Allergic seminal vulvovaginitis is a contact allergic reaction to semen characterized by burning, tingling, itching, and redness around the vulva and vagina.
The human body is allergic to various foreign substances, although some are harmless. An allergic reaction is the body's way of getting rid of that foreign substance. A cascade of reactions occurs in the body by producing antibodies, leading to noticeable symptoms. During the first contact with the allergen, your body identifies and marks it as harmful. After the subsequent contacts, an inflammatory response is triggered, leading to symptoms like redness, itching, etc. Anaphylaxis is a severe form of an allergic reaction that can be life-threatening. Interestingly, the human body can be sensitive to pollen, dust, clothes, chemicals, and sometimes even sperms.
Allergic seminal vulvovaginitis is an allergic reaction to the sperms that causes inflammation in women's vagina and external genitalia. Once the sperm comes in contact with the vagina, a response is triggered. This response manifests as urticaria, meaning an immediate redness, swelling, and itching develop on the affected skin. Symptoms of sperm allergy may be localized, generalized, or both. Seminal allergy is also known as seminal plasma allergy or hypersensitivity and seminal fluid hypersensitivity.
On a general note, allergies are thought to be the body’s natural reaction to foreign substances. But the reason why the human body identifies substances as harmful is still unknown. Likewise, the cause of semen allergy remains a question. Several researchers have put forward their hypothesis that explains genital-tract immunomodulation (changes in the body’s immune system that modifies the immune response).
A. Hormonal changes like pregnancy and menopause.
B. Hereditary and genetic factors.
C. Surgical procedures involving the genital tract.
An accurate estimate of allergic vulvovaginitis has not been determined. Most cases go undiagnosed because of sensitive nature. A survey conducted in the United States estimated around 8 % prevalence. The details go as follows:
Semen contact allergy affects women, and 40% of them show symptoms after the first sexual intercourse.
It affects women in their second or third decade of life, sometimes after menopause.
Cases are significantly associated with a family history or a genetic predisposition.
Vulvovaginal (localized) symptoms occurred in 31% of women.
28% of women experienced general systemic symptoms.
39% developed from both localized and systemic symptoms.
Only one percent developed a cutaneous reaction (changes in the skin).
The symptoms can be exclusively localized, involving only the external genitalia. The reaction can start immediately on any part of the body the semen comes in contact with.
1. Vulvovaginal burning, itching sensation.
2. Tingling sensation around the vaginal opening.
3. Redness and swelling in the vulvovaginal region.
4. Blistering and pain are uncommon symptoms.
5. Uterine contractions and weak lower extremities.
Symptoms may last up to several days after the exposure, and the intensity of the reactions may increase. Localized reactions are often present with systemic manifestations. The general systemic symptoms include:
1. Generalized urticaria (itching of the skin triggered by an allergen).
2. Tongue, lips, and throat may become swollen (angioedema).
3. Common respiratory symptoms are wheezing, tightness in the chest, cough, sneezing, and runny nose.
4. Nausea, vomiting, and diarrhea are gastrointestinal symptoms.
5. In severe cases, anaphylaxis (severe life-threatening allergic reaction) may occur in extreme cases. But no cases of death have been reported.
Diagnosis can be made on the clinical history and lab investigations.
A. Physical vaginal examination to identify the symptoms.
B. Swabs from the vagina can be collected to rule out sexually transmitted diseases.
C. Lab tests include a complete blood count, kidney and liver function tests etc.
A specific test to identify semen allergy is a skin prick test. The procedure includes:
1. Freshly ejaculated sperms are liquefied for half an hour at room temperature.
2. The sample is centrifuged to separate components.
3. The components are used for the prick test. After the prick, if an allergic rash develops on the skin, the test is said to be positive.
This condition indirectly affects pregnancy and conception because of the reduced frequency of sexual intercourse. It has a psychological impact on individuals and their relationships, resulting in anxiety and sexual dysfunction. If the condition is managed, natural conception can be achieved. Patients can also opt for artificial insemination with washed sperms, but cases of persistent allergy have been reported.
The treatment for allergic seminal vulvovaginitis includes general and specific management.
A. General Management:
1. Use of contraceptives (condoms or vaginal diaphragms) to avoid the allergen.
2. Allergy medications like antihistamines can be taken 30 to 60 minutes before intercourse as prophylaxis. This may reduce the severity of the reaction.
3. A handy adrenaline injection is recommended.
4. Sexual education and counseling will help patients deal with psychological impact.
B. Specific Management:
Desensitization is a process that involves gradual stimulation of the immune system by increasing the doses of the allergen. This modifies the immune system, and eventually, the body stops allergic response. Desensitization of the semen can be achieved intravaginally (inside the vagina) or subcutaneously (under the skin). It is an effective technique that eliminates the allergy in more than 95% of women after two to three times of weekly exposure.
Allergic seminal vulvovaginitis is a condition characterized by an allergic reaction to semen. It is an uncommon condition, often associated with local and systemic symptoms. Burning, stinging, swelling, redness, and blistering around the vaginal opening is common. Systemic symptoms include urticaria, wheezing, and anaphylaxis in extreme cases. Diagnosis is confirmed after a positive reaction to the prick test. This condition can be managed by using prophylactic anti-allergy medications and desensitization.
Last reviewed at:
26 Oct 2022 - 4 min read
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