“There’s No Way I Could Have Syphilis!”

“There’s no way I could have syphilis,” you say. “That’s what YOU think!” I say.

Deb, in her 70s, had a long-term affair with a man (we’ll call him Eddie) who used to make frequent business trips to Bangkok with his boss, and he told her, more than once, how Mr. Boss Man would pay to have sex with teenage girls. “The girls would be on show behind one-way glass,” Deb remembers her boyfriend telling her, “and his boss would choose the one he wanted.”

A few years ago, Deb’s doctor recommended that she have an STD panel (as in sexually transmitted diseases), to rule out the possibility that she had syphilis, among other diseases.  “I told my doctor that was crazy, how could I possibly have syphilis,” Deb said, “but she responded that women or men who’ve had unprotected intercourse (anal, oral or vaginal) with more than one partner should be tested, so I went ahead and had my blood taken.”

Lo and behold, the test results revealed that Deb’s blood contained antibodies to syphilis. Antibodies are produced when a virus or bacteria provokes a response from the immune system. This response can come from natural exposure or from a vaccination. The results were considered “weakly positive,” which could mean Deb didn’t actually have syphilis, so her doctor wanted her to have a second test to confirm the diagnosis. When that test also produced weakly positive results, the doctor advised Deb to see another doctor who specializes in infectious diseases.

Fast forward: Deb had a series of three penicillin injections, in a large butt muscle, spaced out at weekly intervals. She learned that this procedure, recommended for anyone with “late latent syphilis,” will kill the syphilis bacterium.  And it did. When Deb was retested, about three months after getting the final injection, her test results were negative.

Turns out that symptoms of “primary stage” syphilis (a single or multiple sores) often go unnoticed because they’re painless, the infectious disease doc told Deb. They usually last three to six weeks and heal whether or not someone gets treatment.

Skin rashes and or sores in your mouth, anus or vagina may appear during the secondary stage, which can start several weeks after the primary sore has healed. The rash usually won’t itch, and it’s sometimes so faint that it’s also unnoticeable.  It, too, disappears, even if you don’t receive treatment.

skin rash

The latent stage of syphilis begins when all of the earlier symptoms disappear. And, here’s the really scary part:  Without treatment, you can continue to have syphilis in your body for years without any signs or symptoms. Although most people with untreated syphilis don’t develop late-stage syphilis, it’s very serious if you do, and could occur 10 to 30 or more years after the infection began.

Symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, blindness, and dementia. Late-stage syphilis damages your internal organs and can cause death. “The doctor told me that he is often called to test older patients for syphilis, who have been admitted to institutions for mental disorders,” Deb explained. “If he learns the patient does have syphilis, he immediately starts them on a potent intravenous drug to halt further progression.”

When Deb thinks back to her relationship with Eddie, she realizes she probably contracted syphilis from him. “When he told me about his boss having sex with teenage girls in Bangkok, he really was talking about himself, too.  That’s my guess. Goodness knows how many men had sex with these young girls.”

Deb is far from alone in her naivete about STDs. That’s because women in her generation, as well as the early boomers, were generally monogamous when they were younger, so they missed the sexual education women started getting in the eighties. (“When I was in my 20s, I thought prostitutes were the only women who got syphilis,” Deb said.) Then, when many of them divorced, like Deb, they became involved with multiple partners, and didn’t use protection because they were postmenopausal. Divorced men, in the meantime, started taking Viagra and continued to have active sex lives with many different women.  

It may strike some as surprising, but the rates of sexually transmitted disease (STD) in older adults are rising. Older people who are sexually active may be at risk for diseases such as syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, genital warts, and trichomoniasis,” notes the Benjamin Rose Institute on Aging.  “It is essential that older adults and their caregivers get educated about the risks of STDs. Age does not protect you from sexually transmitted diseases.”

Just think about Deb!