Introduction

We present a young couple with human seminal plasma allergy (HSPA) consistent with vaginal burning sensation upon contact with semen reported by the female partner. An easy solution is proposed.

Case presentation

A couple in their late twenties turned to the clinic because the female partner had vaginal burning sensation upon contact with semen starting from their first intercourse three years earlier. She did not suffer from this problem with former partners. The male partner did not suffer from pain upon ejaculation or urination, and reported having a similar problem with one past partner. The couple had been using condoms and extra-vaginal ejaculation to overcome this problem, but was unhappy with these methods. In addition, they were planning their first pregnancy and were concerned as to how to proceed. The female partner went through gynecological examinations with no evidence of disease or anatomical pathology. The male partner was sent to a STD clinic where he was tested for venereal diseases, semen culture and pH. All came back normal.

Both male and female partners had no history of food allergy, drug allergy, or other allergies. Still, HSPA was suspected. The couple was instructed to use an over the counter antihistamine gel (Dimethindene maleate) intra-vaginally prior to intercourse. Two months later, the couple reported few or no symptoms at all upon contact with semen. The gel was most effective when used intra-vaginally 20 minutes prior to intercourse. When the gel was used on the male partner just prior to intercourse there was a reduction in symptom level, but the female partner still reported a slight burning sensation upon contact with semen. A few months later, they conceived naturally.

Discussion

Semen allergy, also known as sperm allergy, or HSPA, is a rare phenomenon reported 80 times in medical literature until 2004 [1]. It is thought to be caused by IgE-mediated sensitization to proteins in the seminal fluid [2]. Symptoms range between local vaginal pruritus and life-threatening anaphylaxis. Treatment for HSPA is usually use of condoms [1]. Desensitization, i.e., immunotherapy via injections of seminal plasma proteins, is used in rare cases [3]. In couples trying to conceive, intrauterine insemination may be advised [4]. We have decided to try something different: an antihistamine gel. Naturally this method should be tried on more couples, but as the basic pathology is a localized allergic reaction, it makes sense that the solution can be as simple as an antihistamine gel applied locally.