Syphilis is a sexually transmitted infection (STI). It is not as common as some sexually transmitted infections but if left untreated it can cause very serious health problems in both men and women.
This page gives you information about syphilis, what you can do if you are worried that you might have the infection and advice on how to protect yourself.
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Syphilis is caused by bacteria known as Treponema pallidum. This is easily passed from one person to another through sexual contact. Anyone who is sexually active can get it. Both men and women can have syphilis, and pass it on.
You can pass syphilis on without knowing you have the infection because symptoms can be mild and you may not notice or recognise them.
You cannot catch syphilis from kissing, hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery.
The signs and symptoms are the same in both men and women. They can be difficult to recognise and you might not notice them.
Syphilis can develop in three stages:
If you do get symptoms, you might notice the following:
If the infection remains untreated the second stage usually occurs some weeks after any sores have appeared and healed. Syphilis is still infectious at this stage and can be passed on to someone else.
The symptoms include:
When syphilis remains untreated it goes into another phase known as third stage or latent syphilis. Untreated syphilis may, after many years, start to cause very serious damage to the heart, brain, eyes, other internal organs, bones and nervous system. At this stage syphilis can lead to death.
Third stage syphilis is rare in the UK and this booklet does not cover it.
You can only be certain you have syphilis if you have a test. If you think you might have syphilis it is important that you don’t delay getting a test. Even if you don’t have symptoms you may wish to be tested, particularly if:
Don’t delay seeking advice – clinics don’t mind doing sexual health check-ups.
It is important not to delay getting a test if you think you might have syphilis. Syphilis may not show up on the test straightaway, so it will be repeated at a later appointment.
The doctor or nurse will ask you to give a blood sample.
They will do a genital examination. For women this may include an internal examination of the vagina and for men an examination of the penis, foreskin and urethral opening (where urine comes out).
Both men and women may have the anus examined internally and externally.
The doctor or nurse will also check the body generally for any rashes or warty growths. They may check the mouth and throat area.
They will use a swab to collect a sample of fluid from any sores. A swab looks a bit like a cotton bud, but is smaller and rounded. It sometimes has a small plastic loop on the end rather than a cotton tip. It is wiped over any sores to pick up samples of discharge and cells. This only takes a few seconds and is not painful, though it may be uncomfortable for a moment.
Cervical screening tests and routine blood tests do not detect syphilis. If you are not sure whether you have been tested for syphilis, just ask.
No tests are 100 per cent accurate, but syphilis tests should pick up almost all infections.
There are a number of services you can go to. Choose the service you feel most comfortable with. A test can be done at:
For information on how to find a service see How to get help with your sexual health.
Pregnant women attending antenatal services and some gynaecology services will routinely be offered a test. See What happens if I get syphilis when I’m pregnant?
All tests are free through NHS services. Treatment is also free unless you go to your general practice when you may have to pay a prescription charge for the treatment.
First and second stage syphilis is treated using a single antibiotic injection or a course of injections or by taking antibiotic tablets or capsules. Penicillin is the most common treatment for syphilis, but there are several different antibiotics that can be used. Let the doctor or nurse know if you are allergic to penicillin.
Treatment is very effective for both first and second stage syphilis. As long as the treatment is taken correctly the syphilis will be completely cured.
Syphilis at this stage can be treated, but any damage already done to your body will be permanent.
After the first treatment some people get a reaction known as the Jarisch-Herxheimer reaction. This is a flu-like illness with high temperature, headache and aches and pains in the muscles and joints. This only lasts for up to 24 hours and starts within 4–6 hours after treatment. It is thought to be caused by the treatment causing a big release of the bacteria into the blood stream all at the same time. If you are concerned ask your doctor or nurse for advice.
Yes. You will need to go back for follow-up tests to check that the infection has gone and that you have not come into contact with the infection again.
Your blood test will probably remain positive in any future tests – even after successful treatment. So, if you need documents for emigration or any other reason, ask your clinic for a certificate explaining your treatment. This also means that you will be advised to have regular blood tests to check that there are no changes, monitor your condition and make sure that all is okay.
If you have any questions, ask the doctor or nurse and make sure you know how to protect yourself in the future.
Without proper treatment the infection can spread to other parts of the body causing serious, long-term complications.
Left untreated, syphilis may start to cause very serious damage to the heart, brain, eyes, other internal organs, bones and nervous system. This damage could lead to death.
No. If you delay seeking treatment you risk the infection causing long-term damage and you might pass the infection on to someone else.
It is strongly advised that you do not have any sexual intercourse, including vaginal, anal or oral sex until you and your partner(s) have both finished the treatment and any follow-up treatment. If you or a partner have any sores or rashes you should avoid any kind of skin contact until the treatment has been completed and until sores are fully healed. This is to help prevent you being re-infected or passing the infection on to someone else. If it is not possible to avoid sex, make sure that you use a condom. This might reduce the risk of infection, but won’t eliminate it.
The syphilis test cannot accurately tell you how long the infection has been there. If you have had more than one sexual partner it can be difficult to know which partner you got syphilis from. If you feel upset or angry about having syphilis and find it difficult to talk to your partner(s) or friends, don’t be afraid to discuss how you feel with the staff at the clinic or general practice.
If the test shows that you have syphilis then it is very important that your current sexual partner(s) and any other recent partners are also tested and treated. The staff at the clinic or general practice can discuss with you which of your sexual partners will need to be tested.
You may be given a ‘contact slip’ to send or give to your partner(s) or, with your permission, the clinic can do this for you. The slip explains that they may have been exposed to a sexually transmitted infection and suggests that they go for a check-up. It may or may not say what the infection is. It will not have your name on it, so your confidentiality is protected.
This is called partner notification. You are strongly advised to tell your partner(s), but it isn’t compulsory.
No. There is no evidence that syphilis will affect fertility in men or women.
All pregnant women are screened for syphilis. You should be offered an explanation and a blood test for syphilis when you attend for antenatal care. If syphilis is found, you can be given treatment safely during pregnancy. This can help prevent the baby from becoming infected and there is no risk of the treatment harming the baby.
If the syphilis is untreated you may pass the infection to your baby in the uterus. This can lead to miscarriage or stillbirth, or the baby being born with syphilis.
There is no evidence that syphilis causes cervical cancer.
It is possible to get syphilis and other sexually transmitted infections by having sex with someone who has the infection but has no symptoms. The following measures will help protect you from syphilis and most other sexually transmitted infections including HIV, chlamydia and gonorrhoea. If you have a sexually transmitted infection without knowing it they will also help prevent you from passing it on to a partner.
Last updated November 2012. Next update available October 2013.