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Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions here once a week. To ask her your own question, click here.

Hi Dr. Kate,

I have been in a monogamous relationship with my boyfriend for one year. A few months ago I had a yeast infection, which I treated. About a month later, I started to notice a strong burning pain inside my vagina when he ejaculates inside of me. It lasts anywhere from 10 minutes to an hour, although I feel slight relief if I take a shower afterward. He has since stopped ejaculating inside of me, but I still feel a brief burning pain when I urinate after sex. And the last time I had sex, there were very small red spots on my chest and upper arms afterward.  We have not been using condoms at all since I started the birth control pill. However, I did not notice any problems while we were using condoms in the past. I have not experienced this pain with any other partners, however I have always used a condom with all of my previous partners. I occasionally use KY Jelly as a lubricant, but the pain occurs whether or not lubricant is used. Would a new pill prescription alleviate the pain? (I was also tested for STDs at the beginning of our relationship and the test came back clear.)

Burning Below

Dear Burning,

I doubt very much that the pill has anything to do with your symptoms – it doesn’t change the chemistry or the makeup of your vagina. And it doesn’t sound like other typical causes: reaction to lubricant or spermicide, a latex allergy, or another yeast infection (even bad ones don’t last that long when treated).To be sure, though, your gyno can check you again for yeast or other vaginal infections, or even any vaginal tears, just to rule them out.

Since your symptoms only happen with this boyfriend, and not when you use condoms, it sounds like you may be allergic to his semen. It’s not common, but women can be allergic to one of the proteins in their partner’s semen…often with a particular partner, but some unlucky women have this reaction with all partners.

Symptoms of a semen allergy can include redness, pain, burning, itching, and swelling in areas where the semen has touched, often the vulva or vagina. A small number of women may have a more severe allergic reaction, including rashes, hives, or difficulty breathing. Symptoms usually occur quickly–within 30 minutes of contact–but can last for hours, or even days.

Short-term fix? Condoms, of course. Longer-term fix?  If you’re going to be with this guy for a long time (perhaps forever), it may be worth seeing an allergist to discuss de-sensitization treatment. This is NOT something to try on your own, mind you–if you’ve gotten a rash elsewhere on your body, I wouldn’t want your allergy to get worse without a doctor’s care. This kind of therapy can be expensive and generally isn’t covered by insurance.  But a consultation with an allergist likely is covered, and will give you the answers to all of these questions.

With regards to fertility, semen allergy won’t make you infertile.  If you and your boyfriend want to conceive a child together, you can see a fertility specialist to discuss the possibilities of intrauterine insemination (IUI), where his (washed) sperm are placed directly into your uterus, or in-vitro fertilization.

Have you ever had burning after sex that no gyno could give you an answer for?

— Dr. Kate
Gyotalk

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.