Prevalence of human seminal plasma hypersensitivity among symptomatic women

Experience with human seminal plasma hypersensitivity in the last decade has led to increased physician awareness of symptoms consistent with human seminal plasma sensitization in women. Incidence and prevalence of human seminal plasma hypersensitivity in women are unknown.

A questionnaire survey was distributed to determine the prevalence of human seminal plasma hypersensitivity among a population of women suspected of having this disorder.

A questionnaire designed to elicit age, symptoms, duration of symptoms, number of sexual partners, time to onset of symptoms after first human seminal plasma exposure, onset of symptoms after first intercourse, recent gynecologic procedures, history of atopy, vaginitis, food or drug allergy and family history of atopy was distributed to 1,073 women who suspected they had symptoms consistent with human seminal plasma hypersensitivity. Women were considered "possible" for human seminal plasma hypersensitivity if they reported two or more symptoms consistent with localized or systemic human seminal plasma hypersensitivity. Women were considered "probable" for disease if they fulfilled the "ultimate criterion" defined as complete prevention of symptoms with a condom. Women with "possible" localized or systemic human seminal plasma hypersensitivity who had persistent symptoms despite use of a condom served as cohort control groups.

Two-hundred sixty-six women reported symptoms "possible" for human seminal plasma hypersensitivity (88 localized and 178 systemic). When the "ultimate criterion" was applied, 130 (46 localized and 84 systemic) of the 266 women were identified as having "probable" human seminal plasma hypersensitivity. The responses to most of the questions from each group were very similar. A significantly shorter time interval to symptom onset after initial human seminal plasma exposure was more common for women with "probable" localized human seminal plasma hypersensitivity compared with their cohort control group (49 months versus 108 months; P < .02) whereas a significantly increased number of women with "probable" systemic human seminal hypersensitivity gave positive food allergy histories compared with their cohort control group (31 versus 20; P < .05). Atopy did not appear to be a risk factor for human seminal plasma hypersensitivity.

Evaluation of women with symptoms suggestive of human seminal plasma hypersensitivity using a validated questionnaire indicates that this disorder is more common than previously recognized.