This gets tricky, because of the nature of the bug. In women and in men the process is similar.
The initial sore is usually a small, shallow, often painless ulcer in the genital region, but in women, if the sore is inside the vagina it may be missed, giving no clues, or just a slight bloody discharge. The sore will usually appear within two to twelve weeks from the actual ‘infective encounter’. The skin heals up and, if no diagnosis is made, and no treatment given, the bug hides until the next instalment, one to three months later.
The next sign is a rash. It is a pale pink spotty rash on the chest, generally, and sometimes on the face, palms and soles. This is not just a fleeting flush, so don’t get panicky every time you develop a little colour. It usually hangs around for at least ten days. It is often associated with a ‘flu-like’ illness, with fevers, tiredness, gland swelling and headache. There may be some wart-like growths in skin creases.
The rash then disappears, and it may be anytime later within the next two to twenty years chat the last, irreversible, phase begins. The bacteria affects the nervous system, and can give any number of symptoms, depending on which part of the brain or nerves are affected. Going mad was what most of the more memorable syphilis sufferers of history did, but it can also affect the nerves controlling the arms and legs and balance. It may also cause problems in other important things, like major blood vessels.
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