Sat | Feb 23, 2019

Dear Doc | My Girlfriend is allergic to sperm

Published:Sunday | January 27, 2019 | 12:26 AM

Q. Dear Doc, I have a concern about me and my girlfriend. We have been together for some time now and I feel we can stop using condoms, but every time I bring it up, she gets upset. This is because from we started dating, she told me she was allergic to sperm. I thought it was just what she said to make sure I always used a condom, but now after all this time, she still claiming so, and gets upset whenever I bring up going bareback.

I never hear this yet!

Is this really something? And how can I work around it?

 

A. This is actually a very real thing, and your girlfriend likely is not making it up as you may think. It is not very common, and also not well studied or discussed due to embarrassment with the situation, as well as misdiagnoses being made for other vaginal conditions.

Semen contains sperm as well as other components including proteins. When a woman has a 'sperm allergy', it refers to allergic reactions to the proteins in the semen and it usually occurs as either a systemic (all over the body) reaction or a localised (vaginal) reaction. The reaction happens either during or after sexual intercourse, and both types of allergic reactions are prevented by condom use.

Systemic reactions typically begin within minutes after ejaculation. Initial symptoms commonly include vulval and vaginal itching and/or swelling, followed by generalised itching to the body, nasal obstruction, itchy eyes, and/or swelling to the face, lips, tongue and throat.

Life-threatening systemic reactions with profound hypotension (low blood pressure) and cardiovascular collapse requiring emergency treatment, has been reported, but are very few and uncommon.

Localised reactions are essentially vaginal reactions to semen, and appears as vulval and vaginal pain, itching, burning and swelling. These signs and symptoms can occur either immediately after ejaculation or can be delayed and appears minutes to hours after semen contact. The vulval and vaginal discomfort can last for several days.

An important point to note however, is that allergic symptoms from oral semen contact, have not yet been reported.

In majority of patients, symptoms arise within the first 30 minutes of semen contact, and symptoms usually resolve within 24 hours, although some symptoms, such as the vaginal pain, itching and discomfort lingers for days to weeks.

Couples usually have great anxiety, and raise much concern about their ability to conceive, however, this is usually not a problem if the condition is managed effectively.

Management options include condom use, prophylactic (preventative) medications taken before intercourse, and various types of desensitisation therapy.

Coitus interruptus (the pull out method) is another possible strategy, however, most couples find this impractical.

The use of prophylactic antihistamines, has been effective in preventing mild reactions when premedication with antihistamines is done.

It is important to emphasise for your girlfriend’s sake, that ALL types of reactions are prevented by the use of condoms.

Patients are warned that intercourse without condoms can lead to more severe reactions.

Whenever you both decide you are ready to have a child, you will need to visit your doctor to discuss your options.

'Stoppage of water'

Q. Dear doc, I’m having an issue and not sure if I really have to go to a doctor for it. I've been suffering with stoppage of water for some time now. I stop lift up heavy things cause they say is that was causing it, but it still not getting better. Do I need a medication to fix it or I should give it some more time to get better?

A. What you are calling stoppage of water is caused by what is medically called  "Benign prostatic hyperplasia (BPH)”, which simply put is an enlarged prostate. The prostate is a gland that surrounds the urethra (the tube that drains urine from the bladder through the penis). With age, the gland gets bigger, which causes squeezing of the urethra, making it more difficult to pass urine; hence the term, 'stoppage of water'.

BPH is a common problem and has nothing to do with prostate cancer. Men with BPH can have no symptoms at all, or the following:

- Passing urine often, especially at night
- Difficulty starting to urinate, often needing to strain before any urine will     come out
- Having a weak flow of urine
- Leaking or dribbling of urine
- Feeling as if your bladder is not empty even after urinating

In severe cases, some men are unable to pass urine at all. This is a serious problem, and if it occurs, you should see your doctor immediately!

You might be able to improve your BPH symptoms by:

- Reducing the amount of fluids you drink, especially before bedtime.
- Reducing the alcohol and caffeine you drink.

These drinks can make you urinate more often.

'Double Voiding', is what we call it when after you empty your bladder, you wait a moment, relax, and try to urinate again.

If you are having symptoms like the ones listed above, see your doctor to find out if BPH is what is actually causing them, as those same symptoms can be caused by other problems, so it is important to have them checked out. If you do have BPH, your doctor can offer you different treatment options. However, you do not have to get treated if your symptoms are not bothering you.