex-stis/sexually-transmitted-infections/syphilis

CDC Syphilis. Accessed on February 7, 2021 https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm

medlineplus.gov. Syphilis. Accessed on February 7, 2021 https://medlineplus.gov/syphilis.html

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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