Rare and often misdiagnosed, an allergic reaction to semen can make even just the thought of having sex quite uncomfortable. For women with severe human seminal plasma hypersensitivity (HSP) or sperm allergy, unprotected sex can even lead to a life-threatening situation.

The condition mostly affects women, but there are also cases of men being allergic to their own semen. When the flareup starts, what symptoms appear, and how long it lasts all vary from one individual to another. Keep reading to learn more about sperm allergy and what you can do about it.

Causes and Symptoms

The culprit is a protein. Certain proteins found in human semen causes an allergic reaction. Experts believe that a prostate-specific antigen acts as the major allergen, with other proteins found in the seminal fluid also playing a role.

Many women who have sperm allergy experienced the symptoms as early as right after their first-ever unprotected sex. Some women have described their symptoms as post-coital asthma or post-sex itching, not knowing that these are already symptoms of sperm allergy.

Sperm allergy can occur with only one specific sexual partner. There are also instances when it happens suddenly with a long-term partner. Other women suddenly experience an allergic reaction to semen with a new partner even when they never showed any symptoms of sperm allergy with previous sexual partners.

Depending on the woman’s allergic reaction, the symptoms may appear right after exposure to semen. There have been reports of women experiencing symptoms within 5 minutes after exposure to semen.

On average, however, experts believe that it takes about 20-30 minutes before symptoms show, and they can be localized or limited just in the vaginal area or whichever part of the body had physical contact with the seminal fluid.

Women with severe allergies to semen tend to experience systemic allergic reactions, which means that the symptoms affect not only their vaginal area but the entire body.

What is often misdiagnosed as post-coital asthma is actually already part of the systemic allergic reaction.

For people with allergies, anaphylaxis is probably the most frightening of all allergic reactions. Just like any other types of allergies, sperm allergy can also cause anaphylaxis, which can be life-threatening if not treated promptly.

Lightheadedness, vomiting, low blood pressure, an itchy rash, and shortness of breath are all common symptoms of anaphylaxis. When you’re wheezing and short of breath after having unprotected sex, you may think that it’s just post-coital asthma, but it’s already anaphylaxis.

Anaphylaxis due to sperm allergy is most dangerous when it causes the tongue or the throat to swell. A swollen throat causes constriction in the airway. This means that when your tongue or throat has become swollen, it will be extremely difficult for you to breath.

When Do the Symptoms Disappear?

Even with treatment, sperm allergy symptoms may still last for a few hours. In some cases, it takes days before the symptoms clear up. Antihistamines can help reduce some of the symptoms, but the itching, redness, and swelling in the vaginal area may persist for a day or two before subsiding.

For those whose allergic reactions are severe, an epinephrine injection can take care of the more serious symptoms such as swollen throat or tongue, but it’s best to take the patient to the hospital until all the other symptoms go away.

Treatment Options

Diagnosing human seminal plasma hypersensitivity can be done through skin prick testing. The simplest way to determine if the allergy is caused by semen exposure is by using a condom prophylactic during sex.

If the symptoms don’t appear when you wear protection but start showing up again when you don’t use a condom, then most likely the allergy is caused by exposure to semen. Hence, if you and your partner have no plans of getting pregnant anytime soon, you can manage sperm allergy simply by wearing protection every time you have sex.

However, using a condom wouldn’t be enough to treat the problem if the couple wishes to have a child. In such situations, doctors may recommend either subcutaneous desensitization or an intravaginal graded challenge.

Either treatment option requires exposure to semen, which means that the symptoms may appear during treatment. With subcutaneous desensitization, a small drop of a diluted or fractionated semen sample is placed on the skin. The skin is then pricked or scratched. This is repeatedly done with an interval of several days or so until there’s no more allergic reaction.

An intravaginal graded challenge, on the one hand, involves the placement of diluted semen inside the vagina. The first exposure will make use of an extremely diluted semen sample. After 15-30 minutes, the doctor will use a less diluted semen sample. The process is repeated and, eventually, the undiluted sample of the partner’s semen will be placed inside the woman’s vagina.

Both subcutaneous desensitization and intravaginal graded challenge aim to increase the patient’s tolerance for the partner’s semen. After the desensitization treatment, doctors usually advise their patients to engage in sex as frequently as every day or two so as to maintain the desensitized state.

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