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Syphilis is a bacterial infection primarily passed on through sex. However, if an infected person has symptoms and that comes into contact with damaged or broken skin then it is possible to pass on even in the absence of sex.
Those who have symptoms should be tested immediately but if there has been any risky exposure then testing is advised on routine basis because Syphilis may not present any symptoms.
Symptoms of Syphilis are wide-ranging and can be difficult to interpret. There are several different stages for Syphilis and each stage presents with different symptoms.
The first stage of Syphilis presents with sore(s) at the location the infection entered the body, typically around the genital region but it can present on the anus or mouth as well. The sores tend to be round and are painless which can lead to a delay in identifying them. They may remain for up to 6 weeks where they will gradually disappear on their own.
However, this does not mean it has been cured, you will still require treatment.
The second stage usually presents with a widespread rash that can be anywhere on the body but the typical areas tend to be the hands/feet and torso region. The rashes are not itchy and they can appear quite flat, sometimes making them easy to miss.
It is possible to have rashes appear just as the primary phase is still healing. It is also possible for rashes to appear many weeks after the primary stage symptoms have settled.
This stage is characterised by a lack of symptoms. Most will feel normal but the infection may remain in your system for many years.
This final stage is the most worrying and can develop in approximately 30% of people who have untreated, latent Syphilis. Tertiary Syphilis can occur many decades after the initial infection and is characterised by spread to internal organs such as heart and brain. This can lead to serious complications and even death. One worrying aspect is neurosyphilis where the infection has spread to the brain. The common location within the brain is the area responsible for personality. This is why some cases of tertiary Syphilis are diagnosed when a patient presents with personality change and sexual disinhibition. Even if the disease is detected at this stage and treated, the patient will almost certainly remain with their altered personality.
This illustrates the importance of treating syphilis early and halting its progress to this tertiary stage.
Diagnosis is possible by acknowledging physical symptoms such as sores and rashes but formal blood tests are required for further analysis and guiding treatment. The blood tests will give us a diagnosis but also a baseline for monitoring the trend of the infection after treatment has been administered.
Blood test results are notoriously tricky to interpret which is why it is important for a trained physician to analyse them.
For example a particular pattern of blood results for someone who has a known history of Syphilis would indicate they have been cured and are stable but that same blood pattern for someone with no known history of Syphilis would indicate a current or active infection that requires immediate treatment.
Thankfully most cases of Syphilis respond to recommended treatment. Standard treatment is a single antibiotic injection but certain cases may require up to 3 injections spread over 3 weeks. If that treatment fails or there is a drug allergy to consider then an alternative oral antibiotic taken for one month may be administered.
Blood tests would be performed 2-3 months after treatment to monitor the trend and allow us to see if the infection has been cured or not. Often blood tests are repeated every 3 months for up to 2 years to ensure that Syphilis has not returned.
Untreated Syphilis, as mentioned above, can enter a latent phase. While this phase may have no outward symptoms, the infection can reactivate at any time producing new symptoms. Additionally, during this time you will still remain infectious.
However, the more worrying scenario is the development of tertiary Syphilis. We have already discussed this above but the take away message is that tertiary Syphilis can lead to irreversible organ damage, which also includes damage to the brain as well.
Protection goes a long way to help prevent Syphilis passed on through sex. However, even with protection, regular checks for symptoms as well as blood tests to ensure latent Syphilis is not present helps to reduce the risk of Syphilis. If you see that a partner has potential symptoms then it is best to ask them to seek medical advice, particularly if they have an unexplained rash because this may allow skin to skin transmission of Syphilis.
Feel free to come and speak to our friendly and approachable doctors about any issues you may be having. Remember we still cover all the GP stuff as well.
Both are bacteria that can potentially be present on the skin, particularly around the genital region. They can be passed on through skin contact of contaminated areas as well as through sex.
HIV is a virus that can pass on primarily through sex and sharing of unsanitised drug needles. The former is the primary mode of transmission particularly unprotected vaginal or anal sex. Thankfully oral sex is considered negligible risk for HIV.
This is an important point because HIV often has no symptoms in the early stage. Some may experience severe symptoms such as high fever, marked body aches, chills, runny nose, sore throat and fatigue approximately 3 weeks after infection but there is considerable overlap with other conditions such as the flu and Covid 19. Therefore symptoms at the early stage are unreliable and should not be used to exclude or diagnose HIV. Testing is the only accurate way to do this.
Trichomonas is a fairly common parasite passed on through sex and affects women more often.
In a majority of people with Trichomonas, symptoms can be absent making it difficult to identify without testing. However, if symptoms are present then the below list shows the common presentation:
HPV is a virus that can infect many areas of the body. There are over 100 strains and the majority are low risk and reside on the skin and can cause conditions such as warts. While this isn’t pleasant it can be easily treated. Approximately 40 HPV strains can be passed on through sex but 12 to 14 of these are considered high risk for certain types of cancer.
Low risk strains of HPV may produce warts. Those that are passed on sexually may produce genital warts which are fleshy growths from the skin around the genital and anal region. High risk strains often have no symptoms until it is too late. If we take cervical cancer as an example, many women who are developing this cancer due to HPV have no symptoms at all.
Gonorrhoea is a bacterial infection that is commonly passed on through unprotected sex (vaginal, anal and oral).
Chlamydia is another bacterial infection exclusively passed on during sex (oral, vaginal and anal). As with gonorrhoea the risk is much higher in unprotected sex but if protection is not used correctly then the risk is increased as well.
Herpes/Herpes Simplex Virus (HSV) is a virus that affects the skin. There are two major types known as type 1 and type 2. Typically HSV type 1 affects the mouth area and is associated with cold sores (passed on through kissing). HSV type 2 typically affects the genital area and is associated with sexual transmission.
HSV presents as painful/burning blisters that are often clustered together on the skin. For some the initial symptom will be a tingling sensation in the affected area before visual symptoms appear. Symptoms are very similar to shingles which is a condition caused by another member of the Herpes family.
You should consider screening if you have symptoms of a possible STD, if you have had a recent risky exposure (unprotected sex with a casual partner), or both.
Yes, you can. The common misconception is that oral sex is not considered ‘real’ sex and therfore has no risk but the opposite is true. Often oral sex is performed without protection and this is why infections such as chlamydia and gonorrhoea can pass on through oral sex.
Thankfully the majority can be cured but there are some such as Herpes and HIV that can be treated but not cured. This is why prevention is better than cure and ensuring safe sex goes a long way to reduce your risks.
At STD Screening Singapore we aim to provide caring, compassionate, and non-judgemental expertise on all sexual health and sexually transmitted disease/infection (STD/STI) related issues.
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