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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2025№9
Triggers of allergic reactions in...

Triggers of allergic reactions in the female genital tract and modern methods for diagnosing sensibilization

DOI
https://dx.doi.org/10.18565/aig.2025.188

Bychkova N.V., Krechetova L.V., Mezhevitinova E.A., Kepsha M.A.

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

Allergic reactions in the female genital tract are a clinically relevant but understudied issue in obstetrics and gynecology. Frequently they present as infectious and hormonal disorders resulting in the chronic course of vulvovaginitis and reduced quality of life. This article provides a structured review of current concepts about the possible triggers of allergic reactions in the female genital tract. The main contact triggers are sperm, latex, metals, especially nickel, infectious allergens, including Candida, cosmetics and hygiene products, a number of drugs for local use. Food, aeroallergens and systemic drugs are considered as systemic allergens. The article analyzes in detail the various methods of modern allergy diagnosis, both in vivo and in vitro, including skin and provocative testing, assessment of specific IgE levels, and the basophil activation test. It emphasizes that an allergology examination should be conducted comprehensively using a variety of methods depending on the specific clinical symptoms. As a preventive measure, it is recommended to eliminate confirmed allergens and to use rational care procedures for the perineal area.      
Conclusion: Knowledge of the triggers of allergic reactions in the female genital tract and the algorithm for their detection will allow the physician to significantly improve the diagnosis of the disease. The management of women with a previous allergic history should be carried out by a group of doctors including an obstetrician-gynecologist and an allergologist-immunologist as it may effectively help patients with combined pathology.

Authors’ contributions: Bychkova N.V., Mezhevitinova E.A. – developing the concept and design of the study, writing the text; Krechetova L.V., Kepsha M.A. – editing the article.
Conflicts of interest: Authors declare the lack of the possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Bychkova N.V., Krechetova L.V., Mezhevitinova E.A., Kepsha M.A. Triggers of allergic reactions in the female genital tract and modern methods for diagnosing sensibilization.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (9): 46-55 (in Russian)
https://dx.doi.org/10.18565/aig.2025.188

Keywords

allergy
vulvovaginitis
hypersensitivity
allergy diagnosis
basophil activation test
Full text (in Russian)

