“The number of syphilis diagnoses in CeGIDD (free centers for information, screening and diagnosis of sexually transmitted infections) has been relatively stable since 2016. In 2021, 3,300 cases of syphilis were diagnosed there,” note health insurance. If it mainly affects men who have sex with men (78% of cases diagnosed in 2021 in CeGIDD), women can also contract it. What are their symptoms? How does the disease progress? Doctor Didier Constant, volunteer gynecologist from the Initiative for patients with gynecological cancers (IMAGYN) provides some answers.
Syphilis is a sexually transmitted infection (STI), caused by a spirochete-type bacteria called treponema pallidum, or pale treponema. It can therefore be contracted through unprotected anal passage, or vaginally, or via oral-genital intercourse (mouth-sex, mouth-anus relationships). “The condom is the only means of prevention but its protection is not absolute, the lesions may be located outside the area protected by condom”, specifies the gynecologist. It can also be transmitted via drug abuse materials.
Symptoms of syphilis in women
Syphilis comes in four stages, explains the gynecologist. The symptoms are similar for a woman and a man. Red spots develop and develop into painless ulcers. They can be located at the level of the penis, the anus, in the mouth, but also at the level of the vagina or on the cervix. “Their time of appearance varies between 10 and 100 days after contamination”, explains Didier Constant. This is the primary stage of the disease, and it is these cankers that make the disease very contagious. “That said, they heal within one to two months, without leaving a scar,” specifies the gynecologist.
If left untreated, secondary syphilis develops. It manifests itself as a rash on the trunk, on the palms of the hands, the soles of the feet, on the face… It can lead to fever or even meningitis. Health Insurance adds that there may be “excoriated skin or mucous membrane lesions(superficially scratched).” The symptoms then disappear to give way to latent syphilis. We also speak of tertiary syphilis up to 25 years of illness. In some people, syphilis is asymptomatic.
The consequences of this disease are “eye damage which can lead to blindness, arteritis of the aorta, aneurysm, neurological disorders, damage to the bones and liver, psychiatric disorders…”, lists the gynecologist.
“The risk of contagion is considered maximum during the first year of disease progression (early period). The treponemes are then present first on the chancre, then on the surface of the skin lesions and especially the mucous membranes. specifies Ameli. Furthermore, you can be infected several times with treponema, you do not develop immunity to this bacteria.
The special case of congenital syphilis
In the case of women, there is a particular risk especially if they are pregnant. Syphilis can be transmitted from mother to child during pregnancy, recalls Health Insurance, it is then called “congenital syphilis”. In France, as pregnant women are screened during the first prenatal examination (the latter is 100% covered), this eventuality is particularly rare. “If a mother becomes infected and is not treated, she can pass the disease on to her child. Transplacental passage of bacteria is possible from the 11th week of amenorrhea (SA) and certain from 16 weeks then throughout the pregnancy. This transmission can also take place during childbirth through contact with infected maternal secretions. notes the Ameli site.
The risk of transmission for an infected mother-to-be is very high if the syphilis is early (less than a year old), it is estimated at 70%. On the other hand, if it is late syphilis, the risk is much lower: 10%. The consequences on the child’s health can be serious. After-effects, such as vision or hearing problems, are possible, as are malformations, a higher risk of prematurity, low birth weight or even death in utero, or at birth.
How is syphilis in women diagnosed and treated?
“There is of course first a clinical examination, and possibly an examination of ulcerations with a sample,” notes Didier Constant. A blood test will confirm the infection. But the doctor specifies that this diagnosis is difficult because syphilis is similar to many other diseases, it is also called the “great simulator”.
Syphilis is a disease that can be cured with an injection of an antibiotic, such as penicillin. Doxycycline may also be used if the patient is resistant or allergic to the first antibiotic.
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