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Syphilis is caused by bacteria known as Treponema pallidum. This is easily passed from one person to another through sexual contact. Anyone who is sexually active can get it. Both men and women can have syphilis, and pass it on.

Passing of Syphills:

You can pass syphilis on without knowing you have the infection because symptoms can be mild and you may not notice or recognize them.

Syphilis can be passed from one person to another during sex and by direct skin contact with someone who has syphilis sores or a syphilis rash. It can be passed on before symptoms are noticeable, or after they’ve disappeared.

The infection can spread if you have vaginal, anal or oral sex, or share sex toys. Using a condom correctly will reduce your chance of getting or passing on syphilis.

Syphilis can also be transmitted by blood transfusion. However, in the UK all blood donors are screened to detect this before the blood is used.

It is also possible for a pregnant woman to pass the infection to her unborn baby. This is known as congenital syphilis.

You cannot catch syphilis from kissing, hugging, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery.

Signs and symptoms:

The signs and symptoms are the same in both men and women. They can be difficult to recognize and you might not notice them.

Syphilis can develop in three stages:

o	the first stage: called primary syphilis
o	the second stage: called secondary syphilis
o	the third or latent stage: called tertiary syphilis.

If you do get symptoms, you might notice the following:

First stage syphilis

o	One or more sores (called a chancre – pronounced ‘shanker’) – usually painless – will appear where the bacteria entered the body. On average, this will be 2–3 weeks after coming into contact with syphilis. This can be a bit shorter and sometimes longer.
o	These sores can appear anywhere on the body. In women, they are found mainly on the vulva (the lips around the opening to the vagina), the clitoris, cervix (entrance to the womb), and around the opening of the urethra (tube where urine comes out) and the anus.
o	In men, they appear mainly around the opening of the urethra, on the penis and foreskin, and around the anus.
o	Less commonly, in men and women, sores may appear in the mouth, and on the lips, tonsils, fingers or buttocks.
o	The sores of first stage syphilis are very infectious and may take 2–6 weeks to heal. By this time, the bacteria will have spread to other parts of the body and it will then be known as second stage syphilis.

Second stage syphilis

If the infection remains untreated the second stage usually occurs some weeks after any sores have appeared and healed. Syphilis is still infectious at this stage and can be passed on to someone else.

The symptoms include:

.	A painless rash that is not normally itchy. It can spread all over the body, or appear in patches, but it is often seen on the palms of the hands and soles of the feet.
.	Flat, warty-looking growths on the vulva in women and around the anus in both men and women (often mistaken for genital warts).
.	A flu-like illness, tiredness and loss of appetite, with swollen glands (this can last for weeks or months).
.	White patches on the tongue or roof of the mouth.
.	Patchy hair loss.

Third stage or latent syphilis

o	When syphilis remains untreated it goes into another phase known as third stage or latent syphilis. Untreated syphilis may, after many years, start to cause very serious damage to the heart, brain, eyes, other internal organs, bones and nervous system. At this stage syphilis can lead to death.

Third stage syphilis is rare in the UK and this leaflet does not cover it.

Treatment for Syphilis:

First and second stage syphilis is treated using a single antibiotic injection or a course of injections or by taking antibiotic tablets or capsules. Penicillin is the most common treatment for syphilis, but there are several different antibiotics that can be used. Let the doctor or nurse know if you are allergic to penicillin.

Treatment usually lasts up to 10–14 days but sometimes longer. If complications have occurred you may also need other treatment.

If there is a high chance of you having the infection, treatment may be started before the results of the test are back. You will usually be given treatment if any sexual partner has syphilis.

Some of the antibiotics that are used to treat syphilis interact with methods of contraception that contain the hormones estrogen and progestogen (for example, the combined oral contraceptive pill and contraceptive patch). Tell the doctor or nurse if you are using one of these methods so they can advise you on how to ensure you are protected from pregnancy.

You cannot buy any treatments without a prescription.

There is no evidence that complementary therapies can cure syphilis.

Treatment can safely be given in pregnancy.

Treatment for First and second stage syphilis:

Treatment is very effective for both first and second stage syphilis. As long as the treatment is taken correctly the syphilis will be completely cured.

Sexual partners should not have vaginal, anal or oral sex and you should avoid any kind of skin contact with your partner if either of you has any sores or rashes, until the treatment has been completed.

Treatment for Third stage or latent syphilis:

Syphilis at this stage can be treated, but any damage already done to your body will be permanent.

Follow-Up Tests for Syphilis:

You will need to go back for follow-up tests to check that the infection has gone and that you have not come into contact with the infection again.

Your blood test will probably remain positive in any future tests – even after successful treatment. So, if you need documents for emigration or any other reason, ask your clinic for a certificate explaining your treatment. This also means that you will be advised to have regular blood tests to make sure that all is well.

If you have any questions, ask the doctor, nurse or sexual health adviser and make sure you know how to protect yourself in the future.

What happens if syphilis isn’t treated?

Without proper treatment the infection can spread to other parts of the body causing serious, long-term complications.

Left untreated, syphilis may start to cause very serious damage to the heart, brain, eyes, other internal organs, bones and nervous system. This damage could lead to death.

Can syphilis go away without treatment?

No. If you delay seeking treatment you risk the infection causing long-term damage and you might pass the infection on to someone else.

How soon can I have sex again?

It is strongly advised that you do not have vaginal, anal or oral sex until you and your partner have both finished the treatment, otherwise you could be reinfected or pass the infection on to someone else. If it is not possible to avoid sex, make sure you use a condom.

Will I know how long I’ve had the infection?

The syphilis test cannot accurately tell you how long the infection has been there. If you have had more than one sexual partner it can be difficult to know which partner you got syphilis from. If you feel upset or angry about having syphilis and find it difficult to talk to your partner or friends, don’t be afraid to discuss how you feel with the staff at the clinic or general practice.

Syphilis and Fertility:

There is no evidence that syphilis will affect fertility in men or women.

Syphilis and Pregnancy:

All pregnant women are screened for syphilis. You should be offered an explanation and a blood test for syphilis when you attend for antenatal care. If syphilis is found, you can be given treatment safely during pregnancy. This can help prevent the baby from becoming infected and there is no risk of the treatment harming the baby.

If the syphilis is untreated you may pass the infection to your baby in the womb. This can lead to miscarriage or stillbirth, or the baby being born with syphilis.

Protect you from Syphilis:

o	Use condoms (male or female) every time you have vaginal or anal sex.
o	If you have oral sex, cover the penis with a condom or the female genitals with a dam (latex or polyurethane (soft plastic) square).
o	Avoid sharing sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.
o	These measures can also protect you from some other sexually transmitted infections, such as HIV, Chlamydia and gonorrhea. If you have syphilis without knowing it they will also help prevent you from passing it on to your partner.

Source: Website of FPA (Family Planning Association) of Uk

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