Allergic to Spunk

For about two years in high school, I would occasionally break out into pretty severe hives. I would first notice a mild itch on my wrists or ankles, and I would know that the hives were coming if I gently scratched my forearm and raised red streaks were left behind (I have a picture somewhere of a large inflamed smiley face I drew on my chest during one of these episodes). A dose or two fo Benedryl would completely knock the hives down, but left untreated, they would spread over my entire body. It was almost certainly an allergic reaction, but despite a battery of tests at an allergist’s office, I never did learn what the offender was. These hives weren’t pleasant, but in truth, I’m pretty fortunate when it comes to allergies.

allergy
(Source – sorry I resorted to the LOLcats, but as you’ll see, most potential images for this story would be decidedly NSFW)

Fifty million other Americans aren’t so lucky*. From relatively benign** seasonal allergies, to life threatening food allergies, humans can be allergic to just about any foreign molecule and allergies of all sorts are on the rise. On twitter the other day, Christie Wilcox mentioned that a friend that was curious about a rarely talked about, though surprisingly common allergy: Seminal Plasma Protein Allergy (SPPA). Also known as being allergic to sperm.


Actually, “sperm allergy” isn’t quite right. Semen can be divided into two components: The sperm themselves are specialized cells that carry a half-compliment of genetica material, but they swim in seminal fluid (mostly secreted by the prostate gland), and it’s proteins in this fluid that causes the allergy. The only recorded cases I could find were women, but this makes perfect sense. Allergies are directed at foreign substances, and seminal fluid is hardly foreign to us males.

Like most allergies, SPPA is thought to be caused by the production of specialized antibodies called IgE. Instead of floating around in the blood looking for a target, IgE gets picked up and held on the surface of mast cells. Mast cells are filled with nasty chemicals like histamines and inflammation-inducing cytokines, and are programed to spew out massive quantities when they see a foreign particle through their bound IgE. When directed against worms and other parasites, this is great, but when mast cells flip out over pollen or peanuts, misery ensues. The severity of documented semen allergy runs the gamut from mild itching and burning after sex to life-threatening systemic (whole-body) allergic reactions, including extreme fatigue, hives, shortness of breath and vomiting.

But it’s hard to get good numbers on just how common this allergy is. This review from 2004 calls it a “rare phenomenon” in the title and only found 80 reported cases in the medical literature. However, a different review noted:

The incidence of human semen allergy is probably higher than reported because of lack of recognition in the medical community and underreporting by patients.

They mentioned a paper from 1997 with possibly the greatest author list ever (Bernstein, Sugumaran, Bernstein and Bernstein) managed to find 130 women with “probable” SPPA in a single study. The many Bernsteins gave questionnaires to about a thousand women with symptoms consistant with SPPA, and determined that about 25% had “possible” SPPA and 12% had “probable” SPPA – the criteria for the latter group was the ability to completely eliminate the symptoms by using a condom.

That’s the good news for sufferers – the most effective treatment (condoms) is incredibly easy***. The bad news comes if a woman wants to get pregnant. Even if the symptoms aren’t that severe, the resulting inflammation can make conception nearly impossible. There’s been some success with desensitization – small injections of the offending substance in controlled environments can make the body figure out that the allergen isn’t a threat – but this doesn’t work in all cases. Thankfully, it seems that in vitro fertilization can be effective for couples that want to conceive, but this is just one more example where the over-exuberance of the immune system can make life miserable.

Later this week, I’ll tell you about some truly bizarre case studies I ran across while researching this post – from a woman allergic to her husband’s sweat to sexually-transmitted food allergies. Stay tuned!

—-

* Actually, I’d probably be lumped into that statistic too
** Seasonal allergies can also be debilitating for some, but for most people it’s merely an irritation.
*** Though I did find this case report of a woman with an allergy to semen AND latex. That’s just excessive.

