Question:
Ever since my partner and I have been having unprotected sex, I have been having a severe reaction straight after he ejaculates in me. It happens almost immediately with swelling internally and externally, burning, and pain for at least the next two hours. If I wash myself quickly sometimes this can help but if I'm too late then the pain continues. Recently I went to the doctor and the possibilities were "thrush, acidity or allergy". I was positive for thrush and commenced treatment. I reacted to the 7 day treatment of miconazole nitrate 2% in a very similar way to the semen. It also made the thrush ten times worse. The same occurred with clotrimazole once only cream and with Nystatin 100,000 i.u 14 day treatment cream (which I stopped at day 4) and then I tried the once tablet fluconazole 150mg which I developed a dry taste in my mouth and then a metal taste and severe abdominal cramping. All these side effects lasted for two weeks at a time. The thrush finally cleared with the tablet.
After having sex again the problem was still there. I then tried taking fexofenadine hydrochloride 180mg tablet half an hour before sex and this reduced the pain from 7/10 compared to 10/10 but the problem was still there. With the acidity part we both tried drinking only water, this didn't change anything. I'm getting married in November and I'm worried. Is there anything we can do? What tests can we get done to determine if I have an allergy to semen? Should I get a referral to a gynecologist? and how can I stop the pain? and if I get thrush again what options do I have left? C. from Australia
Answer:
Hello C. from Australia,
It is not very common but women can develop an allergy to semen, since it is a protein (medically known as "seminal plasma hypersensitivity"). It is a difficult problem to treat. Basically, you need to use a condom to avoid the contact with the semen. Sometimes, if enough time passes without contact with the semen, the allergy will resolve. Fungal infections (yeast infection) are the most common vaginal infections that women can have. You should be cultured for other bacteria as well to make sure that the symptoms you are having are NOT due to a different type of bacterial infection, and was due to the yeast. I am surprised that you had such a reaction to each of the vaginal medications used. That makes me think that there is something else going on and not a yeast infection. It is also possible that with all the inflammation your vagina is going through, it just has not had any time to heal.
So, I would recommend a natural treatment for the prevention of yeast, which is to use plain yogurt, mix it in a douche bottle (buy a douching kit from the store but DON"T use the vinegar solution given) with half/half water. Then use this to irrigate the vagina 2-3 times per week. This will increase the vaginal bacteria called lactobacillus, which will help to prevent yeast infections.
I would also recommend that you try intercourse with a condom and see if you get any type of vaginal irritation or reaction (unfortunately, when you will eventually try to get pregnant this method will be counter-productive). If you don't, then it is most likely that you have a semen allergy. If you do, then it is unlikely that you have a semen allergy but have something else going on. You should then make sure that your gynecologist does a vaginal culture. If it does look like you have an allergy to semen (the symptoms only occur with ejaculation in the vagina), then you may have to see an allergist to see if there is a way to desensitize you to your husband's semen. Your husband should also see a Urologist to have the semen checked and make sure that it is the correct pH. If it is not, and is more acidic, he may have something going on that needs treatment. It usually is best to see a male fertility specialist rather than a general urologist but there aren't very many so that may be harder. You may also need to be placed on a antihistamine and vaginal steroid to be taken before intercourse to reduce the inflammatory/allergic reaction.
If and when you decide to try to have children, and you do indeed have severe seminal plasma hypersensitivity, then you may have to resort to intra-uterine insemination or IVF. Going this route will allow the semen to be washed free of semen proteins making pregnancy possible by preventing an allergic reaction.
Sorry I can't give more specific information. I hope this will give you some guidance.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
http://www.montereybayivf.com/
Monterey, California, U.S.A.
Comment: Thank you so much for your reply. It is slowly becoming more clearer to me in how to go forward with my allergy to semen. In reply to your note, I do not get any symptoms of irritation when using a condom. I can find some relief in this method at least. And I'm glad to hear of a way to prevent the thrush. Your information has been in depth and very helpful.
