Human seminal plasma allergy as a cause of postcoital asthma.

It was with great interest that we recently read a report by Dr. Picado [I] in which a female patient developed severe postcoital asthma. We recently reported, for the first time from India, a patient who presented with postcoital wheezing dyspnoea caused by human seminal plasma allergy (HSPA) [2). Our patient showed strong intradennal test reactions to the seminal plasma antigens prepared from her husband, and those from a healthy volunteer. Although the mechanisms of postcoital asthma appear different in both cases, sexual activity in some asthmatic patients may result in a lifethreatening condition, especially in patients with HSPA who present with systemic manifestations [38]. However, it would have been interesting to know whether Dr Picado's patient would have experienced relief in her symptoms, even without prior prophylactic bronchodilator, with condom usage only. Dr Picado correctly points out that clinical histories in asthmatic patients do not usually include the effect of sex on asthma. We would like to stress that postcoital asthma may easily be overlooked due to Jack of physician awareness and patient embarassment Further studies on these aspects are warranted.