References

  1. Moraes P.S., Taketomi E.A. Allergic vulvovaginitis. Ann. Allergy Asthma Immunol. 2000; 85(4): 253-65; quiz 265-7. https://dx.doi.org/10.1016/S1081-1206(10)62527-6
  2. Paladine H.L., Desai U.A. Vaginitis: diagnosis and treatment. Am. Fam. Physician. 2018; 97: 321-9.
  3. Hildebrand J.P., Carlson K., Kansagor A.T. Vaginitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
  4. Harper J., Zirwas M. Allergic contact dermatitis of the vagina and perineum: causes, incidence of, and differentiating factors. Clin. Obstet. Gynecol. 2015; 58: 153-7. https://dx.doi.org/10.1097/GRF.0000000000000094
  5. Woodruff C.M., Trivedi M.K., Botto N., Kornik R. Allergic contact dermatitis of the vulva. Dermatitis. 2018; 29(5): 233-43. https://dx.doi.org/10.1097/DER.0000000000000339
  6. Чернова Н.И., Перламутров Ю.Н., Задорожная И.С., Носова Д.Б. Аллергия и рецидивирующий вульвовагинит. Доктор.Ру. 2020; 19(8): 91-5. [Chernova N.I., Perlamutrov Yu.N., Zadorozhnaya I.S., Nosova D.B. Allergy and recurrent vulvovaginitis. Doctor.Ru. 2020; 19(8): 91-5 (in Russian)]. https://dx.doi.org/10.31550/1727-2378-2020-19-8-91-95
  7. Oliveira A.S., Rolo J., Gaspar C., Palmeira de Oliveira R., Martinez de Oliveira J., Palmeira de Oliveira A. Allergic vulvovaginitis: a systematic literature review. Arch. Gynecol. Obstet. 2022; 306(3): 593-622. https://dx.doi.org/10.1007/s00404-021-06332-z
  8. Abe S., Ohtsubo H. [Two cases of allergic vulvovaginitis diagnosed by direct microscopic urine sediment examination]. Arerugi. 2024; 73(2): 201-5. Japanese. https://dx.doi.org/10.15036/arerugi.73.201
  9. Chong K.Y, Tyagi-Bhatia J. Vulval fixed drug eruption following trimethoprim use. BMJ Case Rep. 2025; 18(2): e264098. https://dx.doi.org/10.1136/bcr-2024-264098
  10. Павлова А.А., Долгушина Н.В., Латышева Е.А., Ковалева А.А., Колодько В.Г. Значение аллергии в развитии хронического вульвовагинита. Акушерство и гинекология. 2015; 9: 68-74. [Pavlova A.A., Dolgushina N.V., Latysheva E.A., Kovaleva A.A., Kolodko V.G. Significance of allergy in the development of chronic vulvovaginitis. Obstetrics and Gynecology. 2015; (9): 68-74 (in Russian)].
  11. Павлова А.А., Долгушина Н.В., Донников А.Е., Бурменская О.В., Иванец Т.Ю., Латышева Е.А. Оценка экспрессии и полиморфизма генов цитокинов как предикторов хронического вульвовагинита, ассоциированного с аллергическим воспалением. Акушерство и гинекология. 2016; 3: 64-70. [Pavlova A.A., Dolgushina N.V., Donnikov A.E., Burmenskaya O.V., Ivanets T.Yu., Latysheva E.A. Estimation of cytokine gene expression and polymorphism as predictors for chronic allergic vulvovaginitis. Obstetrics and Gynecology. 2016; (3): 64-70. (in Russian)]. https://dx.doi.org/10.18565/aig.2016.3.64-70
  12. Crowder C.A., Jeney S.E.S., Kraus C.N., Bernal N., Lane F. Vulvovaginal involvement in Stevens – Johnson syndrome and toxic epidermal necrolysis: management and techniques used to reduce gynecologic sequelae. Int. J. Dermatol. 2022; 61(2): 158-63. https://dx.doi.org/10.1111/ijd.15676
  13. DenAdel M.A., Hendrickson S.E., Fuchs E. Stevens Johnson syndrome: past, present, and future directions gynecologic manifestations and management in SJS / TEN. Front. Med. (Lausanne). 2022; 9: 874445. https://dx.doi.org/10.3389/fmed.2022.874445
  14. Eubel J., Diepgen T.L., Weisshaar E. [Allergic diseases in the genital area]. Hautarzt. 2015; 66(1): 45-52. German. https://dx.doi.org/10.1007/s00105-014-3561-1
  15. Peckruhn M., Elsner P. [Vulvar diseases]. Hautarzt. 2015; 66(1): 38-44. German. https://dx.doi.org/10.1007/s00105-014-3552-2
  16. Jutel M., Agache I., Zemelka-Wiacek M., Akdis M., Chivato T., Del Giacco S. et al. Nomenclature of allergic diseases and hypersensitivity reactions: adapted to modern needs: an EAACI position paper. Allergy. 2023; 78(11): 2851-74. https://dx.doi.org/10.1111/all.15889
