Sexually Transmitted Infections: Syphilis
Syphilis is a completely treatable Sexually Transmitted Infection (STI). However, if syphilis is left untreated, it can lead to serious health complications. Syphilis is caused by a bacteria known as Treponema Pallidum.
The statistics from the Centers for Diseases Control (CDC) reveals a creeping increase of syphilis cases over recent years among both heterosexuals and homosexuals.
How can Syphilis Spread?
Syphilis can be transmitted by direct contact with a syphilis sore/ulcer during oral, vaginal or anal sex. Syphilis sore is typically found around the vagina, penis, anus, the mouth or the lips. Syphilis can also be passed from an infected untreated mother to her unborn baby.
What are the Symptoms of Syphilis?
Syphilis can be divided into 4 stages- primary, secondary, latent and tertiary stages. Each stage is associated with different symptoms and signs.
- A person can appear with a sore or multiple sores (also medically known as chancre) at the site of infections. The sites of sores are typically found around the genitals, back passage or even around the mouth. Although individuals may differ, the sores typically are not painful, round and firm.
- The sores in Primary Syphilis tend to appear 10-90 days after infection.
- The sores last 3-6 weeks and heals spontaneously regardless of whether you have received treatment. This can allow syphilis to go unnoticed and untreated. Even if the sores have healed, you still need to get yourself treated to prevent your infection from proceeding further to secondary syphilis.
- One may appear with more systemic symptoms such as fever, skin rash, swollen lymph nodes, patchy hair loss, weight loss, lethargy, muscle and joint aches, headache. You may experience skin rashes that ranges to red or brown spots over your palms and bottom of your feet. Some may even experience rashes over the mouth or the body.
- Secondary Syphilis symptoms typically occurs 3 weeks to 6 months after infection.
- Eventually, the symptoms will resolve even if you don’t receive treatment. It is important to receive the right treatment to prevent the infection from further progress to the latent and tertiary stages of syphilis.
*Primary and Secondary Syphilis may be missed by both the infected person and the physician as the symptoms can appear mild, and recover over time without much notice.
Latent Phase of Syphilis
- This is a stage where the infected person presents without any signs and symptoms.
- This phase can occur within 1 year of onset of infection, or beyond 1 year of onset of infection, some with an unknown duration of onset of infection.
- This stage of Syphilis can be associated with severe health problems, affecting a person’s heart, brain, the nerve system, and the eye.
- In severe cases, tertiary syphilis can damage your internal organs and result in fatality.
- Tertiary syphilis can lag behind the time of infection up to 10-30 years later.
- When untreated syphilis is spread to the brain and the nervous system, it is known as neurosyphilis.
- Symptoms of neurosyphilis include:
- Profound headache
- Muscle paralysis and numbness
- Poor coordination of movement
- Mental disorder and memory impairment (dementia)
- When untreated syphilis is spread to the eyes, it is known as ocular syphilis
- One may experience:
- Visual disturbances
- Or even blindness
*Both neuro and ocular syphilis can occur any stages of syphilis discussed above.
Should I get myself tested for syphilis?
You should consider getting yourself tested if you:
- Are pregnant, and are at your first prenatal visit with your obstetrician
- You are sexually active
- You have sexual partners who have been tested positive for syphilis.
- You are a man who has sex with men
- You have HIV
- You are otherwise considered to be at increased risk for syphilis
What do I expect when I consult my doctor regarding Syphilis?
Your doctor will take a relevant medical history regarding your symptoms and a sexual history. Your genital region will be examined as part of a physical examination.
You will be offered blood tests to screen for syphilis:
- Serological Non-Treponemal blood tests (such as VDRL, RPR blood test)
- Serological Treponemal blood tests (such as TPPA assay, EIA tests, FTA-ABS tests, Rapid Treponemal assays, Chemiluminescence immunoassays, immunoblots)
Sometimes, your doctor may offer a swab test from the Syphilis sore.
You may also be offered screening for other STIs.
What are the treatment options for Syphilis?
The good news is syphilis is curable with the right antibiotics. However, the treatment will not be able to reverse any damage done by syphilis infection, hence, early screening and treatment are imperative.
Treatment for syphilis is via penicillin antibiotics given through injections. The dosage and number of injections will be dependent on the stages of Syphilis. Those with penicillin allergies should speak to their doctors on other possible treatment options.
You will need regular blood tests over a few month intervals to monitor the treatment progression of Syphilis. In cases where treatment is unable to clear up the infection, additional antibiotics may be required for a longer period of time. You are advised to abstain from sex until the infection has cleared, to reduce risk of spreading Syphilis to others.
Can I avoid getting Syphilis?
Treated syphilis does not immunize a person from future syphilis, re-infection is possible. Safe sex is encouraged.
Of course, complete abstinence from all forms of sex will guarantee avoidance of STIs.
If you are sexually active, you can lower your risk of getting syphilis by:
- Using barrier contraception such as condoms the right way every time when you have sex. This is provided the syphilis sore is covered by the condoms. If the sores occur over areas not covered by the condom, syphilis still is able to be spread via contact to the affected area.
- Encouraging healthy monogamous relationship with your partner who is tested and free from syphilis.
Screen for Syphilis, seek treatment. Protect yourself and your loved ones.