Rising Syphilis Cases Among Women in the UK
Over the past decade, there has been a significant increase in syphilis cases among women in the UK. Experts are sounding the alarm, as many infections may be going undiagnosed due to the subtle and often misleading nature of the symptoms.
While the majority of syphilis cases in the UK still occur among men who have sex with men, the proportion of cases in women has risen sharply. According to the latest data from the UK Health Security Agency (UKHSA), women accounted for just over six per cent of all syphilis diagnoses last year — a more than 200 per cent increase over the same period.
The Challenge of Diagnosis
The early signs of syphilis, such as painless sores, are often internal or located in hard-to-see areas, making them easy to miss. When they do appear, these sores are frequently mistaken for other conditions like herpes, thrush, ingrown hairs, or minor skin irritation. As the infection progresses, a rash can develop on the palms of the hands and soles of the feet, which may be misdiagnosed as eczema, psoriasis, dermatitis, or allergic reactions.
Another symptom is syphilitic alopecia, where hair begins to fall out. This condition can lead to further confusion and misdiagnosis, as it resembles other forms of hair loss.
Personal Stories Highlight the Risks
One woman in her twenties shared her experience of being misdiagnosed for over two years before finally being tested for syphilis. She described struggling with a range of symptoms, including hair loss and severe brain fog, which led doctors to suspect autoimmune diseases. Her personality changes also raised concerns about mental health.
She said:
“I thought I was having a mental health crisis. It took two years for a doctor to actually test me for syphilis. I thought it was some kind of Victorian disease, not something that I’d ever be at risk of.”
Thankfully, she was able to receive treatment and has no lasting effects. However, the two years of uncertainty and stress were extremely difficult.
Delays in Diagnosis and Consequences
Researchers from Brighton and Sussex Medical School found similar delays in diagnosis when reviewing cases within an NHS trust. Their analysis of six patients, including one woman, revealed multiple missed opportunities to test for syphilis, even after individuals presented with severe symptoms. These included abscesses, inflamed joints, weight loss, hearing loss, nerve damage, and abnormal liver function results. Delays in diagnosis ranged from one month to more than three years.
Syphilis is often called “the great imitator” because it can mimic a wide range of other illnesses. As a result, some patients underwent unnecessary and sometimes invasive investigations. Two individuals experienced severe psychological distress due to the prolonged uncertainty.
Importance of Early Detection
Although syphilis is easily treatable once diagnosed, untreated infections can lead to serious complications. The risks are particularly severe for babies born with congenital syphilis, which can cause significant illness or death. While this condition is rare in the UK, screening is recommended for all pregnant women.
Between 2020 and 2024, more than 1,300 pregnant women in England were diagnosed with syphilis. Valentina Milanova, chief executive and founder of women’s health company Daye, highlighted the role of stigma and misconceptions around testing in contributing to missed cases.
She said:
“The way the health system approaches STI testing is worrying. It is often framed as something people do after a scare, rather than a routine part of preventative healthcare.”
“Many infections can exist without obvious symptoms while continuing to affect the body. By the time some people are diagnosed, they may already be dealing with complications linked to fertility or long-term reproductive health.”
“There is still a perception that STI testing is only necessary for certain groups or behaviours — but that simply isn’t true. Sexual health should be treated like any other part of routine healthcare.”