References:
Bernstein JA, Sugumaran R, Bernstein DI, & Bernstein IL. (1997) Prevalence of human seminal plasma hypersensitivity among symptomatic women. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 78(1), 54-8. PMID: 9012622

Ludman, B. (1999) Human Seminal Plasma Protein Allergy: A Diagnosis Rarely Considered. Journal of Obstetric, Gynecologic, Neonatal Nursing, 28(4), 359-363. DOI: 10.1111/j.1552-6909.1999.tb02003.x

Resnick DJ, Hatzis DC, Kanganis P, Liccardi FL, Lee-Wong M, & Bernstein JA. (2004) The approach to conception for women with seminal plasma protein hypersensitivity. American journal of reproductive immunology (New York, N.Y. : 1989), 52(1), 42-4. PMID: 15214941

Shah, A., & Panjabi, C. (2004) Human seminal plasma allergy: a review of a rare phenomenon. Clinical Experimental Allergy, 34(6), 827-838. DOI: 10.1111/j.1365-2222.2004.01962.x

Comments

  1. #1 Jon
    July 27, 2011

    Posted on our Immunology Facebook page here: http://www.facebook.com/immunologynews

    Great article!

  2. #2 Kevin
    July 27, 2011

    Thanks :-)

  3. #3 Domestigoth
    July 27, 2011

    Sexually transmitted food allergies? That sounds both horrible and fascinating!

    I’m sure one of the major issues with under-reporting is probably just that it’s not something people are aware of. It’s an odd thing to be allergic to, and it’s not like you’re going to go around asking other women in casual conversation, “do you get itchy when your guy gets semen on you?” So even if you are someone who has a reaction to it, you might not realize that it’s abnormal unless the reaction is VERY severe. Milder cases probably just get dismissed as “oh, my skin’s just sensitive”.

  4. #4 Kevin
    July 27, 2011

    @ Domestigoth – Actually, it’s generally not a contact-hypersensitivity (ie – getting semen on the skin usually isn’t a problem). It’s mostly a problem with the internal tissues that are a little more porous.

    But otherwise, yes, it’s probably a lack-of-awareness problem. Also, I think lots of people are uncomfortable talking about medical issues around the issue of sex.

  5. #5 Arlo Hemphill
    July 27, 2011

    I’m still trying to figure out if you were somehow attributing to your teen year hives to spunk? Were you – ahem, you know, – and forgetting to wash your hands before scratching yourself? Ha!

  6. #6 Kevin
    July 27, 2011

    @ Arlo – Erm, I was worried I might give that impression :-/ but no, the problem went away, and I haven’t stopped – ahem, you know…

  7. #7 elburto
    July 28, 2011

    Thank science for non-latex condoms, for that poor woman.

    I’ve got an allergy to a certain fruit, my (also female) partner has an allergy to a different fruit in the same group. We have to avoid eating the fruit that the other is allergic to, as even if we avoid oral contact, the mutual allergies seem to cause reactions after contact with each others’ secretions.

    I think the lack of vitamin c is worth not having to go to hospital mid-shag, and explain what’s going on.

  8. #8 Kevin
    July 28, 2011

    @ Elburto – I’m writing about similar things for my next post. It’s amazing how many of these allergens can get from your gut into random secretions.

  9. #9 APic
    July 29, 2011

    There’s been some success with desensitization – small injections of the offending substance in controlled environments

    So for SPPA, what exactly are you injecting? I’m not sure i’d want that injected in a controlled environment – or anywhere else…

  10. #10 Kevin
    July 29, 2011

    @ APic – If that weirds you out, you should probably avoid the post I put up today… it involves skin-prick testing of sweat, ground up hair and semen pooled from multiple donors…

  11. #11 oneoflokis
    July 29, 2011

    I’ve heard “desensitization” is dangerous and often doesn’t work. Every so often in uk I hear about “vaccines” against eg hay fever – then the news disappears again. Only way I’ve heard of to switch off allergic response is to eat whipworm eggs!

  12. #12 Kevin
    July 29, 2011

    @ oneoflokis – there’s a lot of promise in using helminth therapy (like whipworm) for a lot of inflammatory disorders. I would say it’s not quite ready for prime-time yet, but the theoretical basis is certainly there, and there have been a number of promising clinical trials.

