Women who have vaginal itching, burning and other symptoms after intercourse may be allergic to their partner’s semen – yet, for some, having more frequent sex can be part of the treatment. Women also may react to other allergic substances transmitted in seminal fluid, according to information presented at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Philadelphia.
Although it is not known how many women may be allergic to their partner’s semen, immunotherapy treatments may overcome the problem, provided the couple continues to have sexual intercourse regularly.
In some cases, substances such as certain medications and foods, may cause allergic reactions when transmitted through seminal fluid.
While the prevalence of semen allergy is not known, the condition does exist and should be considered as a possible diagnosis for women who report symptoms that occur shortly after intercourse. Symptoms may include itching, burning and swelling in the genital area. In the most severe cases, hives or swelling may appear elsewhere on the body and the woman may experience difficulty breathing.
“Typically symptoms occur within 30 minutes of intercourse, but in rare cases it may be hours or even days later,” said David J. Resnick, M.D., acting director, division of allergy, the New York Presbyterian Hospital, New York City.
Semen allergy is particularly suspected if symptoms go away with condom use or abstinence, he said.
In one study of 1,073 women who sought information from a researcher on semen allergy concerning their vaginal symptoms, 130, or approximately 13 percent, were determined to have semen allergy, according to Dr. Resnick.
“Although reports of the condition in the scientific literature are relatively rare, there may be women with semen allergy who go undiagnosed because their symptoms are mild or they routinely use condoms,” he said. There also are cases of women who have had allergic reactions to allergens transmitted through the seminal fluid, including the medications vinblastine, penicillin and thioridazine and some food and beverages, including walnuts and Coca-Cola.
Treatment for Semen Allergy
- Patients with semen allergy should be provided with a self-injectable epinephrine kit in the event of a severe reaction. Epinephrine (adrenaline) is the first-line treatment for severe allergic reactions. In addition, there are two immunotherapy options, a technique designed to desensitize the immune system to a particular allergen:
- Intravaginal Seminal Graded Challenge (ISGC). In this technique, semen samples are placed into the vagina every 20 minutes, beginning with highly diluted samples and gradually increasing the concentration. The technique, which is performed over a few hours, must be followed by frequent sexual contact (two to three times per week) to maintain the woman’s desensitization to semen.
“Treatment failure is associated with couples who do not engage in frequent intercourse that re-exposes the patient to the allergen,” Dr. Resnick said. “Patients not living near their partners can refrigerate or freeze specimens so they can continue frequent exposure.”
- When ISGC is unsuccessful, allergy shots have been used in some cases. This procedure involves injecting a small amount of semen under the skin at regular intervals over the course of several weeks, in a manner similar to the allergy shots used to treat allergic rhinitis and asthma. As with ISGC, patients must continue unprotected intercourse two to three times per week to maintain immunity.
According to Dr. Resnick, approximately 50 percent of women with semen allergy have other allergic diseases, such as skin allergy and allergic rhinitis (so-called “hay fever”). Most women are between age 20 and 30, and 41 percent experience symptoms with their first sexual intercourse. “In most cases, symptoms gradually worsen and occur sooner with subsequent exposures,” he said.
Semen allergy is not a direct cause of infertility, according to Dr. Resnick. Women may conceive after successfully undergoing immunotherapy, or may consider artificial insemination with “washed” sperm. In vitro fertilization also is an option.
In some women, the reaction occurs with one partner while others are allergic to all partners, he said. There are also reported cases where women have “outgrown” the allergy without treatment.