HYPERSENSITIVITY TO HUMAN SEMINAL PLASMA IN A TRANSGENDER MALE

Abstract

<h3>Introduction</h3> Human seminal plasma (HSP) hypersensitivity is a rare allergy to human semen proteins that can present in female patients as local or systemic reactions. Here, we report a case of HSP hypersensitivity in a transgender male. <h3>Case Description</h3> A 21-year-old transgender male (female-to-male) with allergic rhinitis presented with a 5-year history of recurrent vaginal pain after coitus. Vaginal intercourse causes a severe burning sensation for 3-4 hours and is sometimes associated with itching that lasts for days. It is prevented by the use of condoms. Skin contact with semen immediately causes pruritic lesions for 1-2 hours. Receptive oral intercourse causes lip tingling. He has developed abdominal pain and loose bowel movements after swallowing his partner's semen. No associated respiratory or cardiovascular symptoms or angioedema reported. Patient denied using lubricants or spermicides that may cause other allergic reactions. Vulvovaginitis was ruled out with normal pelvic exam per gynecology. For management, prevention of seminal fluid exposure by using condoms was recommended. Also recommended were antihistamine and prophylactic use of cromolyn. <h3>Discussion</h3> The diagnosis of HSP hypersensitivity is made based on a history of symptom development upon HSP exposure and prevention of symptoms with the condom use. No skin testing was performed because localized reaction to HSP is considered non-IgE mediated and no standardized testing is available. Intravaginal/subcutaneous desensitization is not very effective for local reactions.