Strangely, though, even in our own supposedly scientific time, myths about syphilis still abound. These myths have survived even though scientists now know full well what causes syphilis: a bacterium called Treponema pallidum. We know how it spreads: by sexual contact. And we have a sure and simple cure: penicillin. With all these key facts about syphilis well established, the myths that still circulate about this sexually transmitted disease (STD) confuse people. More than that, the myths pose real dangers when they interfere with our ability to protect ourselves from this potentially life-altering illness. Only when you understand the facts about STDs, including syphilis, can you protect your own health and that of your partners. Clarity about these facts equips you to practice safe sex and avoid catching an STD in the first place. Clarity also equips you to obtain proper care if you do get syphilis or another STD.
Wrongheaded Ideas Afoot Today
As mentioned above, syphilis is but one illness among many other sexually transmitted infections. “It stands out for being perhaps the most feared, reviled, and possibly misunderstood,” says Jane Bogart, EdD, the director of Columbia University’s Center for Student Wellness in New York City and the author of Sexploration: The Ultimate Guide to Feeling Truly Great in Bed. Dr. Bogart spells out some big myths about syphilis that still confuse and endanger people today:
Myth 1: Syphilis Is a Thing of the Past
Fact: “One of the big myths is that syphilis doesn’t exist anymore,” Bogart says. Many people think of syphilis as a disease that happened a long time ago, killed lots of people, but is no longer a worry. “People will think, ‘Didn’t syphilis go away with the plague?’” says Damian P. Alagia III, MD, a senior medical director of women’s health for Quest Diagnostics who is based in the Washington, DC, area. Like Bogart, he has encountered people who wrongly believe that syphilis is no longer an issue. In fact, syphilis definitely qualifies as an active concern. “It is something that you need to think about if you’re sexually active,” Bogart says. She points out that syphilis rates have been increasing in recent years, especially (but not only) in certain groups. Year by year, syphilis rates in the United States have been trending upward since the year 2000. Syphilis rates are climbing for people with all sexual preferences, heterosexuals included. But the rates of all STDs, including syphilis, are especially high among men who have sex with men and among Black Americans. (1) Elsewhere, in parts of Canada and Europe, syphilis rates have also risen in recent years.
Myth 2: Syphilis Makes You Go Insane
Fact: “Before there were [effective] treatments for syphilis, which are antibiotics, some very famous people had end-stage syphilis, and one of the symptoms of that is actually insanity,” says Bogart. But today syphilis is completely curable, especially if it is diagnosed and treated early in the course of the illness. “Most people don’t progress to that end stage unless it’s untreated,” she says.
Myth 3: Syphilis Is Incurable
Fact: “That is just not true,” says Bogart. “Once antibiotics became available, syphilis became completely curable.” It is true, though, that if a diagnosis comes late in the course of the illness, any organ damage already caused by syphilis may prove irreversible.
Myth 4: You Can Tell if You Have Syphilis
Fact: While you will have some symptoms soon after the infection occurs, you won’t necessarily notice them or recognize them as syphilis. At the location where the bacterium first entered your body, a sore called a chancre will crop up. “You can miss that sore,” says Bogart. It may be visible if it’s on the penis, but it may not be visible if it’s tucked away inside your anus, vulva, or cervix. Unlike the shallow, painful, weeping ulcers that are caused by herpes, a chancre that serves as a first sign of syphilis is painless. “Some people could confuse that [chancre] for chafing, if they are exercising a lot or bicycling a lot or just having more friction during their sexual relations,” says Dr. Alagia. “They may think that it’s normal and that it just happened. That’s one reason we call syphilis ‘the great pretender.’” “If you notice anything, any change on your skin or any sore on your penis or anus, get that checked out,” says Bogart. “It could be one of several sexually transmitted diseases, including syphilis. If it is syphilis, the earlier that you catch it and the earlier that you treat it, the better off you will be.”
3 Myths From Earlier Times
Old Myth 1: Sex With a Virgin Cures Syphilis
This myth took hold in the 17th century. Horrifyingly, even today some people believe it. This wrongheaded idea has also shifted over time to include sex with a virgin as a cure for AIDS. As a result, news reports indicate that a growing number of men with AIDS have raped children in South Africa in hopes of a cure. (2) Obviously, nothing could be further from the truth. Having sex with an uninfected person — sexually experienced or not — simply puts that person at risk of acquiring the infection.
Old Myth 2: Syphilis Can Only Enter a Flaccid Penis
A soft male member “drinks the infection in like a sponge,” wrote François Ranchin, a French physician in the 17th century. This idea ties in with another old myth that ejaculation during sex with a syphilitic woman leaves a man vulnerable to the infection. In truth, once a man is having sex with an infected partner, he is vulnerable whether he ejaculates or not.
Old Myth 3: Syphilis Is an Inherited Disease
So called “folk wisdom” in Europe maintained that the “syphilitic taint” passed to the sperm or an egg during one sexual encounter. It would infect the person born of that sexual encounter, who could then pass it on to his or her children, and so on through many generations. It’s now known that this is untrue, although a pregnant woman who has syphilis can pass it to her baby, often with disastrous results. (3)
Key Truths to Understand and Act On
Whether you’re male, female, or have another gender identity, if you engage in high-risk behaviors, you need to get tested regularly for STDs, including syphilis. High-risk behaviors include having multiple sex partners. Every pregnant woman should also be tested for syphilis early in her pregnancy. If she engages in high-risk behaviors, such as having sex with a new partner during pregnancy, she needs to be tested again in the third trimester, advises Alagia. The CDC’s recommendations regarding screening for syphilis include these guidelines:
Screening in all pregnant women at their first prenatal visitAdditional testing in pregnant women in the third trimester and at delivery if at high riskScreening at least annually in men who have sex with menScreening every three to six months in men who have sex with men if at high riskAnnual screening in sexually active people living with HIV
The CDC has additional recommendations for other STDs. In all cases, more frequent screening or screening for additional STDs may be appropriate for certain individuals, depending on their risk factors, including sexual behavior and how common a particular disease is in their area.
Don’t Count on Your Doctor for Testing Reminders
Don’t rely on a doctor to make sure you get the STD testing you need. Just as many laypeople are uncomfortable talking about sex and STDs, so are many doctors uneasy talking about these issues. (4) “These are hard conversations for doctors to have,” says Alagia. And doctors may not realize that some of their patients are at high risk for STDs. For example, Alagia says, a doctor may skip testing a prenatal patient for syphilis because she doesn’t “seem” at risk. The answer: Take charge of your own well-being. Calmly bring up STD testing with your doctor or another healthcare provider. Get the tests and any treatment you may need. This way, you can stay healthy and help your children and sexual partners stay healthy, too.
