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How do I know if I have syphilis? Are there different stages?
I had unprotected sex a while ago and now I’m worried about syphilis. What are the symptoms of syphilis? How would I know if I have it? Are there different stages?
Eric Christoff, MD, AAHIVM on September 20, 2011
Thanks so much for sharing your concern with us, and I’m happy to offer you some information about syphilis to get started. But remember, the only way to know for sure whether you have syphilis is to get tested.
First, how exactly do people get a syphilis infection? You’re right. Most cases of syphilis in adults happen through unprotected sex with an infected partner. Specifically, syphilis is caused by a bacteria that is transmitted between people upon contact with a syphilis rash or sore of an infected person. Syphilis infection can occur in many places of the body…the penis, vagina, anus, mouth and even the throat.
What do syphilis symptoms look like over time? You’re also right to ask about syphilis stages. If left untreated, syphilis has three stages with different signs and symptoms:
- Symptoms of primary syphilis: The classic sign of primary syphilis is a small, round, firm and painless sore (or “chancre”) at the location that the syphilis bacteria entered the body. Not everyone with syphilis notices this stage of infection because, again, the chancre could be inside the vagina, rectum, or mouth. Typically, a chancre shows an average of 21 days after exposure and goes away after three to six weeks…even without treatment. But if syphilis isn’t treated at this stage, the disease will progress to its secondary stage...
- Symptoms of secondary syphilis: One typical sign of secondary syphilis is a red, non-itchy rash that first appears on the torso and may spread to other parts of the body (including palms and the soles of the feet)…but the rash can be faint, so some people with secondary syphilis don’t even notice it. Some other signs of infection that may appear in this stage of the disease include a fever, sore throat and muscle aches.
- Symptoms of latent and late-stage syphilis: If secondary syphilis isn’t treated, it can progress into the latent stage...where there are no signs or symptoms. Over time (10-20 years), the infection can evolve into late-stage syphilis in which the syphilis bacteria attacks organs like the brain, heart, liver, bones, eyes, nerves and joints. Not surprisingly, this bodily attack can cause host of problems from paralysis to gradual blindness and dementia.
That said, keep in mind that syphilis is often called "the great imitator" because its symptoms look similar to those of other sexually transmitted diseases (STDs) and skin conditions. So if you’re experiencing any of these symptoms, it doesn’t necessarily mean you have syphilis (and vice versa)…again, getting tested if the only way to know for sure.
What about syphilis risk factors? You mentioned that you recently had unprotected sex...which is one risk factor for catching syphilis and other STDs. If you’re not sure if your partner has any STDs, I encourage you (and your partner) to get tested for syphilis along with other common STDs like chlamydia, gonorrhea, herpes and HIV.
Remember, syphilis, chlamydia and gonorrhea can all be cured easily with an antibiotic prescription...but knowing you have the disease is the first step to treatment. Other STDs, like HIV, are treatable with increasingly effective medications that can help you live a healthy life for as long as possible.
You can learn more about risks, symptoms, testing, treatment and prevention in our Expert Guide to Syphilis for a review of stages, symptoms, testing and treatment.
Thanks again for your question…and I wish you good health.
Dr. Christoff is a practicing physician at Northwestern Memorial Hospital, as well as Assistant Professor of Clinical Medicine at the Feinberg School of Medicine, Northwestern University. His areas of expertise include the treatment of HIV and syphilis along with other STDs, the medical treatment of depression and chronic fatigue, and the specific health needs of gay and lesbian patients. Dr. Christoff was educated at the University of Toledo, College of Medicine and completed his residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.