This scary STD is on the rise in a major way.
The bacterial infection, which can be spread via vaginal, oral or anal sex, progresses in three stages that pretty much go from scary to horrible to terrifying.
In the first two stages, syphilis can easily be treated with a quick round of antibiotics. But if you don’t treat syphilis within 12 months, it goes latent, meaning the bacteria is still in your body but you may not have symptoms for many years.
Ten to 30 years down the line, it can become active again, though. In its third stage, syphilis can damage your brain, nerves, eyes, heart and other organs, leading to blindness, paralysis and even death, according to the American College of Obstetricians and Gynecologists (ACOG).
“It’s important to diagnose and treat syphilis early because it can progress to stages that can affect your brain or your overall health, and it can be transferred to babies if it’s not diagnosed in pregnancy,” says obstetrician and gynaecologist Dr Jessica Shepherd.
Dr Shepherd says most people notice syphilis symptoms in the first or second stages of the disease, although it’s not uncommon for people to not realise their symptoms are caused by syphilis.
Here are eight syphilis symptoms in women you need to know about.
1. Firm, round, painless sores
In the first stage of syphilis, which lasts three to six weeks, you may or may not notice multiple sores at the spot of infection, according to the US Centers for Disease Control and Prevention (CDC).
“They’re painless and firm, and kind of have a vesicular (i.e., a small fluid-filled sac) feel,” explains Dr Shepherd. There are usually several in one area, each slightly larger than a pimple, or about half a centimetre in width. “They do go away. If you don’t go to your doctor in time, you may not see them,” says Dr Shepherd. Untreated, the infection progresses to second-stage syphilis.
2. Fever and swollen lymph glands
Another symptom that can appear at any stage of syphilis is a low-grade fever, generally around 38 to 38.1 degrees Celsius. “It wouldn’t last for very long – a few days, if at all,” says Dr Shepherd.
To be fair, a fever can be a sign of lots of things, so if you haven’t noticed other syphilis symptoms it’s probably nothing to worry about. Still, if you’re concerned it’s never a bad idea to phone your doctor.
3. Skin rashes
Notice a funky rash anywhere on your body? Always a good reason to check in with your doctor. In the secondary stage of untreated syphilis, you may discover a rash on some pretty random parts of your body. “You’ll notice small, rough red bumps, and it may go unnoticed because it doesn’t cause itching,” says Dr Shepherd.
While a syphilis rash most often appears on the palms of your hands or the soles of your feet, it can pop up elsewhere – although Dr Shepherd says it’s usually pretty localised. At this point, the syphilis bacteria has travelled through your blood, she explains, so it’s starting to affect parts of your body beyond where you were first exposed.
4. Sores in the mouth, vagina or anus
Another sign of secondary-stage syphilis: multiple large (1-3cm), raised grey or white sores that appear in moist areas like your mouth, underarms or groin. “They’re wart-like, somewhat raised and not painful,” Dr Shepherd says. “In fact they can be misdiagnosed as genital warts, which aren’t painful either.” Either way, if you notice these kinds of bumps it’s a good idea to book an appointment with your gynae right away.
5. Patchy hair loss
In the secondary stages of syphilis, you might find patchy bald spots on your scalp. Known as syphilitic alopecia, “this is not one of the big symptoms, and it’s not typical in what we would normally see,” says Dr Shepherd. In fact, hair loss in women can have all other kinds of causes, including hormonal changes, medications and medical conditions. “If you have hair loss, we usually see other symptoms like a rash, and we piece it together,” she adds. Once syphilis is treated, hair grows back.
6. Weight loss
Some women notice they might lose a couple of kilos in second-stage syphilis, but nothing dramatic, says Dr Shepherd. “We usually only notice it when we start to piece things together. Women may also have other symptoms rather than just weight loss,” she says. Other symptoms of second-stage syphilis are cold-like and include headaches, muscle aches, sore throat and fatigue, all of which will go away with or without treatment, according to the CDC.
7. Sensory deficits and clumsiness
Once untreated syphilis reaches the tertiary stage, bacteria can eventually affect the brain, says Dr Shepherd. Known as neurosyphilis, according to the CDC, it affects up to 10% of patients with untreated syphilis and can lead to meningitis, or inflammation of the brain and spinal cord.
In addition to headaches and difficulty coordinating muscle movements, other symptoms include altered behaviour, paralysis, sensory deficits and dementia, according to the US Mayo Clinic. The good news is, syphilis is treatable at any stage with antibiotics – although you’ll need to see your doctor to get diagnosed, and you’ll likely need to take medication for weeks or potentially be hospitalised for IV antibiotics at this stage.
8. Fuzzy vision
Ocular syphilis is another tertiary effect of untreated syphilis, where bacteria affect the optic nerve in the brain, according to the CDC. Symptoms can include vision changes up to permanent blindness.
“Syphilis is a blood-borne pathogen, so once it’s in the brain it will affect that organ. It’s just a matter of time before gets there,” says Dr Shepherd. There’s one more good reason to check in with your doctor right away if you notice any early-stage syphilis symptoms.