| Type of hypersensitivity | Localized vaginal reactions | Systemic reactions | Combined reactions | Other rare reactions |
| Signs and symptoms | - Severe burning and pain (most common)
- Vulvar/vaginal itching and edema (less common)
| - Vulvar and vaginal pruritus and/or edema (usually the initial symptom)
- Diffuse pruritus, nasal obstruction, itchy eyes
- Urticaria and/or angioedema, often involving the face, lips, tongue, and throat
- Gastrointestinal symptoms
- Dyspnea, wheezing, and/or stridor
- Hypotension
- Cardiovascular collapse
| - Combinations of local and systemic symptoms
- May start as hives and angioedema or breathing difficulties with or without localized vaginal itching or pain
| - Fixed cutaneous eruption
- Serum sickness-like reaction
|
| Timing | - Within minutes of ejaculation or delayed for several hours
- Resolves over days
| - Within minutes of ejaculation but some symptoms (eg, vaginal discomfort, malaise) may linger for several days
- Uncommonly, reaction is delayed up to several hours after ejaculation
| - Within minutes of ejaculation
| - Delayed (days after ejaculation)
|
| Key historical features | - Prevented by careful condom use
- Most commonly develops in reproductive-age females
| - Prevented by careful condom use
- Most commonly develops in reproductive-age females
| - Prevented by careful condom use
- Most commonly develops in reproductive-age females
| - Prevented by careful condom use
- Most commonly develops in reproductive-age females
|
| Postulated mechanism | - Immediate onset may be IgE-mediated
- Mechanism of delayed reactions unknown
| | - Mixed IgE-mediated and non IgE-mediated
| |
| Skin testing to whole seminal fluid | | | - Can be positive or negative
| - Skin testing is not part of the evaluation
|
| Desensitization effective? | | | | |
