Immunoglobutin E antibodies to seminal fluid in women with vulvar vestibulitis syndrome: Relation to onset and timing of symptoms

Objective: Patients with vulvar vestibulitis syndrome and control subjects were tested for evidence of allergy to seminal fluid to differentiate women with a clinical diagnosis of vulvar vestibulitis syndrome into discrete categories. Study Design: Plasma samples from 52 women with vulvar vestibulitis syndrome and 43 control subjects were tested for immunoglobulin E antibodies to seminal fluid, total immunoglobulin E, interleukin-4, and interleukin-12 by enzyme-linked immunosorbent assay. Demographic and medical histories were obtained by questionnaire and interview. Results: Sixteen of,the patients (30.8%) with vulvar vestibulitis syndrome and 2 control subjects (4.7%) tested positive for immunoglobulin E antiseminal fluid. Symptoms began after sexual intercourse in 43.8% of the women who tested immunoglobulin E positive and 11.1% of the women who tested immunoglobulin E negative (P = .02). Symptom, initiation after a yeast infection was reported by 31.3% of the women who tested immunoglobulin E positive and by 2.8% of the women who tested immunoglobulin E negative (P =.008). Other symptom-initiating events were reported by 47.2% of the women who tested immunoglobulin E negative and by none of the women who tested immunoglobulin E positive (P =.0008). Fifty percent of the women who tested immunoglobulin E positive, as opposed to 22.2% of the women who tested immunoglobulin E negative, reported pain only after intercourse (P =.05). Pain at other times occurred in 50% of the women who tested immunoglobulin E positive and in 72.2% of the women who tested immunoglobulin E negative (P =.001). There was no relation between immunoglobulin E antiseminal fluid and total immunoglobulin E, interieukin-4,or interleukin-12. Conclusion: A subset of women with vulvar vestibulitis syndrome are sensitized to seminal fluid, and an allergic reaction to seminal fluid may be associated with the initiation and persistence of their symptoms. (C) 2004 Elsevier Inc. All rights reserved.