Semen allergy is becoming better recognised and acknowledged as being more common than previously thought 1. The medical name for this is human seminal plasma (HSP) hypersensitivity.
What is a semen allergy?
A semen allergy is actually thought to be, at least primarily, an allergy to a specific component of semen, prostate-specific antigen (PSA). Other proteins are suspected to also be involved, but this is the major one. It can happen at any time, not just the first time you have sex, sometimes developing later in life. About half of cases appear after first-time sex. It is not an allergy to sperm, but to the fluid that sperm travels in, the seminal fluid.
The human body is designed to attack foreign invaders, which semen could be construed as. It was previously believed that the human body couldn’t become allergic to another human or itself, however that has long proved not to be true.
Symptoms and risk factors
There seem to be two distinct types of reaction. One is throughout the entire body, and one is localised and restricted to the vagina. It is possible to have both. Those with just the vaginal reaction are known to have fewer antibodies than those women with a systemic allergic reaction.
- Chronic vaginitis (can be mistaken for vaginitis)
- Vaginal irritation, swelling, burning, itching
- Severe pain, blisters, welts, soreness and redness
Entire body (systemic) reaction
- Itching, swelling, burning over entire body
- Difficulty breathing, shortness of breath, faintness, dizziness, wheezing, chest tightness,
- Hives, urticaria
- Anaphylaxis (in severe reactions) resulting in unconsciousness and the theoretical possibility of death (however there are no recorded deaths by semen as yet)
How it happens
- Symptoms can appear minutes after sex, or occur hours later in a slower reaction
- The allergy can develop over months or years, then appear seemingly out of nowhere
- Women who have this allergy are likely to have other allergies like hayfever, asthma and food allergies
- It is more likely to happen after childbirth or other vaginal surgeries or trauma
- Once you have had your first allergy attack, the tendency is for them to continue and become worse, rather than better and fewer
Diagnosis of semen allergy
Diagnosing this condition requires careful case-taking and evaluation of a person’s history. The ‘gold standard’ is classified as symptoms completely abating with the use of a condom during sex, which isn’t particularly scientific, but gets the job done. A skin prick test or blood test will look for what’s called serum-specific immunoglobulin E to seminal fluids or specific proteins, but this does not always give a definitive answer.
How do I know if I have this?
Before you spend the time and money figuring out if this is the cause of your problem, there are a few key questions to ask.
1. Do you have vaginal pain and burning that can last hours or days occurring directly after contact with semen? Or in your mouth or on your skin, when it is in contact with semen? This can indicate localised seminal plasma hypersensitivity, or local allergy. You can establish if semen is the problem by using condoms for sex, and seeing if the problem goes away.
2. Do you have one or more of the following symptoms up to an hour after contact with semen: hives, swelling, chest tightness, shortness of breath, wheezing, diarrhoea, dizziness and/or loss of consciousness? If so, you may have a systemic seminal plasma hypersensitivity.
3. Importantly, have you been checked recently for sexually transmitted infections? STIs can cause vaginal or systemic hypersensitivity as your body reacts to the infection. It is important to rule this out.
Preventative action is to avoid semen altogether by using condoms or pulling out prior to ejaculation (coitus interruptus). (If condoms frighten you, look at skins for a better experience.) If pulling out, be aware that ‘pre-cum’ ejaculate/prostatic fluid can escape the penis prior to actual ejaculation, which could cause a problem. This will depend on your sensitivity, and your partner’s particular ‘ways of the penis’, and will be different for everyone.
But, these aren’t your only options. You can try what’s known as intravaginal graded challenges using diluted amounts of your partner’s semen inserted into the vagina at specific times (according to the instructions by your doctor). This costs around US$250, and can be put onto American insurance. It is known to be successful in over 90 percent of cases. It is done over the course of one or two days, and uses diluted seminal fluid prepared by the lab from your partner’s semen. Depending on where you live, the cost will need to be discussed with your practitioner – it may be covered under your country’s medical system and be free or low-cost.
Subcutaneous desensitisation is another, more delicate procedure if the challenge is unsuccessful, with subcutaneous referring to under the skin, so proteins inserted under your skin to desensitise you to your sexual partner’s semen. This means you are going to want to be with them for a while, since this (in the USA) costs around $2,000 and can’t be put on insurance. The skin version is done over the course of about three hours, and involves the same type of procedure that those allergic to different types of venom (wasp, bee) and penicillin undertake. It is commonly performed, thought to be safe, and quite effective.
These treatments are arranged by your doctor and the clinic involved (one such clinic is the University of Cincinnati), with your doctor taking the samples and testing for STIs and organising your medical records to be sent across, and you and your partner must travel to Ohio for two or three days, prepared several months in advance, for treatment – if you are accepted by the clinic for treatment.
These methods aim to desensitise you to the proteins, making your body less reactive, and theoretically curing you of the problem altogether. There are also some antihistamines that can be used with some success, particularly cromolyn topically.
This is a discussion you will need to have with your doctor to see which option will suit you the best, with one or more of these approaches being very successful. There have been some cases of allergy so severe that after the first allergic reaction, even kissing would trigger off the allergy2. Excellent way to have your relationship completely ruined!
While immunology is a complex topic, some interesting alternative medical practices do have some helpful adjuncts that you can investigate for their suitability to your circumstance.
EFT/NLP, while still being researched for the reasons why it gets results so often, can be a great way to dive right into the back end of your brain and rewire it. With a skilled therapist it is possible that you can retrain your brain to kill the allergy.
Herbal medicine has a lot to offer allergy sufferers, and a skilled herbalist or naturopath can investigate your particular body type and peculiarities and find herbal medicine to help your body to recalibrate so it is not allergic to semen anymore. A semen allergy is an incorrect response to outside stimulus, but indicates a deeper level of immune function causing the reactivity. This can often be balanced out using herbs, and only for a period of time – you won’t have to be taking herbs for a long period of time.
Will a semen allergy affect my chances of getting pregnant?
Although it seems like it might due to the inability to have semen inside your vagina, evidence has proved that a semen allergy does not affect your chances of getting pregnant – so long as you can tolerate the allergic symptoms long enough to actually get pregnant. Naturally if you suffer from life-threatening anaphylaxis, you should avoid semen entirely, and if you want to get pregnant, you may need to look at different routes of implanting the fertilised egg inside your uterus (IVF).
- Bernstein, Jonathan A et al. Prevalence of Human Seminal Plasma Hypersensitivity Among Symptomatic Women, Annals of Allergy, Asthma & Immunology, Volume 78 , Issue 1 , 54 – 58 ↩
- Ole D. Wolthers, A Five-Year Followup of Human Seminal Plasma Allergy in an 18-Year-Old Woman, Case Reports in Medicine, vol. 2012, Article ID 257246, 2 pages, 2012. doi:10.1155/2012/257246 ↩