What are the symptoms of syphilis in women?

Written by Huang Ling Juan
Dermatology
Updated on June 25, 2025
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In the early stages of syphilis in women, a hard chancre appears, often accompanied by swollen inguinal lymph nodes. These nodes are about the size of a finger, relatively hard, non-fusing, painless, and without tenderness; their surfaces exhibit no redness, swelling, or signs of inflammation such as fever. The lymph fluid from a puncture will contain Treponema pallidum (the syphilis bacterium). During the early stage of syphilis, the appearance of a hard chancre significantly increases the positivity rate for syphilis. If the hard chancre is not treated timely, it generally disappears naturally within three to four weeks, after which it enters the latent phase of secondary syphilis. The second stage of syphilis is typically characterized by patches of varying-sized erythemas on the trunk and copper-red, symmetrical maculopapular rashes on the palms and soles. Upon detection of syphilis, prompt and thorough treatment is essential.

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Written by Zhu Zhu
Dermatology
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Early symptoms of syphilis

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum, with the disease course within two years referred to as early syphilis. Not all infected individuals display symptoms; asymptomatic syphilis is also known as latent syphilis. Symptomatic early syphilis primarily manifests as either primary or secondary syphilis. The main symptom of primary syphilis is a chancre, typically occurring as a clear-bordered ulcer in the genital area. It is flesh-colored and neither painful nor itchy. Several weeks after the chancre heals, secondary syphilis can develop, characterized by a rash that may resemble other skin conditions. Common manifestations include macules, papular macules, copper-red papules on hands and feet, flat condyloma, and syphilitic alopecia. Individuals who suspect they may have been exposed to syphilis should visit a hospital for a blood test to detect syphilis antibodies. Antibodies can usually be detected four weeks after infection, and a negative result three months later can rule out syphilis.

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Written by Zhai Yu Juan
Dermatology Department
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Is syphilis contagious?

Syphilis is a sexually transmitted disease caused by infection with the syphilis spirochete. After infection, the pathogen can invade various organs throughout the body, causing a variety of symptoms. As a classic sexually transmitted disease, syphilis is contagious, with its main routes of transmission being through sexual contact, mother-to-child transmission, and also through close contact, such as kissing, or the use of daily items from a syphilis patient, such as towels, razors, cutlery, etc. If syphilis is not treated, its infectivity gradually decreases over time.

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Written by Zhu Zhu
Dermatology
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Can you still have children with third-stage syphilis?

Third-stage syphilis is the most severe stage of the disease, and it is not possible to have children if one has third-stage syphilis, because syphilis can be transmitted from mother to fetus. The infectivity is particularly strong during the third stage. If a child is conceived at this time, it could lead to stillbirth. Besides stillbirth, even if the child is born by chance, they may have abnormal development or be born with diseases. This is tremendously painful and tormenting for both the parent and child. Therefore, one cannot have children with third-stage syphilis.

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Written by Zhu Zhu
Dermatology
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Can third stage syphilis be detected?

Third-stage syphilis can be detected. Syphilis is divided into primary, secondary, and tertiary stages, with the severity progressively increasing from the primary to tertiary stage, making tertiary syphilis a relatively advanced and serious condition. It can be detected by measuring the titers in serum, although the titers in tertiary syphilis may be lower than in the primary and secondary stages, and may sometimes present as negative. However, through the symptoms of tertiary syphilis, particularly some complications affecting the skin, cardiovascular system, bones, joints, and other organs, combined with the titer levels, it can definitely be detected.

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Written by Zhu Zhu
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Does tertiary syphilis have titers?

If one is suffering from stage three syphilis, syphilis titers will be present. However, syphilis titers do not always correlate directly with the severity of the condition. It is possible for the titers in stage one and two syphilis to be higher than in stage three. It's often the case that stage three syphilis represents the late stages of the disease, and the titers might decrease as the disease progresses into these later stages. Examples include titers such as 1:8 or 1:4, although some patients might exhibit titers of 1:16.