  17. Lavery W.J., Stevenson M., Bernstein J.A. An overview of seminal plasma hypersensitivity and approach to treatment. J. Allergy Clin. Immunol. Pract. 2020; 8(9): 2937-42. https://dx.doi.org/10.1016/j.jaip.2020.04.067
  18. Schacher K., Dalloul M., Muneyyirci-Delale O. Seminal plasma hypersensitivity: a systematic review of clinical presentation, diagnostics, and management options. Am. J. Reprod. Immunol. 2024; 91(5): e13865. https://dx.doi.org/10.1111/aji.13865
  19. Glatzel V., Bertlich M., Oppel E.M. Seltene allergie auf sperma. [Rare semen allergy]. Die Dermatologie (Heidelb). 2024; 75(S1): 25-7. German. https://dx.doi.org/10.1007/s00105-024-05345-4
  20. Schlosser B.J. Contact dermatitis of the vulva. Dermatol. Clin. 2010; 28(4): 697-706. https://dx.doi.org/10.1016/j.det.2010.08.006
  21. von der Gathen Y., Sander I., Flagge A., Brüning T., Raulf-Heimsoth M. Quantification of protein and latex allergen content of various natural rubber latex products. Allergol. Select. 2017; 1(2): 109-19. https://dx.doi.org/10.5414/ALX01461E
  22. Carra S., Schatz M., Mertes P.M., Torres M.J., Fuchs F., Senna G. et al. Anaphylaxis and pregnancy: a systematic review and call for public health actions. J. Allergy Clin. Immunol. Pract. 2021; 9(12): 4270-8. https://dx.doi.org/10.1016/j.jaip.2021.07.046
  23. Foote C.A., Brady S.P., Brady K.L., Clark N.S., Mercurio M.G. Vulvar dermatitis from allergy to moist flushable wipes. J. Low Genit. Tract Dis. 2014; 18(1): E16-8. https://dx.doi.org/10.1097/LGT.0b013e31828e499f
  24. Slodownik D., Bar J., Daniely D. Trends in contact sensitization, results, and implications from a contact dermatitis clinic in Israel. Contact Dermatitis. 2024; 90(6): 556-65. https://dx.doi.org/10.1111/cod.14524
  25. Haverhoek E., Reid C., Gordon L., Marshman G., Wood J., Selva-Nayagam P. Prospective study of patch testing in patients with vulval pruritus. Australas J. Dermatol. 2008; 49(2): 80-5. https://dx.doi.org/10.1111/j.1440-0960.2008.00442.x
  26. Corazza M., Virgili A., Toni G., Minghetti S., Tiengo S., Borghi A. Level of use and safety of botanical products for itching vulvar dermatoses. Are patch tests useful? Contact Dermatitis. 2016; 74(5): 289-94. https://dx.doi.org/10.1111/cod.12559
  27. Lucke T.W., Fleming C.J., McHenry P., Lever R. Patch testing in vulval dermatoses: how relevant is nickel? Contact Dermatitis. 1998; 38(2): 111-2. https://dx.doi.org/10.1111/j.1600-0536.1998.tb05666.x
  28. Vandeweege S., Debaene B., Lapeere H., Verstraelen H. A systematic review of allergic and irritant contact dermatitis of the vulva: the most important allergens / irritants and the role of patch testing. Contact Dermatitis. 2023; 88(4): 249-62. https://dx.doi.org/10.1111/cod.14258
  29. Cheng H.S., Fernández-Peñas P. Allergic contact dermatitis of the anogenital region in men and women. J. Low Genit. Tract Dis. 2020; 24(2): 221-4. https://dx.doi.org/10.1097/LGT.0000000000000516
  30. Yuk J.S., Shin J.S., Shin J.Y., Oh E., Kim H., Park W.I. Nickel allergy is a risk factor for endometriosis: an 11-year population-based nested case-control study. PLOS One. 2015; 10(10): e0139388. https://dx.doi.org/10.1371/journal.pone.0139388
  31. Borghini R., Porpora M.G., Casale R., Marino M., Palmieri E., Greco N. et al. Irritable bowel syndrome-like disorders in endometriosis: prevalence of nickel sensitivity and effects of a low-nickel diet. An open-label pilot study. Nutrients. 2020; 12(2): 341. https://dx.doi.org/10.3390/nu12020341
  32. Nguyen H.L., Yiannias J.A. Contact dermatitis to medications and skin products. Clin. Rev. Allergy Immunol. 2019; 56(1): 41-59. https://dx.doi.org/10.1007/s12016-018-8705-0
  33. Meech R.J., Smith J.M., Chew T. Pathogenic mechanisms in recurrent genital candidosis in women. N. Z. Med. J. 1985; 98(771): 1-5.