    I hadn’t heard about the dangers of desensitization, though if you are violently allergic to something, I suppose it makes sense. As long as it’s done in a controlled environment like a hospital though, there are a lot of interventions that doctors can take to mitigate potential problems. Definitely not something to try at home.

  13. #13 Crissa
    July 30, 2011

    I’ve had this allergy! I’ve also had cholenergic urticaria – allergic to being touched – after taking a relatively common diuretic. Personally, I only reacted this way to one manufacture of that diuretic, so I think it wasn’t actually the medicine but something in the ‘inactive’ portion of the pills.

    Although my friend (in medical school) had a story about his time as a paramedic and showing up and trying to help a man who had extreme reaction to benadryl. He said it was the most frustrating thing; nearly all of the tools in his box were useless for this guy, so they had to use physical means to stabilize until they got to the hospital.

    I think this one is probably underreported in men, because what guys want to mention this? Or even notice the correlation? And whether a reaction is big or small can change based upon external features. As a kid, I knew when flea season began because I would get rashes for a couple weeks, and then rashes went away – but that didn’t mean the fleas stopped biting me.

    Allergies are fascinating. Do you know of any studies on psychosomatic allergies? I know my friend who has peanut allergies has trouble discerning when it’s a just a panic attack, and when they need to look out to avoid taking the allergen home.

  14. #14 Kim Cannibals
    July 30, 2011

    Seriously now, have you ever heard of Hazelnut Psychosis? 30g/day for Jan-Mar then 60g/day for Apr-June then *pow*, the full 2 week story of god, creation the universe, food, and everything.

  15. #15 EcoPhysioMichelle
    July 30, 2011

    hahahaha oh my god I think I have this. :( :( :(

  16. #16 Kevin
    July 31, 2011

    @ Crissa – Which do you think is underrepoted in men? The semen allergy? It actually shouldn’t happen in men since all the proteins would be “self” proteins. If a man did get an immune response, it would probably be called “autoimmunity” rather than allergy. And the symptoms would likely be quite different – the cells that produced the protein in the prostate (alliteration not intended) would likely be destroyed without much outward symptoms, but the man might be infertile.

    @ Kim – Is that along the lines of eating massive quantities of morning glory seeds? I think if I ever want to trip, I would go with the more efficient psilocybin or LSD.

    @ Michelle – Sucks.

  17. #17 Kim Cannibals
    July 31, 2011

    @Kevin no I wasn’t trying to trip, there are easier ways than embarking on a completely undocumented 6 month regime of 140g /day then 280g /day of hazelnut chocolate (it as cadbury’s wholenut). As I say, I’m not interested in cunning natural ways to trip, I just want to know if it is safe for me to continue to eat large quantities of my favourite chocolate.

    I’ve had LSD and Psilocybin and I can tell you they don’t have the same effect as what I described as “*pow* for 2 weeks”.

    The ‘hallucinations’ I had were more akin to the way people describe DMT (which I have never had).

    The only thing that was going on at the time (apart from stress, but what’s new?) was the hazelnut chocolate and I’d quit drinking 5 years previously but isn’t that a rather long time to wait for alcohol withdrawal psychosis to strike?

  18. #18 Rose
    August 1, 2011

    I am one of those under reported women who have this. I’m a poor grad student who can’t afford to go to a doctor, but what good would that do anyway, really? I don’t want kids, so that is fortunate. Mine is pretty severe, but luckily I am not allergic to latex!

  19. #19 Kim Cannibals
    August 4, 2011

    The quest continues. Hazelnuts contain diterpenes. These can be psychoactive!

    Salvinorin A is a diterpene. I have never used it but it is rumoured that regular use of small (non active) amounts can accumulate and cause unexpected effects!

    Possible?

  20. #20 Lena
    January 20, 2012

    That’s interesting how immune system works “quietly” against intestinal parasites and so explosive with polen particules, spem, or dust…

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