The role of the man in the etiology of recurrent
vaginitis was examined in three women who reported an association between coitus and the initiation of clinical symptoms. The patients' disorders consisted of vaginal
pruritus, burning, a white discharge, and painful coitus. Vaginal pH in each case was 4.5. Microscopic examination of wet mounts of vaginal secretion had no clue cells and no organisms other than lactobacillus. One culture was positive for Candida albicans; however, successful treatment of the C. albicans
vaginitis did not eliminate the patient's symptoms. Semen samples from the patients' partners were negative for C. albicans. One of the seminal fluids had highly elevated concentrations of total
IgE. The other two semen samples contained
IgE antibodies that were reactive with a particulate fraction of vaginal fluids obtained from their wives. In contrast, vaginal fluids from the patients were all negative for
IgE antibodies to their partner's semen. Use of a
condom during coitus ended the recurring cycles of
vaginitis in all three women.
Vaginitis may be induced by an
allergic reaction initiated by the transfer from men to women during coitus of
IgE antibodies reactive either to
antigens of the female genital tract or components of semen. Men allergic to female vaginal secretions, to vaginal microbes or their products, or to semen represent a previously unrecognized noninfectious vector for this disorder.