What are the symptoms of syphilis in females?

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Syphilis generally causes the same symptoms in males and females.

The first stage of syphilis causes a sore known as a chancre to develop at the point of contact with another person’s sores.

As this mainly occurs due to sexual contact, sores might occur in the vagina or vulva. During the first stage of syphilis, chancres will last 3 to 6 weeks, but they should not cause pain. They usually heal on their own, but treatment for syphilis is still important to prevent it from progressing to its second stage.

It is important to note that a person may not notice a chancre, particularly if they develop inside the vagina.

Learn more about what can cause genital sores in females.

Symptoms of syphilis generally develop in stages. They are usually the same for females and males.

After the sores develop in the first stage, a person may go on to experience symptoms of the second, latent, and tertiary stages of syphilis.

Second stage syphilis

Second stage syphilis typically causes a non-itchy rash to develop. It usually affects the trunk, the soles of the feet, and the palms of the hands, though it can develop elsewhere in the body.

The rash may occur while the chancre is healing, but it often develops afterward. The rash is sometimes faint and hard to notice. It may take the form of red or brown rough spots.

Large, raised lesions called condyloma lata might also develop in warm, moist areas, such as the mouth, groin, or armpit.

As there are many possible causes of rashes, it is important to contact a doctor for an accurate diagnosis. The rash can also appear different on different skin tones, so a person should inform a doctor about any skin symptoms.

Other symptoms during this stage might include:

• fever
• sore throat
• headaches
• patchy hair loss
• swollen glands
• unexplained weight loss
• fatigue
• aching muscles

Latent syphilis

During this stage, a person usually experiences no symptoms at all. Syphilis remains in the body, but it is inactive.

This stage can last for years. Treatment is still necessary to prevent progression to the tertiary stage.

Tertiary stage syphilis

This stage is rare and only occurs in people who have not received adequate treatment for syphilis.

It may occur up to 30 years after the initial infection. Tertiary syphilis can have potentially fatal or disabling effects on major organs, the nervous system, and the ability to see and hear.

This stage can also cause:

• cardiovascular syphilis, which can cause inflammation of the aorta
• neurosyphilis, which can cause:
  • meningitis
  • headaches
  • confusion
  • stroke
  • changes in how a person walks
  • seizures
  • psychiatric problems
• gummatous syphilis, which can cause lesions on the skin, in the organs, or in bone

Syphilis symptoms can develop 10 to 90 days after T. pallidum infection. On average, a person may not show symptoms for an average of 21 days.

As syphilis symptoms such as chancres may develop inside the vulva or vagina, where they will be harder to see, a person might not be aware that they have syphilis.

Syphilis occurs when bacteria called T. pallidum enter the body. These bacteria pass between humans through contact with chancres during vaginal, anal, or oral sex.

Transmission of syphilis usually occurs in the earlier stages.

It can also pass from pregnant people to unborn children through the placenta.

To assist with reaching an accurate diagnosis, a doctor may begin by performing a physical examination, asking questions about symptoms, and taking a medical history.

They may then order a blood test to confirm the diagnosis.

Antibiotics are the main treatment for syphilis. Doctors will usually recommend injections of penicillin.

However, penicillin does not undo any damage to the organs or nervous system that occurs during tertiary syphilis. It is vital to identify syphilis as early as possible and receive antibiotics before this damage occurs.

Syphilis can lead to several complications if it reaches the tertiary stage. These are the same for males and females and may include:

• heart issues, such as heart failure, aortic aneurysm, and angina
• seizures
• memory issues
• changes in personality
• dementia
• nerve issues, such as shooting pains and pins and needles
• joint pain and damage

Syphilis can cause complications with any other organ, particularly the skin, bones, and liver. Contacting a doctor as soon as a person has concerns about syphilis can help them begin treatment as early as possible, reducing the likelihood of complications.

It is possible to transmit syphilis to the fetus during pregnancy.

A 2022 review reported that syphilis is the second-leading cause of stillbirth worldwide. It can also lead to the following complications:

• newborn infections
• premature delivery
• low birth weight

The Centers for Disease Control and Prevention (CDC) recommends that every pregnant person gets a syphilis test at their first prenatal visit.

Can a person breastfeed if they have syphilis?

A person with syphilis may be able to breastfeed or chestfeed. If they have no sores around their nipples or on the breast, it will probably be safe.

Those with sores that have spread to the chest area could hand-express or pump milk until the sores heal. However, if the breast pump touches a sore, it is not safe to use this milk.

Here are some frequently asked questions about syphilis.

How long can a female have syphilis without knowing?

Syphilis symptoms can take 10 to 90 days to develop after the initial infection. On average, people may not be aware they have syphilis until after around 21 days. Some people may not notice symptoms.

What is the most common first symptom of syphilis?

A small sore called a chancre is often the first symptom of syphilis. It usually develops in the genital area. Chancres usually resolve without treatment within 3 to 6 weeks, but the condition will usually progress to the next stage without treatment.

Syphilis causes similar symptoms in females and males. In females, sores called chancres can develop in the vulva or vagina. Other symptoms can include:

• rash
• sore throat
• headache
• fever
• hair loss
• swollen glands
• fatigue

It is possible to transmit syphilis to the fetus during pregnancy. Every pregnant person should undergo testing for syphilis as soon as possible.

People can still breastfeed or chestfeed if they have syphilis but may need to switch to pumping milk, being careful to avoid sores. If a bottle or an infant’s mouth touches a sore, there is a risk of transmission.

Antibiotics can treat syphilis and prevent severe complications, including cognitive changes and organ damage. It is important to contact a doctor as early as possible for an accurate diagnosis and treatment.