Recurrent vaginitis as a result of sexual transmission of IgE antibodies.

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.