How to test for syphilis in women

Medically reviewed by Neka Miller, PhD on July 15, 2021. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


Syphilis is a common sexually transmitted infection. In 2018, the U.S. saw over 146,000 new cases of syphilis. While a majority of cases of syphilis occur in men who have sex with men (MSM), the infection rates of syphilis among heterosexual men and women still remain high and have actually been on the rise in recent years.

Once identified through STD testing, syphilis can be easily treated and cured. Ignoring it, however, can be a serious mistake. Left untreated, the infection can result in permanent damage, and it may even be fatal. Testing is one of the first lines of defense against the spread of syphilis and can provide the first steps toward receiving treatment. Learn more about syphilis and how to test for syphilis in women below.

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What is Syphilis?

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. The bacteria can infect any part of the genitals and the anus, and it can sometimes infect the mouth and lips. Left untreated, the bacteria can eventually spread to the central nervous system and contribute to severe, permanent issues.

Symptoms and Stages of Syphilis

Syphilis infections typically develop in a few different stages that present different symptoms.

Primary Stage

The primary stage is characterized by a set of symptoms of syphilis in females, which includes the appearance of sores, known as chancres, on the infected areas. These sores usually look firm and round, sometimes open and wet, but they are rarely painful.

This is also when the disease is at its most transmissible. Sores are extremely contagious, especially when they are open, allowing for easy transmission through sexual contact. This becomes even trickier because of the painless nature of chancre sores. They can be easily ignored or mistaken for ingrown hairs, pimples, or harmless bumps. Sores can also appear in places that are hard to see, like in the folds of your foreskin or deep in the vagina.

Syphilis is most commonly spread through anal and vaginal sex. Transmission through oral sex is less common though still possible. A mother can also spread syphilis to her child while pregnant or during childbirth. However, syphilis can’t be spread through casual contact, meaning you can’t get it or transmit it via hugging, holding hands, coughing, or sneezing.

Chancre sores typically appear three weeks to three months following initial exposure. The sores can remain for about three to six weeks, after which they will usually go away on their own without treatment. However, just because the sores are gone does not mean the infection has cleared up.

Secondary Stage

In its secondary stage, syphilis can manifest in the form of a skin rash that starts on the trunk before spreading to other parts of the body, including the palms of your hands and soles of your feet. The rash is not typically itchy or painful. Some people also develop wart-like sores in their mouths as well as genital warts. The rash is sometimes accompanied by general flu-like symptoms, like a fever, muscle aches, sore throat, and general fatigue.

This stage usually lasts two to six weeks at a time before subsiding and returning over the course of two years.

Late Stage

Untreated, syphilis can stay in the system, during which it may have its latent periods and periods where symptoms flare up again. Up to 30 percent of people with syphilis who go untreated will progress into the late stage. During this late syphilis stage, the infection may spread to other parts of the body and cause severe damage. This may result in tumors, blindness, paralysis, and other nervous system issues.

While medication can help to cure the infection at this stage, it cannot reverse the damage that occurs in the late stage.

Testing for Syphilis

While a syphilis infection is easy to treat, many people don’t realize they even have it until it’s too late. Much like with any other illness, you can’t actually tell that you have syphilis just from how you feel. A diagnostic syphilis test is the only way to know for sure.

The good news is that you can get tested at almost any point, regardless of whether you have chancre sores or show any symptoms. Testing often only requires a blood sample. Blood can be tested for the presence of syphilis antibodies, which can determine past or current infections.

Your doctor can also test your cerebrospinal fluid through a process called lumbar puncture, better known as a spinal tap. This can help to determine if the infection has spread to your nervous system and, if so, the extent of that spread.

Where to Get Tested

You can get tested for syphilis at your doctor’s office, community health clinic, local Planned Parenthood center, or health department. You can ask for an STD test during a regular checkup or gynecologist visit. At-home kits, like the Everlywell STD test for women, also offer an easy option for those who might be afraid or those who simply want to take the test in the comfort of their homes.

When to Get Tested

Most prominently, you should get tested if you show any signs of syphilis, like a chancre sore on your genitals. You should also get tested if you have had unprotected sex or if someone you’ve had sex with has syphilis. Your doctor may also recommend testing if you are pregnant. To learn more about STIs and pregnancy, check out our blog post about chlamydia while pregnant.

In general, if you are sexually active, you should get tested for syphilis and other STDs about once per year for optimal sexual health. Most importantly, if your test results do come back positive for syphilis or another sexually transmitted disease, make sure that your partner also gets tested. Even if you get treated, your partner can potentially reinfect you, causing you to pass the infection back and forth between you.

Treatments for Syphilis

Once you know for sure that you have syphilis, you can receive treatment for it. The good news: syphilis can be easily cured, particularly in its early stages. A simple course of antibiotics is usually enough to fully clear the infection from your system. This usually involves penicillin, but there are alternatives if you are allergic or otherwise can’t take penicillin.

Some things to keep in mind when getting treated:

  • As noted, make sure that your partner gets tested and receives treatment as well to prevent reinfection.
  • Complete the full course of your antibiotic medication as prescribed by your doctor, even if the syphilis symptoms seem to go away before you finish.
  • Avoid any form of sex until you have completed the full course of your antibiotic treatment and all sores have healed.
  • Don’t share your medication with anyone. If your partner does test positive for syphilis, they need to get their own dosage of antibiotics.

Remember that you can still get syphilis again. You aren’t immune from it once you have gotten it. To prevent reinfections, make sure that you practice safe sex. Use a condom and/or dental dams and other forms of protection, and make sure you get tested annually.

The sooner you get tested for syphilis, the sooner you can receive treatment. Syphilis is easier to treat the earlier you catch it, so get tested at your local clinic or consider trying the Everlywell at-home STD test for women, which tests for syphilis and six other common STIs.


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References

1. Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States. Centers for Disease Control and Prevention. URL. Accessed July 15, 2021.

2. Syphilis & MSM (Men Who Have Sex With Men) – CDC Fact Sheet. Centers for Disease Control and Prevention. URL. Accessed July 15, 2021.

3. Syphilis. Mayo Clinic. URL. Accessed July 15, 2021.

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