If intercourse routinely leaves you itchy, sore or unwell — and condoms assist — you could be allergic to semen
Think about itching, burning, swelling, and even struggling to breathe simply moments after intercourse. For a small however rising variety of girls, that’s not a clumsy anecdote — it’s a medical situation. It’s known as seminal plasma hypersensitivity (SPH) — an allergy to semen.
This uncommon however underdiagnosed allergy isn’t triggered by sperm cells, however by proteins within the seminal plasma — the fluid that carries sperm. First documented in 1967, when a girl was hospitalized after a “violent allergic response” to intercourse, SPH is now acknowledged as a kind 1 hypersensitivity, the identical class as hay fever, peanut allergy and cat dander.
Signs vary from delicate to extreme. Some girls expertise native reactions: burning, itching, redness and swelling of the vulva or vagina. Others develop full-body signs: hives, wheezing, dizziness, runny nostril and even anaphylaxis, a probably life-threatening immune response.
Till 1997, SPH was thought to have an effect on fewer than 100 girls globally. However a examine led by allergist Jonathan Bernstein discovered that amongst girls reporting postcoital signs, practically 12% might be categorized as having possible SPH.
I performed a small, unpublished survey in 2013 and located an identical 12% charge. The true determine could also be larger nonetheless. Many circumstances go unreported, misdiagnosed, or dismissed as STIs, yeast infections, or normal “sensitivity”. One revealing clue: signs disappear when condoms are used.
A 2024 examine bolstered this discovering, suggesting that SPH is each extra widespread and extra generally misdiagnosed than beforehand believed.
The issue isn’t the sperm
The principle allergen seems to be prostate-specific antigen (PSA): a protein present in all seminal plasma, not simply that of a specific associate. In different phrases, girls can develop a response to any man’s semen, not simply their common associate’s.
There’s additionally proof of cross-reactivity. For instance, Can f 5, a protein present in canine dander, is structurally just like human PSA. So girls allergic to canine could discover themselves reacting to semen too. In a single uncommon case, a girl with a Brazil nut allergy broke out in hives after intercourse, in all probability because of hint nut proteins in her associate’s semen.
Prognosis begins with an in depth sexual and medical historical past, typically adopted by pores and skin prick testing with the associate’s semen or blood exams for PSA-specific antibodies (IgE).
In my very own analysis involving symptomatic girls, we demonstrated that testing with washed spermatozoa, free from seminal plasma, may help verify that the allergic set off just isn’t the sperm cells themselves, however proteins within the seminal fluid.
And it’s not simply girls. It’s attainable some males could also be allergic to their very own semen.
This situation, referred to as post-orgasmic sickness syndrome (POIS), causes flu-like signs, corresponding to fatigue, mind fog and muscle aches, instantly after ejaculation. It’s believed to be an autoimmune or allergic response. Prognosis is hard, however pores and skin testing with a person’s personal semen can yield a optimistic response.
What about fertility?
Seminal plasma hypersensitivity doesn’t trigger infertility straight, however it could possibly complicate conception. Avoiding the allergen — normally the simplest therapy for allergic reactions – isn’t possible for {couples} attempting to conceive.
Therapies embrace prophylactic antihistamines (antihistamine drugs taken prematurely of anticipated publicity to an allergen, or earlier than allergy signs are anticipated to look to forestall or scale back the severity of allergic reactions), anti-inflammatories and desensitisation utilizing diluted seminal plasma. In additional extreme circumstances, {couples} could select IVF with washed sperm, bypassing the allergic set off altogether.
It’s essential to notice: SPH just isn’t a type of infertility. Many ladies with SPH have conceived efficiently — some naturally, others with medical help.
So why don’t extra folks find out about this?
As a result of sex-related signs typically go unstated. Embarrassment, stigma and a lack of knowledge amongst docs imply that many ladies endure in silence. In Bernstein’s 1997 examine, virtually half of the ladies who had signs after intercourse had by no means been checked for SPH, and lots of had spent years being misdiagnosed and getting the unsuitable therapy.
If intercourse routinely leaves you itchy, sore or unwell — and condoms assist — you could be allergic to semen.
It’s time to convey this hidden situation out of the shadows and into the session room.
Michael Carrol is an affiliate professor in Reproductive Science, Manchester Metropolitan College.
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