Should I Get Tested for Syphilis?  

Heather Logue Fact Checked
illustration of spiral syphilis virus

Though many of us may see syphilis as an old-timey condition that we don’t hear much about these days, the truth is, when left untreated, it’s still a very real and very dangerous disease.  

Public health experts are ringing the alarm bells because cases of syphilis in cisgender women (cisgender means a person’s gender identity corresponds to their sex assigned at birth) have increased nearly five-fold since 2015. In addition, King County has gone from having zero cases of congenital syphilis before 2019 to 12 cases in 2022 — a large enough jump to create serious concern. 

The Washington State Department of Health and Public Health – Seattle & King County have come out with new testing recommendations — all sexually active women age 45 and under in Washington state who have not had a syphilis test since January 2021 should be tested.  

What is syphilis? 

Though there is plenty to say about syphilis, here are the basics: It’s a sexually transmitted infection that is caused by a bacteria called Treponema pallidum.  

Signs you might have syphilis include the appearance of single or multiple weird sores in your vagina, anus, penis or mouth areas, followed by rashes that can show up in those same areas, or even on your hands and feet. Fever, weight loss, fatigue and other issues may also accompany those symptoms. 

Most importantly, you may not show any signs at all of syphilis. And if left untreated, the disease can spread throughout the body including the heart and brain — plus, it’s very dangerous when contracted by a pregnant person.  

However, syphilis is curable when it’s detected early, with most patients only needing one dose of penicillin or a course of oral antibiotics for penicillin-sensitive folks. Which is exactly why testing is essential, particularly now as the number of people contracting the disease in our community keeps rising.  

We know. There is still shame associated with contracting a sexually transmitted infection (STI), which is why some people would rather just avoid the stigma by avoiding the testing (and, therefore, the possible confirmation that they have the disease). Since that only causes harm to yourself, and any sexual partners, it’s important to embrace STI testing as an essential form of self-care. 

Why should women under 45 get tested for syphilis? 

Though most cases of syphilis in the U.S. are among gay, bisexual and other men who have sex with men, there has been a sharp increase of the disease in women and people who can become pregnant over the last several years.  

“One great concern is congenital syphilis, when a person who is pregnant transmits the disease to their unborn baby,” Dr. Meena Ramchandani, a physician at Harborview Medical Center’s Sexual Health Clinic. This can occur at any stage of syphilis disease or any stage of pregnancy and can result in miscarriage, stillbirth or major medical problems.” 

Congenital syphilis is something that really concerns the public health community, considering how devastating the condition can be. It’s also completely preventable when the pregnant person is tested and treated at least a month before delivering the baby. It’s recommended that people who are pregnant get screened for syphilis at their first prenatal visit and then retested later during the pregnancy depending on their risk factors. 

How does syphilis testing work? 

The good news after all of this doom and gloom: Testing for syphilis is straightforward and easy. Ramchandani explains that blood tests can be done by most doctors and can confirm whether or not syphilis-fighting antibodies are present in your body. 

Looking for somewhere to get tested? The Sexual Health Clinic at Harborview Medical Center is an excellent local option. You can also visit the “Getting Tested” page on the Washington State Department of Health’s website to find other clinics and testing facilities in the state. 

Your local health department will also help with notifying sexual partners if you do test positive — helping them get tested (and treated) and working to keep the virus in check.

What is the biggest concern with the syphilis uptick? 

As mentioned earlier, the biggest concern with this syphilis uptick is the increased risk of congenital syphilis, which is why it’s so important that all sexually active women who are 45 or under — and who have not been tested for syphilis since January 2021 — get tested as soon as they can. 

And remember, even though every person who is sexually active is technically at risk of contracting syphilis, you can lower your chances of getting it by testing and knowing your status (and encouraging your partners to do the same) and using a condom every time you have sex.