Dear Alice,

A few months ago, my fiancé and I, after much consideration, decided to stop using condoms and rely only on the Pill as a contraceptive method. Since then, when he ejaculates inside my vagina, I frequently experience a strong burning sensation a few minutes afterward — varying in both degree and length each time. Could I be allergic to his semen? The pain sometimes subsides if I hold a wet cloth over the area. Sometimes, perhaps during a different part of my cycle, there is no discomfort. Does it have something to do with the pH level or something? It feels very chemical, somehow.

— Sex distressed

Dear Sex distressed,

Instead of basking in the afterglow of sex, it sounds as though you are agonizing over the after-burn and worry. There are a number of possible explanations for the burning feeling you get after your partner ejaculates, including, a semen allergy, vaginitis, an alternation in your vaginal chemistry, or friction caused by insufficient lubrication. If your symptoms continue, a visit to your health care provider is in order to get a proper diagnosis. 

A form of vaginitis (inflammation of the vagina) is a possible cause of the burning sensation. Bacteria and fungi (like yeast) grow in the vagina of all healthy women, and, as you suspect, the balance of those microorganisms can be upset by changes in pH levels. Common forms of vaginitis include yeast infections and Bacterial vaginosis (BV). Vaginitis may make itself known through abnormal discharge, mild or severe itching or burning of the vulva, chafing of the thighs, or frequent urination.

Semen may be the trigger altering your vagina’s chemistry. Other possible triggers are lowered immune resistance, douching, birth control pills, antibiotics, or cuts, abrasions, or other vaginal irritation (friction from intercourse, fingers or fingernails, or tampons). Your partner can also transmit an infection if s/he has one. Birth control pills do not offer protection from sexually transmitted infections (STIs). When considering not using condoms with a sexual partner, in addition to talking with your partner, it’s a good idea to both get an STI check-up. It is possible that you have a semen allergy. Symptoms like burning, pain, and swelling typically start 20 to 30 minutes after contact and can vary in severity and duration. For more information read Allergic to semen?.

Friction from intercourse can irritate vaginal tissues, and may make you more susceptible to vaginitis. Additionally, a side effect of some hormonal birth control methods is vaginal dryness. To combat friction and prevent vaginal irritation, you may want to add water-based lube into the mix during sex. You can also try peeing both before and after intercourse — the acidity of the urine tends to kill off and wash away bacteria. Also, for both you and your boyfriend, washing your hands and genitals before you have sex may make a difference.

Since there are a number of possible causes for your pain and burning, it may be wise to seek the opinion of a health care provider.

Alice!

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