Could you be allergic to sex?

by Charles Downey

For two years, a 26-year-old woman suffered burning and swelling in and near her vagina for 15 minutes after making love.

But she and her husband were puzzled by symptoms that each and every time went away if they used a condom. She finally went to her doctor, and what she learned there was quite startling. Most family physicians and gynecologists are unaware of her mysterious condition.

She is allergic to sex.

Medical researchers have found that some women are allergic to their partner's seminal fluid, the thick liquid that carries sperm. Doctors know the disorder as "human seminal plasma hypersensitivity." In rare cases, the allergic response can cause death.

But there is good news. The malady can usually be treated by allergists although it takes some effort by concerned, caring male partners. But more about the mens' role later.

In addition, doctors have learned that the condition first described in 1958 is much more widespread than they first thought. It came to light when M.D.-brothers Jonathan A., David I. and I. Leonard Bernstein, allergists and assistant professors at the University of Cincinnati College of Medicine, surveyed almost 1100 women who had reported at least some symptoms consistent with the sex allergy.

Their findings? Writing in the January '97 issue of Annals of Allergy, Asthma, & Immunology, the researchers found that 12 percent of patients examined met the diagnostic criteria for an allergy to seminal fluid.

"We don't know yet if the women who have this hypersensitivity are allergic to all seminal fluid or just their partner's," says David Bernstein.

For many women, a sexual allergy is as serious as a heart attack. Most sufferers complain of symptoms that include wheezing, itching and hives all over, chest tightness, vomiting, or diarrhea. Severe reactions include loss of consciousness or complete circulatory collapse. Other women seek medical help complaining of localized reactions such as vaginal burning or swelling. Some women even report blisters in and near their genitalia.

Left untreated, the malady is a sure marriage and relationship wrecker. It's also a source of complete frustration for the couple who wants to have children but must always use a condom.

"A primary candidate for a diagnosis of sexual allergy is a woman who has burning, itching, or swelling in or near her vagina after sexual intimacy has started, AND also has some food allergies," says David Bernstein. "The dead-bang give away to seminal fluid hypersensitivity is when she has zero symptoms after sex with a condom."

In some cases, afflicted women report the start of pesky post-coital symptoms after their very first sexual experience.

So far, there are no actual deaths on record from this condition. However, an afflicted women could conceivably die if anaphylactic shock caused her air pathways to swell up and block completely.

"The condition is so new that it's very possible a family practitioner or even a gynecologist would not be familiar with it," says David Bernstein. "It's also very likely the conditioned is under-reported by both patients and physicians."

In another case, a 30-year-old women went to her doctor because she was having painful burning and tingling in and around her vagina immediately after intercourse. The symptoms then lasted for about six hours. Moreover, several love-making sessions caused her face to swell. But, again, the woman told her doctor there were no symptoms at all when her husband used a condom.

Both that patient and the 26-year-old woman saw an allergist. Through a skin reactivity test, they discovered that were indeed allergic to their husband's seminal fluid. Researchers haven't yet identified the troublesome culprit, but they think that certain proteins in the seminal fluid cause the reaction.

Once the hypersensitivity is diagnosed, partners are called on to do more than just use a condom. Treatment involves injecting the women regularly with their partner's purified seminal proteins. The Bernsteins report a 100% success rate among their patients.

For the initial diagnostic screening, only a single sample of the male's ejaculate is needed. But then the allergist needs five to seven days worth of ejaculate in order to have the volume to formulate enough vaccine for regular injections.

One of the couples went through all the trouble of having the puzzling, painful symtoms diagnosed as sexual allergy. They then worked out a treatment plan, only to discover yet another dimension of human seminal plasma hypersensitivity.

Says Jonathan Bernstein: "When we start giving the woman injections, and she and her partner stop having sex, she can lose her tolerance to his seminal plasma." In other words, couples must continue to have regular intercourse or the bothersome symptoms will return.

This created some logistic difficulties for the 26-year old woman. Because her husband was an airline pilot who was out of town frequently, she was at a loss as to how they would continue their "treatments".

Dr. Bernstein to the rescue. "We tell our patients that if they must be apart for some weeks, the male can leave several samples of ejaculate and the woman can then inject a small amount into the vagina. That will keeps the woman's tolerance up."

In this case, a man's work is never done...

Resources

Bernstein J, Sugumaran R, Bernstein D, Bernstein IL. "Prevalence of human seminal plasma hypersensitivity among symptomatic women." Annals of Allergy, Asthma & Immunology. 1997;78:54-8

Bernstein J, Herd ZA, Bernstein D, Dorbee SI, Bernstein IL. "Evaluation and Treatment of Localized Vaginal Immunoglobulin E-Mediated Hypersensitivity to Human Seminal Plasma." Obstetrics & Gynecology, 1993;82:667-73

Last reviewed March 1997 by Medical Review Board