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Vaginal pain
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An_248383 posted:
So after sex the other night my boyfriend came inside me w/o a condom. In the past when this has happened I have experienced an intense burning sensation. It doesn't happen when he doesn't come inside me. However, this past time it didn't hurt as bad but now i have intense constant vaginal pain. It feels like it's swollen down there and slightly red. Any suggestions??
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Jane Harrison Hohner, RN, RNP responded:
Dear An: There is a very uncommon condition where the woman can be sensitive to one of the proteins in seminal fluid (the largest component of ejaculation material). Here is one of the more recent citations (from 164 publications) on this from the National Library of Medicine site:

Postgrad Med. 2011 Jan;123(1):120-5.
Human seminal plasma hypersensitivity: an under-recognized women's health issue.
Bernstein JA.
Source

Department of Internal Medicine, University of Cincinnati College of Medicine, Division of Immunology/Allergy Section, Cincinnati, OH 45267-0563, USA. jonathan.bernstein@uc.edu
Abstract

Human seminal plasma (HSP) hypersensitivity is defined as a spectrum of systemic and/or localized symptoms after exposure to specific protein components in seminal plasma. The major antigen is believed to be prostate-specific antigen, but other proteins are likely involved in this heterogenous disorder. There are no known risk factors for developing seminal plasma hypersensitivity, although women who develop systemic symptoms are more frequently atopic. Of interest, for both systemic and localized forms, symptoms can manifest after first time intercourse in up to 50% of cases. Diagnosis requires a careful history. The gold standard for diagnosing HSP is that symptoms are completely abated with the use of a condom prophylactic. Although women with HSP hypersensitivity often have difficulty conceiving due to their inability to have unprotected sexual intercourse, infertility has not been demonstrated to be related to HSP hypersensitivity. Patients with HSP hypersensitivity often elicit positive skin prick testing and/or serum-specific immunoglobulin E to whole seminal fluid or fractionated seminal plasma proteins. Treatment involves either avoidance with the use of condoms, an intravaginal graded challenge using dilutions of whole seminal fluid, or subcutaneous desensitization to relevant fractionated seminal plasma proteins obtained from the woman's sexual partner. In most cases, treatment using "265 1 of the above approaches has been very successful.

An,_248383, I would urge you to see your GYN or local family planning clinic. They would be able to rule out irritation from other sources (eg yeast infections, lichen planus) and begin an assessment for "semen allergy" if indicated.

Yours,
Jane


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