Semen allergy is real — and often misdiagnosed. Here are the troubling signs
This is nuts!
For a small but suffering contingent of women, an allergy to semen is seriously interfering with intimacy.
A semen allergy, also known as seminal plasma hypersensitivity (SPH), is a rare reaction to proteins found in male spermatic fluid, according to the Cleveland Clinic.
4 A semen allergy, also known as seminal plasma hypersensitivity (SPH), is a rare allergic reaction to proteins found in male spermatic fluid.
doucefleur – stock.adobe.com
SPH is recognized as a Type 1 hypersensitivity, characterized by a rapid, exaggerated immune response to an allergen, putting semen in the same category as peanuts and pet dander.
For those afflicted, reactions to exposure to ejaculate run the gamut from burning, itching, redness and swelling of the vulva or vagina to hives, shortness of breath, dizziness and even anaphylaxis.
One Colorado college student with SPH reported that oral sex led to inflammation and temporary facial paralysis. She said that the severity of the side effects depends on the quantity of sperm she's encountered.
Experts believe the condition, which can be life-threatening if there's anaphylaxis, is underreported.
SPH was first documented in 1967, when a woman was hospitalized following a 'violent allergic reaction' to sex.
For the next three decades, it was assumed that SPH affected fewer than 100 women worldwide.
Yet, a 1997 study led by allergist Jonathan Bernstein revealed that nearly 12% of reported postcoital symptoms could be classified as SPH.
4 SPH does not directly cause infertility, but it can make conception challenging.
nito – stock.adobe.com
In 2013, Michael Carroll, an associate professor in reproductive science, conducted a small, unpublished survey that found a similar rate.
However, he maintains that the true number may be much higher.
'Many cases go unreported, misdiagnosed or dismissed as STIs, yeast infections or general 'sensitivity,' ' Carroll wrote this week in The Conversation.
'A 2024 study reinforced this finding, suggesting that SPH is both more common and more commonly misdiagnosed than previously believed.'
This condition is now believed to affect one in 40,000 people.
Experts maintain that the main allergen is not sperm cells themselves, but prostate-specific antigen (PSA) in seminal plasma.
4 While condoms mitigate the risk of allergen exposure to PSA, for some unlucky lovers, allergies to semen and condoms make intimacy particularly challenging.
Pixel-Shot – stock.adobe.com
Interestingly, there appears to be cross-reactivity.
Carroll notes that Can f 5, a protein found in dog dander, is structurally similar to human PSA, meaning that women allergic to dogs may have a higher likelihood of experiencing an allergic reaction to semen.
It is also possible to be exposed to an allergen through ejaculate.
In 2022, OnlyFans star Lucy Banks shared her experience of suffering an allergic reaction to peanuts from her partner's ejaculate.
She has since been spreading a warning to others about the dangers of sexually transmitted food allergies — especially from a peanut-loaded penis.
Diagnosis of SPH is, of course, made via skin prick.
4 Lucy Banks is warning others to be cautious of sexually transmitted food allergies after her own experience.
Instagram/ @itsnotlucybanks
While condoms mitigate the risk of allergen exposure to PSA, for some unlucky lovers, allergies to semen and condoms make intimacy particularly troublesome.
SPH does not directly cause infertility, though conception can be challenging. Treatments for would-be parents include antihistamine medication before intercourse, anti-inflammatories after and/or desensitization therapy using diluted seminal plasma.
In cases where the allergic reaction is severe, some couples turn to IVF using washed sperm free from seminal plasma to divert the allergic trigger.
In rare instances, men can be allergic to semen.
Known as post-orgasmic illness syndrome (POIS), the condition is characterized by extreme fatigue, weakness, a fever or sweating, mood changes or irritability, problems concentrating, a stuffy nose and itching eyes following intercourse.
These symptoms can occur within seconds, minutes or even a few hours after ejaculation — and they can last from two to seven days.
POIS was first documented in 2002, and more than 50 cases have been recorded worldwide. However, experts believe that, similar to SPH, the actual incidence rate could be even higher.
Believed to be an autoimmune response or allergic reaction, POIS is also diagnosed via skin testing.
