Women can be allergic to semen and other substances in the seminal fluid of their partner, according to information presented at an annual meeting of medical professionals. Symptoms could include vaginal itching, burning and other symptoms after intercourse. Paradoxically, for some, having more frequent sex can be part of the treatment.
Highlights of gender-related research presented at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) include:
• Although it is not known how many women may be allergic to their partner’s semen, immunotherapy treatments may overcome the problem, provided the couple continues to have sexual intercourse regularly.
• In some cases, substances such as certain medications and foods, may cause allergic reactions when transmitted through seminal fluid.
• Women with asthma display a different pattern of disease than their male counterparts, and they may be particularly susceptible during puberty, menstruation and menopause. In adulthood, women are twice as likely as men to have asthma, and they are 42 percent more likely to die of the disease.
• Laboratory experiments suggest that estrogen may play a positive role in preventing or controlling lung diseases, such as acute respiratory disease syndrome (ARDS) and asthma.
“We are learning that there are significant differences between men and women when it comes to asthma and the other allergic diseases,” said Nancy K. Ostrom, M.D., Allergy and Asthma Medical Group and Research Center, San Diego, Calif., and moderator of the plenary session. “We as professionals must pay particular attention to gender differences in order to improve diagnosis and treatment of asthma and the other allergic diseases.”
Women and Semen Allergy
While the prevalence of semen allergy is not known, the condition does exist and should be considered as a possible diagnosis for women who report symptoms that occur shortly after intercourse. Symptoms may include itching, burning and swelling in the genital area. In the most severe cases, hives or swelling may appear elsewhere on the body and the woman may experience difficulty breathing.
“Typically symptoms occur within 30 minutes of intercourse, but in rare cases it may be hours or even days later,” said David J. Resnick, M.D., acting director, division of allergy, the New York Presbyterian Hospital, New York City.
Semen allergy is particularly suspected if symptoms go away with condom use or abstinence, he said.
In one study of 1,073 women who sought information from a researcher on semen allergy concerning their vaginal symptoms, 130, or approximately 13 percent, were determined to have semen allergy, according to Dr. Resnick.
“Although reports of the condition in the scientific literature are relatively rare, there may be women with semen allergy who go undiagnosed because their symptoms are mild or they routinely use condoms,” he said. There also are cases of women who have had allergic reactions to allergens transmitted through the seminal fluid, including the medications vinblastine, penicillin and thioridazine and some food and beverages, including walnuts and Coca-Cola.
Treatment for Semen Allergy
Patients with semen allergy should be provided with a self-injectable epinephrine kit in the event of a severe reaction. Epinephrine (adrenaline) is the first-line treatment for severe allergic reactions. In addition, there are two immunotherapy options, a technique designed to desensitize the immune system to a particular allergen:
• Intravaginal Seminal Graded Challenge (ISGC). In this technique, semen samples are placed into the vagina every 20 minutes, beginning with highly diluted samples and gradually increasing the concentration. The technique, which is performed over a few hours, must be followed by frequent sexual contact (two to three times per week) to maintain the woman’s desensitization to semen.
“Treatment failure is associated with couples who do not engage in frequent intercourse that re-exposes the patient to the allergen,” Dr. Resnick said. “Patients not living near their partners can refrigerate or freeze specimens so they can continue frequent exposure.”
• When ISGC is unsuccessful, allergy shots have been used in some cases. This procedure involves injecting a small amount of semen under the skin at regular intervals over the course of several weeks, in a manner similar to the allergy shots used to treat allergic rhinitis and asthma. As with ISGC, patients must continue unprotected intercourse two to three times per week to maintain immunity.
All immunotherapy treatments should be performed in a facility equipped to treat a patient who may experience anaphylactic shock – a severe, system-wide reaction to the allergen that can be deadly.
According to Dr. Resnick, approximately 50 percent of women with semen allergy have other allergic diseases, such as skin allergy and allergic rhinitis (so-called “hay fever”). Most women are between age 20 and 30, and 41 percent experience symptoms with their first sexual intercourse. “In most cases, symptoms gradually worsen and occur sooner with subsequent exposures,” he said.
Semen allergy is not a direct cause of infertility, according to Dr. Resnick. Women may conceive after successfully undergoing immunotherapy, or may consider artificial insemination with “washed” sperm. In vitro fertilization also is an option.
In some women, the reaction occurs with one partner while others are allergic to all partners, he said. There are also reported cases where women have “outgrown” the allergy without treatment.
Women and Asthma
In another study, researchers reported significant gender differences in the prevalence of asthma that may be related to fluctuations in sex hormones:
• Before puberty, boys are twice as likely to have asthma as girls.
• By the mid- to late-teen years, females are as likely, or more likely, than males to have asthma. In adulthood, women are twice as likely to have the disease.
• Women are hospitalized and use other medical services more often than men.
“One possible explanation may be differences in sex hormones, although our study did not specifically look at this connection,” said D.W. Cockcroft, M.D., professor, department of medicine, University of Saskatchewan/Royal University Hospital, Canada. “The theory is bolstered by data that suggest asthma worsens during puberty, menstruation and menopause in women,” he said.
In addition to fluctuations in sex hormones, reasons for differences in the incidence of asthma in women and its severity may include obesity, depression, failure to take medications as prescribed and smoking, according to a review published earlier this year in the Annals of Allergy, Asthma and Immunology.
“Successful asthma management requires an ongoing partnership between the patient and her physician, adherence to national guideline recommendations for treating asthma, patient education and action plans,” Dr. Ostrom, author of the study, said. “It is particularly important that asthma be managed aggressively in pregnant women because, when uncontrolled, it can lead to birth complications.”
According to Dr. Ostrom, approximately one-third of women experience improvement in asthma symptoms during pregnancy, one-third have worsening symptoms and one-third experience no change.
Women also are more likely to die of the disease. In 2001, 65 percent of the more than 4,200 asthma-related deaths in the U.S. occurred in women, and African-American women were at highest risk. The risk may be greatest during premenstrual and menstrual periods, she said.
Estrogen May Protect Against Lung Disease, Asthma
Despite recent publicity on the potential adverse effects of estrogen therapy, it may play a positive role in protecting women against asthma and acute lung diseases such as ARDS.
In laboratory studies, rats that were given lung-injuring agents were less likely to suffer injury or had milder symptoms when estrogen supplements were administered at the same time, according to Sami I. Said, M.D., professor of medicine, division of pulmonary and critical care, State University of New York, Stony Brook.
“Since these are animal studies, we must be careful not to assume that similar effects will be seen in humans,” Dr. Said said. “Nonetheless, most breakthroughs in medical science begin with animal research and the association between estrogen and protection of the lung definitely merits further research.”