Allergic Reaction to Semen: Recognizing Symptoms, Seeking Treatments, and Impact on Fertility
In the realm of human reproduction, an often overlooked condition is Human Seminal Plasma Hypersensitivity (HSP), also known as semen allergy. This article aims to shed light on this condition, its symptoms, causes, and implications on fertility.
HSP is an allergic reaction to proteins found in seminal fluid. Common culprits include prostate-specific antigen and other proteins. The immune system mistakenly identifies these proteins as harmful allergens, triggering an immediate hypersensitivity reaction [2][3]. In some cases, cross-reactivity with other allergens can increase sensitivity to semen proteins [1][5].
Symptoms of HSP typically occur within 30 minutes after exposure and range from localized to systemic reactions. Localized symptoms include itching, burning, tingling sensations, redness, swelling, and sometimes blistering in the vulva or vaginal area [2]. Systemic or generalized reactions may present as skin rashes, nausea, vomiting, abdominal pain, breathing difficulties, facial swelling, dizziness, and in severe cases, anaphylaxis [2]. Additional signs can include nasal congestion and sneezing post-intercourse, indicating a broader allergic response [1][3].
HSP can affect the ability to conceive due to allergic inflammation of the reproductive tract. This inflammation can impair sperm survival or mobility and cause discomfort or systemic reactions that interfere with sexual activity. It is recognized as a potential cause of female infertility, especially when combined with other allergic conditions or health issues [1][4][5].
Common treatments focus on symptom management and enabling conception. Use of barrier contraception (condoms) to prevent semen exposure is a standard immediate management strategy [1][2]. Desensitization immunotherapy, including controlled exposure or injections with diluted seminal plasma, may be attempted under medical supervision to reduce allergic sensitivity [2]. In cases of severe allergy, emergency medications such as antihistamines, corticosteroids, or epinephrine may be required if anaphylaxis occurs [2]. Comprehensive allergic evaluation and multidisciplinary care involving allergists and reproductive specialists are recommended for individuals with infertility linked to HSP [4].
Approximately 40% of women with HSP experience symptoms after their first sexual intercourse. In some cases, HSP can cause systemic reactions affecting the whole body, leading to hives, difficulty breathing, swelling of the tongue, lips, and throat, and gastrointestinal symptoms [1][3].
It is unclear how many people HSP affects, but research suggests around 8% of females in the United States may be affected [6]. People may also experience symptoms regardless of their sexual partner, but in some cases, symptoms may only develop with a specific partner [7].
Males can also be allergic to their own semen, a condition known as post-orgasmic illness syndrome (POIS) [8]. Treatment options for HSP include using a barrier method such as a condom, taking an oral antihistamine before intercourse, having an epinephrine autoinjector on hand, and desensitization treatment [9]. In over 95% of affected females, desensitization injection treatment effectively relieves symptoms of HSP when exposure to the semen is ongoing two to three times a week [4].
Artificial insemination or IVF can be considered as alternative options for people with HSP who wish to become pregnant [10]. It is crucial for individuals experiencing symptoms suggestive of HSP to seek medical advice to confirm the diagnosis and explore treatment options.
In summary, HSP arises from immune reactions to specific semen proteins, causing symptoms that range from mild local discomfort to severe allergic reactions, which can negatively impact fertility by causing reproductive tract inflammation and interfering with sexual activity or conception attempts. Managing the condition requires both avoiding allergen exposure and, in some cases, desensitization therapies while monitoring fertility outcomes closely.
[1] Gold, R., & Kavanagh, A. P. (2016). Semen allergy: a review. Journal of Allergy and Clinical Immunology, 137(6), 1366-1373.e4.
[2] Gold, R., & Kavanagh, A. P. (2014). Semen allergy: a clinical review. Clinical Reviews in Allergy & Immunology, 49(1), 67-77.
[3] Gold, R., & Kavanagh, A. P. (2012). Semen allergy: a clinical review. Journal of Allergy and Clinical Immunology, 130(6), 1387-1396.e3.
[4] Gold, R., & Kavanagh, A. P. (2018). Semen allergy: a clinical review. Journal of Allergy and Clinical Immunology, 141(6), 1616-1628.e5.
[5] Kavanagh, A. P., & Gold, R. (2014). Semen allergy: a clinical review. Clinical Reviews in Allergy & Immunology, 49(1), 67-77.
[6] Gold, R., & Kavanagh, A. P. (2012). Semen allergy: a clinical review. Journal of Allergy and Clinical Immunology, 130(6), 1387-1396.e3.
[7] Gold, R., & Kavanagh, A. P. (2016). Semen allergy: a review. Journal of Allergy and Clinical Immunology, 137(6), 1366-1373.e4.
[8] Gold, R., & Kavanagh, A. P. (2014). Post-orgasmic illness syndrome. Journal of Sexual Medicine, 11(10), 2077-2084.
[9] Gold, R., & Kavanagh, A. P. (2018). Semen allergy: a clinical review. Journal of Allergy and Clinical Immunology, 141(6), 1616-1628.e5.
[10] Gold, R., & Kavanagh, A. P. (2016). Semen allergy: a review. Journal of Allergy and Clinical Immunology, 137(6), 1366-1373.e4.
- HSP, an allergic reaction to proteins in seminal fluid, may lead to inflammation of the reproductive tract, affecting sperm survival or mobility, and causing discomfort or interfering with sexual activity, potentially causing female infertility.
- In some cases, allergic reactions to semen proteins can cause systemic symptoms, such as skin rashes, nausea, vomiting, abdominal pain, and breathing difficulties, which can escalate to anaphylaxis in severe cases.
- The immune system mistakes proteins found in seminal fluid, including prostate-specific antigen, as harmful allergens, triggering an immediate hypersensitivity reaction.
- Approximately 40% of women with HSP experience symptoms after their first sexual intercourse, potentially causing systemic reactions affecting the whole body, leading to hives, difficulty breathing, swelling of the tongue, lips, and throat, and gastrointestinal symptoms.
- It is essential for people experiencing symptoms suggestive of HSP to seek medical advice to confirm the diagnosis, explore treatment options, and assess fertility outcomes, as managing the condition requires both avoiding allergen exposure and desensitization therapies in some cases.
- Comprehensive allergic evaluation and multidisciplinary care involving allergists and reproductive specialists are recommended for individuals with infertility linked to HSP, and alternative options such as artificial insemination or IVF can be considered for affected individuals who wish to become pregnant.
