Consider itching, burning, swelling, and even suffering to respire simply moments after intercourse. For a small however rising choice of ladies, that’s now not a clumsy anecdote – it’s a clinical situation. It’s known as seminal plasma allergy (SPH) – an allergic reaction to semen.
This uncommon however underdiagnosed allergic reaction isn’t precipitated by way of sperm cells, however by way of proteins within the seminal plasma — the fluid that carries sperm. First documented in 1967, when a lady was once hospitalised after a “violent allergic reaction” to intercourse, SPH is now recognised as a kind 1 allergy, the similar class as hay fever, peanut allergic reaction and cat dander.
Signs vary from gentle to serious. Some ladies enjoy native reactions: burning, itching, redness and swelling of the vulva or vagina. Others broaden full-body signs: hives, wheezing, dizziness, runny nostril or even anaphylaxis, a probably life-threatening immune reaction.
Till 1997, SPH was once concept to impact fewer than 100 ladies globally. However a find out about led by way of allergist Jonathan Bernstein discovered that amongst ladies reporting postcoital signs, just about 12% might be categorized as having possible SPH.
I performed a small, unpublished survey in 2013 and located a identical 12% charge. The real determine is also upper nonetheless. Many circumstances move unreported, misdiagnosed, or disregarded as STIs, yeast infections, or common “sensitivity”. One revealing clue: signs disappear when condoms are used.
A 2024 find out about bolstered this discovering, suggesting that SPH is each extra commonplace and extra usually misdiagnosed than in the past believed.
The issue isn’t the sperm
The primary allergen seems to be prostate-specific antigen (PSA): a protein present in all seminal plasma, now not simply that of a selected spouse. In different phrases, ladies can broaden a response to any guy’s semen, now not simply their common spouse’s.
There’s additionally proof of cross-reactivity. As an example, Can f 5, a protein present in canine dander, is structurally very similar to human PSA. So ladies allergic to canine would possibly to find themselves reacting to semen too. In a single bizarre case, a lady with a Brazil nut allergic reaction broke out in hives after intercourse, most likely because of hint nut proteins in her spouse’s semen.
Prognosis starts with an in depth sexual and clinical historical past, incessantly adopted by way of pores and skin prick checking out with the spouse’s semen or blood checks for PSA-specific antibodies (IgE).
In my very own analysis involving symptomatic ladies, we demonstrated that checking out with washed spermatozoa, loose from seminal plasma, can assist ascertain that the allergic cause isn’t the sperm cells themselves, however proteins within the seminal fluid.
And it’s now not simply ladies. It’s imaginable some males is also allergic to their very own semen.
This situation, referred to as post-orgasmic sickness syndrome (POIS), reasons flu-like signs, comparable to fatigue, mind fog and muscle aches, in an instant after ejaculation. It’s believed to be an autoimmune or hypersensitive reaction. Prognosis is hard, however pores and skin checking out with a person’s personal semen can yield a good response.
What about fertility?
Seminal plasma allergy doesn’t motive infertility at once, however it could actually complicate conception. Averting the allergen – most often among the finest remedy for hypersensitive reactions – isn’t possible for {couples} looking to conceive.
Therapies come with prophylactic antihistamines (antihistamine drugs taken prematurely of expected publicity to an allergen, or sooner than allergic reaction signs are anticipated to look to forestall or cut back the severity of allergies), anti-inflammatories and desensitisation the use of diluted seminal plasma. In additional serious circumstances, {couples} would possibly select IVF with washed sperm, bypassing the allergic cause altogether.
It’s essential to notice: SPH isn’t a type of infertility. Many ladies with SPH have conceived effectively – some naturally, others with clinical reinforce.
So why don’t extra folks learn about this?
As a result of sex-related signs incessantly move unstated. Embarrassment, stigma and a ignorance amongst medical doctors imply that many ladies endure in silence. In Bernstein’s 1997 find out about, nearly part 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 flawed remedy.
If intercourse mechanically leaves you itchy, sore or in poor health – and condoms assist – you may well be allergic to semen.
It’s time to deliver this hidden situation out of the shadows and into the session room.
