SEMEN ALLERGY: A BIZARRE FORM OF ALLERGY
Allergy doctors always we say that a person can be allergic to anything with which it comes in contact, and it's totally true.
Pollen, dust mites, food or insect bites are causes of allergic reactions; but sometimes our body also reacts to "ingredients" of sexual life, as if they were foreign and dangerous, triggering a response closer to "reject" that the planned "desire".
Sperm or semen allergy is not common but there are increasing cases published. Recent research refers to two important facts: the relationship with dog allergy and its likely involvement as a cause of infertility. Consequently, some questions arise at this point:
How does it manifest semen allergy?
Can cause infertility? Is there a solution?
What to do with dog allergy?
If I am allergic to dog also means that I am to the semen?
Some basics before you start entering the field:
Semen produced in the male genital apparatus comprises sperm (<10%) coming from the testis and seminal fluid (> 90%) coming from the prostate gland and seminal vesicles.
The seminal fluid is responsible for nurturing and transport spermatozoids (sperm). This is achieved because the amount of substances that composes it (vitamins, sugars, proteins, electrolytes, cholesterol, hormones ...).
One of the contraceptive methods used is vasectomy, it is cut and ligated the ducts through which the testicles release sperm. As a result of this operation ejaculated semen does not contain sperm, but it contains the rest of seminal fluid.
Once reviewed these concepts will explain the most important features of this exceptional allergy:
• Although not a common allergy is thought that there are probably more women affected than the statistics show. It is possible that many women have "local discomfort" that relate to sexual activity and do not think that may be due to an allergy, so do not go to the doctor. Also, the symptoms can be easily confused with other disorders such as itching or irritation caused by fungi, parasites or bacteria.
• Most women tend to be around 30-40 years and have an atopic background with personal or family history of asthma, allergic rhino-conjunctivitis and atopic dermatitis. The changes after pregnancy, gynecological surgery or devices like the IUD could alter local immunity and predispose to this allergy. Vasectomy in men could also modify the characteristics of seminal fluid and make it more allergenic.
• The substance responsible for this allergy is a protein, is present in the seminal fluid and is known as PSA (Prostate-Specific Antigen). PSA is produced in the prostate in order to liquefy the semen for sperm to mobilize freely. It is also believed to be useful for coating dissolved woman's cervical mucus, allowing the sperm entry. In men with prostate problems (tumors, prostatitis) measurement used his blood to complement the diagnosis and monitoring, since a small part of this PSA can pass into the bloodstream.
• Symptoms occur during or immediately after intercourse (first time) and if you continue having sex almost probably the clinical onset will start earlier and will have more severe symptoms. Naturally never occur in cases where it is used a preservative (condom) which prevents contact with the semen.
• The usually mild local reactions consist of signs and symptoms such as itching, burning, redness, swelling or edema in the vulvovaginal area that has been in contact with semen. Other general symptoms are difficulty breathing, abdominal pain, vomiting, urticaria, and edema and may even cause anaphylactic shock.
• The diagnosis has to be done very carefully. The clinical history is critical (immediate symptoms after sexual intercourse and full resolution picture if you use a condom). To confirm the skin test is used directly with the seminal fluid of the couple involved and the analytical determination of specific IgE blood against seminal fluid. Both tests are positive.
• In the event that the woman is allergic to a food or a drug, we have to rule out that the sexual partner had previously consumed and which can be removed through semen and make you an allergic reaction.
• Once it is diagnosed, the only way to prevent a reaction is by using condoms.
• The treatment in case of a mild reaction are antihistamines, and if severe (anaphylaxis) self-injectable epinephrine (adrenaline). Some patients have been able to reach long-term desensitization with subcutaneous immunotherapy or local intravaginal seminal fluid.
• Infertility could not be directly related to this type of allergy, and more studies are needed to confirm this. Yes it is known that there is a greater difficulty conceiving because they need sex always with condoms to prevent allergy symptoms. To solve the problems of reproduction, to couples who want to have children are made artificial insemination with washed sperm, that is free of seminal fluid and thus free of allergy.
• One point remains to be clarified in this allergic disease is whether the clinical manifestations appear only after having sex with the same partner or appear with different sexual partners. Due to the strictest privacy of patients this aspect is quite difficult to clarify.
Okay, all this is fine, we have clear concepts of semen allergy and involvement of PSA presents in the seminal fluid as the main culprit, but: what has to do with the dog allergy?
In 2008, Dr Basagaña, from the University Hospital of Girona, in the North-East of Spain, and his team published a worldwide pioneering study in a prestigious research journal of Allergy (J Allergy Clin Immunol 2008, 121: 233-9), which found that women with dog allergy also could be allergic to the seminal fluid. This is because the proteins involved in the two allergies are very similar and the body can get confused, is what we call cross-reactions.
When a person is allergic to the dog, which is a protein found in the epithelial cells of the animal (e.g., dandruff, hair). The latest advances in molecular diagnostics have managed to find five proteins that are involved in total, of these five proteins is the fifth (Can f5) which is substantially similar to the PSA responsible for semen allergy. This Can f5 is produced exclusively in the prostate of male dogs.
Allergic people to dogs can be allergic to one of these five proteins or several of them. Women in the dog allergic protein in which is responsible Can f5 (similar to PSA) may develop an allergy to semen due to a cross-reaction with the PSA.
Note that this protein is present only in male dogs and not females. This could explain why some people just "notice allergy with other dogs but not yours." If your dog is female and only have protein allergy Can f5, perfectly tolerate any dog that is not male.
I admit that even I have looked in consultation with disbelief and skepticism to a patient who after diagnosing a dog allergy he told me the typical phrase "But, I am sure I am not allergic to my dog!"
• The semen allergy exists and is produced by a protein produced by prostate (PSA) and present in the seminal fluid.
• It is not clear if semen allergy is the cause of infertility problems. For couples with this type of allergy, it is possible they can conceive a child by means of artificial insemination with washed sperm (no seminal fluid).
• Some women with dog allergy, not all are to a protein, Can f5, produced in the prostate of male dogs and very similar to human PSA. These women may develop an allergy to semen due to a cross-reaction between the two proteins (PSA and Can f5).
• Dog allergic patients depending upon the proteins involved in allergy can be differently sensitive to male and female dogs.
In forthcoming entries I will write the second installment of the trilogy on sexuality and allergy: "Allergy and contraception: hormones, IUDs, condoms, spermicides". Among other things I will show the wide variety of allergies that can be found in the world of condoms (touch, smell, taste).