syphilis test

Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. Other names for syphilis are 'lues' and a 'hard shanker'. The disease is highly contagious and is transmitted through sex by direct contact with the spots on the skin and mucous membranes. Syphilis is not very common in the Netherlands. Especially men who have sex with men get syphilis here, but anyone can contract it. In other areas of the world, however, syphilis is common. Using a condom makes you much less likely to contract it.

The disease causes inflammation and is divided into 3 stages with different symptoms. You don't get symptoms right away. How long this lasts after infection is called the "incubation period. The incubation period of syphilis varies with each stage of the disease. There are also people who get no symptoms or so mild that they hardly notice it. 

The first stage begins within 2 to 12 weeks of infection. Then you may develop a hard and painless sore on the spot where you are infected. This ulcer looks like a red spot or open wound and is also called an "ulcer" or "hard shanker. Often the ulcer is on the glans or another part of the penis, but a syphilis ulcer can also be deep inside the vagina, anus or in the mouth/throat, where you often can't see or feel it. Usually the ulcer disappears on its own within 3 to 6 weeks, even without treatment. The bacteria are not gone by then and spread through your body via your blood. 

In the second stage of syphilis, you may develop other symptoms. These occur within 3-8 weeks after you got the ulcer and always within 1 year of infection. Symptoms are the same for men and women and may include skin rashes (spots) all over your body and flu symptoms. Even without treatment, these symptoms disappear, but the disease is still there and your blood remains infectious for 1-2 years. 

In the third stage of syphilis, at first you have no symptoms at all. This stage can last from 2 to 30 years, with the disease first spending years in a kind of 'hibernation mode,' but then it can affect all your organs. This is why syphilis is also called 'the great imitator'; it can resemble many other diseases. If you get spots on your skin or mucous membranes in the process, you are contagious again.

Below is an overview of syphilis symptoms by stage of the disease. 

What are the consequences of syphilis? 

If left untreated, syphilis can cause damage to your organs, such as your heart, spinal cord, brain, skin and bones, resulting in severe symptoms and sometimes permanent damage. We know plenty of examples of this from the history books. Fortunately, syphilis is nowadays well treatable with antibiotics. If you catch it in time, syphilis has no permanent consequences. However, we can still see in your blood throughout your life that you once had it, even if you have been properly treated. 

Syphilis sometimes gives no symptoms and is contagious, so get tested early if you have been at risk: preferably 3 months after and immediately if there are symptoms.

You get syphilis mainly through sexual contact with an infected person. You can catch it if your mucous membranes (these include the glans, vagina, anus and mouth) or a wound come in contact with a syphilis spot. So you can contract it mainly through vaginal sex, anal sex and oral sex (blowjobs, chewing, rimming). Using a condom usually protects well; the chances of transmitting or contracting syphilis are then small. 

If there is a syphilis ulcer in the mouth, you can catch it by kissing. 

A person can also have syphilis skin abnormalities. Therefore, you can sometimes catch syphilis when you touch the skin, such as when hugging or caressing naked. 

Syphilis can also pass from mother to child during pregnancy and childbirth. Pregnant women in the Netherlands are therefore routinely tested. 

Sometimes you are more likely to get syphilis. For example, if you are a man who has sex with men or if you or your sex partner are from an area where syphilis is more common, such as Eastern Europe, Asia, Africa, and Central and South America.

Stage 1 (2-12 weeks, primary syphilis):

• Sores on the glans, penis, vagina, anus and/or mouth. Usually this is not painful.
• Swollen lymph nodes 

Stage 2 (3-8 weeks, secondary syphilis):

• Skin rash all over the body, including on the hands and feet. Usually these are red spots that are not itchy 
• Flu-like symptoms such as fever, headache, sore throat and fatigue
• Hair loss with bald patches 
• Eye problems that make it harder to see 

Stage 3 (2-30 years, tertiary syphilis):

• Damage to organs, such as the heart and bones
• Damage to the brain and spinal cord, this is called neurosyphilis. In earlier stages, complaints of the head and nerves also sometimes occur, but permanent damage is still preventable. So discuss such symptoms with your doctor right away. 

There is hardly any difference in the symptoms of syphilis in men and women. Read more about the symptoms of syphilis here.

It is wise to get tested for syphilis if: 

• You have symptoms that could fit syphilis
• you have been warned about syphilis by a sex partner
• you or a sex partner is from a high-risk group*

Do you have complaints? Then come right away. You can get syphilis symptoms starting 10 days after sex. It is also helpful if you take pictures of your rash or ulcer at home beforehand. 

Do you have no symptoms but have been at risk? Then test for syphilis and other STDs such as HIV at least 3 months after the contact. 

It is usually wise to come for other STD tests, such as chlamydia and gonorrhea, 2 weeks after the risk.  

Testing for STDs can help you have finer, carefree sex. We are happy to advise you during your appointment about which tests are wise for you. 

*These are the high-risk groups: 

• men who have sex with men
• sex workers
• transgender persons who have sex with men
• people from areas where syphilis is common (Eastern Europe, Sub-Saharan Africa, South and Southeast Asia, South and Central America, Caribbean)
• people with many alternating sex partners (more than 3 in six months)

Using a condom makes you less likely to get or give syphilis to another person. Use them during oral, vaginal and anal sex. Did you know you can also cut open a condom and put it over the vagina or anus? This way you can still safely eat pussy or rimming. You can also use a dental flap. But even if you use a condom or flap you can very occasionally contract syphilis. Therefore, when in doubt, always get yourself examined.

If you see that someone has an ulcer it is better not to have sex with them at that time. If you yourself have symptoms of syphilis it is also better not to have sex, but get tested first. 

Want to know how to use a condom correctly? Click here. 

Some people find it difficult to start talking about condoms. On the Sense website, you'll find helpful information and tips about this 

Have you tested positive for syphilis? If so, please contact us. 

Treatment for syphilis works with antibiotics given to you through two injections in your buttocks. You get 1 or 3 treatments, depending on your symptoms and test results, among other things. If you have been treated before, sometimes it is not necessary to treat again. We ask you to look up your old test results first. And in certain situations you must first see the neurologist for additional tests before you can be treated. 

Our doctors will look at what is needed for you based on your results and your situation. 

It is important to make an appropriate treatment plan, because then syphilis is curable. The earlier you are treated, the better. This will prevent the syphilis from spreading further through your body and can cause worse symptoms.  

Do you have a regular sex partner? Then mention this when making the appointment, and you can come together. 

After treatment

You may not have sex again until 7 days after your treatment is finished. Do you have an ulcer? Then you have to wait even longer. Having sex will not be safe again until your ulcer is completely gone. 

You can also contract syphilis more often; you don't become immune. This is why it is important to warn your sex partner(s). That way, they can also get tested and treated if necessary. Do you find this difficult? Then we can create a code for you on partnerwaarschuwing.nl. This allows you to anonymously warn your partner(s) about syphilis. 

Remember to make check-up appointments. Usually a syphilis test needs to be done again after 6 and 12 months, sometimes more often. This is to see if the treatment has worked well enough. The doctor will tell you at your treatment appointment how often checkups are needed for you.