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According to the American Diabetes Association, a general target range for adults without pre-diabetes or diabetes is between 70 and 140mg/dL (note that Oura also follows this range, and it's what users can expect to see in their graphs). It's also worth highlighting that 70 to 100mg/dL is considered normal for fasting (particularly in the morning before having food), and under 140 mg/dL is common, especially after meals. "Clinical studies show that even in healthy individuals, a moderate glucose spike (rise above 140mg/dL) can occur on a daily basis. In fact, research suggests that healthy adults will live above 140mg/dL for about 30 minutes, up to 2 hours a day, which is usually 1 to 3 short-lived glucose spikes", says Renee Fitton, registered dietitian and director of education at L-Nutra, a nutrition technology company. Oura Fitton further explained that the number and frequency of glucose spikes depend on various factors, primarily what and when you're eating. 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Left Image: CGM in the self-injector. Right image: CGM on the back of my right arm. Nasha Addarich Martínez/CNET From the Oura app, I could see how my glucose levels fluctuated throughout the day. You can easily access it at the top of the app, where you also see other data metrics like sleep, heart rate, activity and readiness score (a personalized score, ranging from 0 to 100, that provides a snapshot of how well your body has recovered from the previous day's activities and sleep). How even my 'healthy' food choices raised my blood sugar (and that's OK) One of the most eye-opening parts of my testing was seeing how some of my favorite healthy staples played out on the glucose graph. A great example of this was my favorite pressed juice. I had a pressed juice in the morning that contained pineapple, beets, carrots, ginger, cucumber and lemon. It's nutrient-dense, but it also spiked my glucose above what's considered my healthy range for about 6 minutes (a small window and still considered optimal for my age and overall metabolic health). This was enough to make me rethink how and when I consume fruit-heavy beverages. The next day, I experimented with having a fruit smoothie instead of juice. I made a homemade smoothie with berries, banana, plant-based protein powder, peanut butter, soy milk and oats. This smoothie kept my glucose completely in range (zero minutes above my personal threshold). The added protein and fiber from the fruit, oatmeal, peanut butter and protein powder helped slow the absorption of natural sugars into my bloodstream. Nasha Addarich Martínez/CNET What I learned: Even natural fruit juices can cause glucose spikes, especially when consumed on an empty stomach and without any protein or fiber. Smoothies that include protein, fat and fiber can help keep spikes at bay and help stabilize your energy levels. Balance your meals with protein, fats and fiber Nasha Addarich Martínez/CNET Later that week, I had sushi rolls with a side of edamame for dinner. To my surprise, my glucose levels stayed within range the whole time. Oura Advisor (Oura's AI coach) even pointed out that this food combination offered protein and fiber, which likely contributed to the steady glucose levels. This moment was really encouraging for me. It made me realize that I don't need to drastically change what I eat. By just being more intentional about how I pair my foods, I can drastically improve the impact they have on my blood glucose. Pairing your foods with healthy fats like avocados, nuts, seeds and olive oil can also slow digestion and therefore the absorption of sugars. 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Nasha Addarich Martínez/CNET Taking a walk after meals has long been recommended by experts for metabolic health, but seeing the effect in real time made it click for me. I do think that having the cake after having a balanced meal with protein and fiber also contributed to my steady levels of blood sugar. Sometimes, it's not about completely eliminating our favorite treats or carbs, but more so about timing, food pairing and movement. 3 ways I learned to flatten my glucose curve without sacrificing my favorite meals Before using the glucose sensor with Oura, I assumed blood sugar spikes were mostly about foods and how they impact your body. I also thought the only way to manage them was to cut carbs or drastically change my diet. But over these two weeks, I experienced firsthand how and when I eat (and move) matter just as much as what I eat. I learned that these three strategies helped keep my glucose levels in check. Pair carbs and sweets with protein, fiber and healthy fats When I had a berry smoothie with protein powder and soy milk, my glucose levels stayed steady. In contrast, when I had a fruit smoothie earlier that week, my blood sugar levels spiked and crashed more quickly. Takeaway: Carbs on their own, especially refined and processed carbs, can spike blood sugar quickly, but adding protein or fat slows digestion and leads to a more gentle spike. Food pairing examples: Apples and peanut butter, toast with avocado, rice with beans or another it out (especially after sweets) When I had cake as a snack, I was sure my graph would spike dramatically, but it didn't because of my walk (and eating a balanced meal before). A simple walk, even just 10 to 15 minutes, can help offset blood sugar spikes. This small but simple habit helps me now enjoy treats without the crash later. Timing your food matters I also noticed that when I ate higher-carb foods earlier in the day, my body processed them better than when I had them later at night. Breakfast smoothies and bowls kept my levels stable, while the same smoothie after 9 p.m. caused more spikes. "When it comes to blood sugar management, we see that in the morning our body usually has a spike in cortisol (a stress hormone) that can actually help our body take up sugar very quickly and quickly manage blood sugar. Eating in the morning will also calm the cortisol response, reducing the stress on your body. If you wait too long to eat, excess cortisol can create inflammation and also produce larger glucose spikes when you do eat," explained Fitton. Fitton further explained that, conversely, in the evening, the sugar management systems in our bodies start powering down and are not as good at helping blood sugar get into the cells. So it is important to try not to eat too late; otherwise, you'll probably see blood sugar go up and stay up for longer. That doesn't mean you can't eat carbs or treats at night, but eating them earlier in the day when insulin sensitivity tends to be higher can make a real difference.
