What Are the Symptoms of Syphilis in Women?

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Syphilis is a sexually transmitted infection (STI) that is contracted when the body touches a sore on a sexual partner with syphilis during vaginal, anal, or oral sex. Other bodily fluids can also carry infection. Syphilis progresses in four stages, each with its own signs and symptoms. Syphilis can be a serious disease, but it's very easy to cure when it's found and treated early.

This article provides an overview of syphilis symptoms in cisgender women, how it's diagnosed, and how to prevent getting syphilis.

Doctor talking to young woman

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What Is Syphilis?

Syphilis is an STI caused by the bacteria Treponema pallidum, which is spread through sexual contact or from a pregnant person to their baby.

If syphilis is treated early, it's highly curable. But if it isn't, it can become serious and lead to problems with vision and hearing, weakness or paralysis, mental confusion, or dementia.

Syphilis symptoms can go away for many years, but the infection remains. It can be fatal if it reactivates and affects vital organs.

Diagnosing Syphilis in Women

If your healthcare provider suspects syphilis, they can take a blood sample and send it to a lab for confirmation. They can also look at fluid taken from a sore using a technique called dark field microscopy, which lights up material under a microscope so that it can be seen clearly and analyzed.

Syphilis is known as the "great imitator" because the symptoms resemble many other diseases, so a firm diagnosis is important.

What Are the Symptoms of Syphilis in Women?

Syphilis progresses in four definite stages, each of which has distinct signs and symptoms. The stages are primary, secondary, inactive (or latent), and late (or tertiary).

Even when you don't have symptoms, you still have the infection, and you can pass it on to others.

Primary Stage Syphilis Symptoms

One or more firm, round, and painless sores—called chancres—develop around the vagina, anus, rectum, or mouth. Sores appear at the point of contact with a partner's chancre.

Chancres go away after three to six weeks, even if you don't treat them, but the infection remains in your body.

Secondary Stage Syphilis Symptoms

As your primary sores are healing, or within about two to eight weeks, you may develop the following symptoms:

  • Sores (firm, painless chancres near vagina, anus, rectum, or mouth)
  • Rashes (rough, reddish-brown, non-itchy patches often on palms or feet)
  • Fever and swollen lymph glands
  • Sore throat
  • Unexplained hair loss
  • Headache
  • Unexplained weight loss
  • Muscle aches
  • Fatigue

These symptoms will also go away within weeks or months despite treatment, but the infection remains. If untreated, it can progress to a potentially serious phase.

Inactive (Latent) Stage Syphilis Symptoms

You won't have any symptoms during this stage, which is broken up into early and late phases. It can last for years. You may not be infectious during the late phase. If you are not treated, however, your syphilis may progress and become serious.

Late-Stage (Tertiary) Syphilis Symptoms

Tertiary syphilis affects between 14% and 40% of people with syphilis. It can occur 10 to 30 years after initial infection.

Late-stage syphilis can affect many internal organs as well as your nervous system, including senses like hearing and vision. Because it can damage vital organs like the heart, it can be fatal.

Symptoms of late-stage syphilis affecting the nervous system (neurosyphilis) include:

  • Severe headache
  • Muscle weakness and/or trouble with muscle movements
  • Confusion, changes in personality, dementia
  • Changes or loss of vision
  • Eye pain
  • Hearing loss
  • Tinnitus (ringing or other noises in ears)
  • Dizziness or a sense the room is spinning (vertigo)

It's important to note that neurosyphilis can occur during any stage, not just the tertiary stage.

If late-stage syphilis has damaged internal organs, such as the heart or liver, as well as the bones and joints, the symptoms will depend on what organs have been damaged.

If syphilis affects the heart, it can cause an aneurysm, in which the aorta (the main artery that carries blood from the heart) bursts. Lesions can develop on organs like the skin, liver, and other body tissues.

How to Practice Safe Sex

Syphilis is spread through vaginal, anal, or oral sex. Used correctly, condoms will help prevent infection from vaginal or anal sex. If a syphilis sore isn't covered by the condom, the infection can still spread. Refraining from sex is the only way to completely prevent getting or spreading syphilis. Testing will let you know if you are infected. Even if you are treated, you can get syphilis again.


Syphilis is an infection transmitted through vaginal, anal, or oral sex. The first symptom is a sore around the vagina, anus, rectum, or mouth that can be easy to overlook. The sores will heal, but the syphilis infection is still present. Other symptoms will appear, usually within a few weeks, like more sores, rashes, fever, headache, and hair loss. They will go away, but you still have the infection.

Syphilis can reappear years later and be very serious, affecting your sight, hearing, and vital organs. It may even be fatal. However, when found early, syphilis is easy to cure. If you have a reason to think you may have syphilis, get a simple test to find out.

A Word From Verywell

Syphilis is a highly treatable infection. If you have any concerns that you or a sexual partner may have syphilis, the best thing you can do is get tested as soon as possible. If you see a sore but it goes away, don't assume you're cured. Be sure to discuss your symptoms and treatment options with your healthcare provider.

Frequently Asked Questions

  • How long can a woman have syphilis without knowing?

    Syphilis symptoms can appear and then go away. The sores, which show up first, may not be noticeable and can heal in a few weeks, but the infection remains. The second stage of symptoms will also go away, but you still have syphilis. The third stage, when there are no symptoms, can last for decades. A simple test will tell you whether you have it.

  • Does syphilis affect pregnancy?

    Syphilis can be transmitted from mother to fetus and significantly increases the chance of miscarriage, stillbirth, or infant death. About 40% of babies born to women with syphilis will be stillborn or die as newborns. Surviving babies may have serious health problems. You can protect your baby by being tested for syphilis when you are pregnant. It can be cured easily if caught early.

  • Can I breastfeed if I have syphilis?

    If you have syphilis, you can breastfeed as long as your baby does not come in contact with a sore. If you have sores anywhere on your breast, pump your milk until the sores heal.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Syphilis - CDC fact sheet.

  2. U.S. Department of Health and Human Services Office on Women's Health. Syphilis.

  3. National Cancer Institute. Dark field microscope.

  4. Çakmak SK, Tamer E, Karadağ AS, Waugh M. Syphilis: a great imitator. Clin Dermatol. 2019;37(3):182-191. doi:10.1016/j.clindermatol.2019.01.007

  5. Centers for Disease Control and Prevention. STD facts - syphilis (detailed).

  6. Centers for Disease Control and Prevention. Syphilis - CDC fact sheet - detailed.

  7. O’Byrne P, MacPherson P. Syphilis. BMJ. 2019;365:l4159. doi:10.1136/bmj.l4159

  8. Centers for Disease Control and Prevention. Pregnancy and HIV, viral hepatitis, STD, & TB prevention.

  9. National Institutes of Health. Sexually transmitted infections, pregnancy, and breastfeeding.

By Nancy LeBrun
In addition to her extensive health and wellness writing, Nancy has written about many general interest topics for publications as diverse as Newsweek, Teen Vogue, abcnews.com, and Craftsmanship Quarterly. She has authored a book about documentary filmmaking, a screenplay about a lost civil rights hero, and ghostwritten several memoirs.