Syphilis Symptoms in Women

Syphilis is a sexually transmitted infection (STI) that is spread through vaginal, anal, or oral sex with an infected person. It's caused by the bacterium Treponema pallidum.

Syphilis can cause round sores and soft, flat growths to appear on the vulva and vagina, among other symptoms. If left untreated, it can cause damage to the heart, kidneys, and other major organs.

This article will discuss everything you need to know about syphilis in cisgender women and all people with vaginas, including symptoms, diagnosis, treatment, and how syphilis affects pregnancy.

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Syphilis Symptoms in Women

The signs and symptoms of syphilis will vary based on what stage the infection is in. There are four stages: primary syphilis, secondary syphilis, latent syphilis, and tertiary syphilis.

During primary syphilis, the most common sign of infection is a skin sore known as a chancre. These sores are usually firm, round, and painless and appear on the location where the infection entered the body. In women, this includes the cervix or vagina, though the anus, rectum, and mouth are also possible sites.

If left untreated, these sores will heal on their own within three to six weeks, and the disease will progress to secondary syphilis.

Secondary syphilis is marked by a non-itchy rash on one or more body parts. Other secondary syphilis symptoms may include fever, sore throat, swollen lymph nodes, hair loss, weight loss, headache, joint pain, and muscle aches. In women, soft, flat skin growths may appear on the vulva.

Secondary syphilis symptoms also resolve on their own without treatment, which means the infection will progress to the latent stage and potentially the tertiary stage. Latent syphilis has no signs or symptoms of infection and can last for years.

If syphilis reaches the tertiary stage of infection, which can happen 10–30 years after your initial infection, it can cause serious damage to multiple organ systems, including the heart and brain.

What Does Syphilis Look Like?

What syphilis looks like will depend on the stage of infection. During the primary stage, syphilis commonly presents as small, painless, round sores on the genitals, mouth, anus, or rectum.

The secondary stage presents as a non-itchy rash, sometimes appearing as rough, red, or red-brown spots on the palms or bottoms of feet. It can also have a different appearance and occur on different parts of the body. Condyloma lata, which are large, flat-topped raised lesions, may also develop in warm and moist body parts like the vulva.

"The Great Imitator"

Syphilis shares common features with other medical conditions, including canker sores, herpes, and Lyme disease, thus earning it the nickname "the great imitator." For this reason, many cases of syphilis are missed until the infection advances and the symptoms have worsened.

Diagnosing Syphilis in Women

Syphilis is diagnosed primarily through a blood test. A physical examination may be also performed by your healthcare provider to help diagnose syphilis. However, only a blood test can confirm a syphilis infection.

Treatment

The way treatment is administered will depend on which stage the syphilis infection is in. However, syphilis is most often treated with antibiotics; the dose will vary based on the stage of infection.

Syphilis During Pregnancy

If you are pregnant or are planning to become pregnant, it is important to get tested for syphilis, because it can be transmitted to a fetus during pregnancy. This is known as congenital syphilis. Congenital syphilis can cause serious health problems for the baby.

Summary

Syphilis is an STI that can be transmitted through vaginal, anal, or oral sex. There are four stages of syphilis and its appearance varies by the stage. The classic sign of a syphilis infection is a chancre, which in women can show up on the vagina, cervix, vulva, mouth, anus, or rectum.

As the disease progresses it can also cause flat-topped growths known as condyloma lata to show up on the vulva. Syphilis is diagnosed through a blood test and treated with antibiotics.

A Word From Verywell

If you think you have been exposed to syphilis, don't put off getting tested. Syphilis is completely curable with antibiotics if it's caught early enough. But if left untreated, it can eventually cause serious health complications, including brain damage and even death.

Frequently Asked Questions

  • Does syphilis cause vaginal sores?

    Yes, syphilis can cause vaginal sores. These are known as chancres. They are usually small and painless. Sometimes, these sores go unnoticed.

  • What are the first signs of syphilis?

    The first sign of syphilis is a chancre, a small and painless sore. A chancre often appears on the vagina, penis, or around the anus.

  • What can syphilis be mistaken for?

    Syphilis can be mistaken for canker sores, Lyme disease, and herpes.

7 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.
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  2. Centers for Disease Control and Prevention. Syphilis – CDC fact sheet (detailed).

  3. Pourang A, Fung MA, Tartar D, Brassard A. Condyloma lata in secondary syphilisJAAD Case Rep. 2021;10:18-21. Published 2021 Feb 9. doi:10.1016/j.jdcr.2021.01.025

  4. Klausner JD. The great imitator revealed: syphilisTop Antivir Med. 2019;27(2):71–74.

  5. Luo Y, Xie Y, Xiao Y. Laboratory diagnostic tools for syphilis: current status and future prospectsFront Cell Infect Microbiol. 2020;10:574806. doi:10.3389/fcimb.2020.574806

  6. Centers for Disease Control and Prevention. Syphilis - STI treatment guidelines 2021.

  7. Centers for Disease Control and Prevention. Syphilis Treatment and Care.

By Molly Burford
Molly Burford is a mental health advocate and wellness book author with almost 10 years of experience in digital media.