From the Guidelines
Allergic reactions to semen, also known as seminal plasma hypersensitivity, are rare but real conditions where individuals experience symptoms after exposure to seminal fluid, and the most effective management involves desensitization therapy under medical supervision, as stated in the most recent and highest quality study 1.
Causes of Human Seminal Plasma Hypersensitivity (HSP)
The causes of HSP include IgE-mediated sensitization by proteins of varying molecular weights in seminal fluid, as reported in 1. The immune system mistakenly identifies these proteins as harmful substances, triggering the release of histamine and other inflammatory chemicals.
Symptoms of HSP
Common symptoms of HSP include:
- Redness
- Swelling
- Burning
- Itching
- Hives in areas that contact semen, typically occurring within minutes of exposure These symptoms can range from mild to severe and may be localized or systemic, as noted in 1.
Treatment and Management of HSP
Treatment options for HSP include:
- Antihistamines like diphenhydramine (Benadryl) 25-50mg or cetirizine (Zyrtec) 10mg taken before anticipated exposure
- Using condoms as an effective barrier for more severe reactions, as stated in 1
- Desensitization therapy under medical supervision, where gradually increasing amounts of seminal proteins are introduced to build tolerance, as reported in 1 and 1 Some couples pursuing pregnancy with this condition may need assisted reproductive techniques.
Important Considerations
It is essential to note that HSP is not associated with infertility, as stated in 1. However, prolonged abstinence can result in loss of tolerance and recurrence of anaphylactic episodes, emphasizing the need for regular intercourse (2-3 times per week) to maintain the desensitized state, as reported in 1. If you experience difficulty breathing, severe swelling, or other signs of anaphylaxis after semen exposure, seek emergency medical attention immediately.
From the Research
Causes of Human Seminal Plasma Hypersensitivity (HSP)
- HSP is a type I reaction, with symptoms characterized as local and systemic 2
- The main allergens involved are substances in seminal plasma (SP), including prostate-specific antigen (PSA) 2, 3
- Other proteins in seminal plasma, as well as medications or food allergens that accumulate in the SP, can also trigger symptoms 2
- Women with systemic reactions are frequently atopic, and up to 40-50% of cases can occur after first-time intercourse 3, 4
Symptoms of Human Seminal Plasma Hypersensitivity (HSP)
- Local symptoms include itching and swelling at points of contact with semen 2
- Systemic symptoms can include generalized urticaria with angioedema, anaphylaxis, and other allergic reactions 2, 3, 4
- Symptoms can also include vaginal discomfort, urticaria, angioedema, wheezing, dyspnea, gastrointestinal symptoms, or frank anaphylaxis 4
- In some cases, symptoms can be severe and even fatal, as seen in cases of anaphylaxis due to allergen transfer through intimate contact 5
Diagnosis and Treatment of Human Seminal Plasma Hypersensitivity (HSP)
- Diagnosis is based on clinical history and prevention of symptoms with the use of a condom 2, 3, 4
- Skin prick tests and determination of allergen-specific IgE can also be used to aid in diagnosis 2, 3, 4
- Treatment options include avoidance with the use of condoms, intravaginal graded challenge using dilutions of whole seminal fluid, or subcutaneous desensitization to relevant fractionated seminal plasma proteins 2, 3, 4
- Desensitization therapy may be effective for some patients, but not all, and individualized treatment approaches are necessary 4, 6