Syphilis

Syphilis is passed from one person to another during sexual activity.

It is spread by unprotected vaginal, anal and oral sex.

It can also be spread through intimate or skin-to-skin contact with an infected person.

An infected mother can also pass syphilis on to her baby via the placenta during pregnancy, which is called congenital syphilis. Read more about syphilis in pregnancy.

The first signs of syphilis don’t last long, so you can have it and pass it on without knowing.

Sore or ulcer (chancre)

Some people get an ulcer or sore around the genital area or mouth, 3 to 12 weeks after infection.

The sore can be:

• vary in size or shape
• usually does not bleed
• feels like a hard button on the skin
• is painless (so you may not notice it).

If not treated, the sore heals and disappears after a few weeks – but you are still infected, and the bacteria are in the bloodstream and spreading around the body. This is called the primary stage of the disease.

Other symptoms

If syphilis is untreated, more symptoms may appear 2 to 6 months after getting infected. This is the secondary stage, which can last for 6 months or more.

Symptoms may include:

• a skin rash (on the face, palms, and soles of the feet)
• hair loss
• swollen glands
• fever
• headaches
• pain in bones, joints and muscles
• lumps in your groin and around your anus (bum hole) or vulva.

Without treatment, there is a latent stage where there are no visible signs but you are still infectious.

The symptoms will go away but if syphilis is untreated it stays in your body and you can pass it on to other people through sex for up to 2 years. It can also make you very sick.

If you have untreated syphilis for over 2 years (called the tertiary stage), the disease can affect the brain, heart, large blood vessels, the spinal cord, skin and bones. This can lead to disability and death.

Syphilis in pregnancy

If a pregnant person has syphilis, it can be passed on to the baby and put its life at risk. This is called congenital syphilis.

If syphilis is found early in the pregnancy it can be treated, lessening damage to the baby.

Pregnant people should get tested for syphilis early and often throughout their pregnancy.

Read more about syphilis in pregnancy.

Ask for a syphilis blood test

Your doctor will do a blood test for syphilis. However, for a short period just after syphilis enters the body, it can’t be picked up with a test. So if your result is negative, you will need to have the test again after 3 months.

It’s a good idea to get tested for other sexually transmitted infections (STIs) such as chlamydia, gonorrhoea and HIV at the same time.

Find a service where you can get a syphilis blood test at Get the Facts (external site). Search the for a location and select the 'Sexual Health / Pregnancy / Sexuality' option.

Contact tracing

Your doctor should also talk to you about contact tracing.

If you test positive for syphilis, it is important to let your sexual partners know. This is to make sure syphilis does not impact their health and continue to spread. If your regular sexual partners do not get treated, you may get syphilis again.

Contact tracing involves finding and informing the contacts of a person with an infection so they can get counselling, testing and treatment if necessary. You can do the contact tracing yourself and/or with help of a health professional. Discuss this with your doctor. You can also use the Better To Know website (external site) to let your sexual partners know without using your name.

Treatment for syphilis

Syphilis is treated with penicillin or other antibiotics. You need to take the full course and attend all your appointments.

After treatment, you’ll need a blood test to make sure you are cured.

If left untreated

If you have syphilis for more than 2 years and are not treated, it can affect the:

• brain
• heart
• large blood vessels
• spinal cord
• skin
• bones.

This can lead to disability and death.

While you have the infection

Once diagnosis is confirmed, don’t have sex, even with a condom, until after you have completed the full course of treatment. Syphilis is very infectious, particularly during the first and second stages.

You can reduce the risks of getting syphilis, and other STIs by:

• having regular STI checks
• always using the following until you’re totally sure that both you and your partner don’t have an STI:
  • condoms during vaginal and anal sex
  • dams during oral sex
  • water-based lubricant.
• having a long-term relationship where neither of you is already infected, and neither of you has other partners
• limiting your sexual partners – the fewer people you have sex with, the lower the risk of having sex with someone who has syphilis.

Talk about sexual health with your partners

Talking about sexual health can be difficult, but any person you have sex with has a right to know if you have an STI. Discuss it when you are feeling relaxed and confident, not just before you have sex. Your partner will appreciate your honesty and that you don’t want to infect them. You have the right to know if they are infected too.

Read more at Healthysexual (external site).