  34. Witkin S.S., Jeremias J., Ledger W.J. A localized vaginal allergic response in women with recurrent vaginitis. J. Allergy Clin. Immunol. 1988; 81(2): 412-6. https://dx.doi.org/10.1016/0091-6749(88)90909-8
  35. Montagnoli C., Bacci A., Bozza S., Gaziano R., Mosci P., Sharpe A.H. et al. B7/CD28-dependent CD4+CD25+ regulatory T cells are essential components of the memory-protective immunity to Candida albicans. J. Immunol. 2002; 169(11): 6298-308. https://dx.doi.org/10.4049/jimmunol.169.11.6298
  36. Karakoyun A.S., Unal N., Sucu M., Bingöl O., Unal I., Ilkit M. Integrating clinical and microbiological expertise to improve vaginal candidiasis management. Mycopathologia. 2024; 189(6): 96. https://dx.doi.org/10.1007/s11046-024-00904-8
  37. Pereira L.C., Correia A.F., da Silva Z.D.L., de Resende C.N., Brandão F., Almeida R.M. et al. Vulvovaginal candidiasis and current perspectives: new risk factors and laboratory diagnosis by using MALDI TOF for identifying species in primary infection and recurrence. Eur. J. Clin. Microbiol. Infect. Dis. 2021; 40(8): 1681-93. https://dx.doi.org/10.1007/s10096-021-04199-1
  38. Neves N.A., Carvalho L.P., De Oliveira M.A., Giraldo P.C., Bacellar O., Cruz A.A. et al. Association between atopy and recurrent vaginal candidiasis. Clin. Exp. Immunol. 2005; 142(1): 167-71. https://dx.doi.org/10.1111/j.1365-2249.2005.02891.x
  39. Bernstein J.A., Seidu L. Chronic vulvovaginal candida hypersensitivity: an underrecognized and undertreated disorder by allergists. Allergy Rhinol. (Providence). 2015; 6(1): 44-9. https://dx.doi.org/10.2500/ar.2015.6.0113
  40. Talaei Z., Sheikhbahaei S., Ostadi V., Ganjalikhani Hakemi M., Meidani M., Naghshineh E. et al. Recurrent vulvovaginal candidiasis: could it be related to cell-mediated immunity defect in response to candida antigen? Int. J. Fertil. Steril. 2017; 11(3): 134-41. https://dx.doi.org/10.22074/ijfs.2017.4883
  41. Burn M.S., Kwah J.H., Son M. Diagnosis and clinical management of drug allergies in obstetrics and gynecology: an expert review. Am. J. Obstet. Gynecol. 2025; 232(3): 243-61. https://dx.doi.org/10.1016/j.ajog.2024.10.025
  42. Ozturk S., Caliskaner Z., Karaayvaz M., Dede M., Gulec M. Hypersensitivity to aeroallergens in patients with recurrent vulvovaginitis of undetermined etiology. J. Obstet. Gynaecol. Res. 2007; 33(4): 496-500. https://dx.doi.org/10.1111/j.1447-0756.2007.00578.x
  43. Theodoropoulos D.S., Stockdale C.K., Duquette D.R., Morris M.S. Inhalant allergy compounding the chronic vaginitis syndrome: characterization of sensitization patterns, comorbidities and responses to sublingual immunotherapy. Arch. Gynecol. Obstet. 2016; 294(3): 541-8. https://dx.doi.org/10.1007/s00404-016-4081-2
  44. Graziottin A., Murina F., Gambini D., Taraborrelli S., Gardella B., Campo M. Vulvar pain: the revealing scenario of leading comorbidities in 1183 cases. Eur. J. Obstet. Gynecol. Reprod. Biol. 2020; 252: 50-5. https://dx.doi.org/10.1016/j.ejogrb.2020.05.052
  45. Sompornrattanaphan M., Kreetapirom P., Srinoulprasert Y., Kanistanon D., Klinniyom A., Wongsa C. et al. Severe anaphylaxis after pelvic examination: a case report of dual latex and chlorhexidine allergies. Allergy Asthma Clin. Immunol. 2019; 15: 19. https://dx.doi.org/10.1186/s13223-019-0335-4
  46. Nucera E., Pollastrini E., Sabato V., Colagiovanni A., Aruanno A., Rizzi A. et al. Challenge tests in the diagnosis of latex allergy. Int. J. Immunopathol. Pharmacol. 2010; 23(2): 543-52. https://dx.doi.org/10.1177/039463201002300216
  47. Зайков С.В., Полищук Ю.В. Диагностика и лечение аллергических заболеваний половых органов. Новости медицины и фармации. 2013; 1(454): 17-21. [Zaikov S.V., Polischuk Yu.V. Diagnostics and treatment of allergic diseases of the genital organs. News of medicine and pharmacy. 2013; 1(454): 17-21 (in Russian)].
  48. Cooper L., Harbour J., Sneddon J., Seaton R.A. Seaton safety and efficacy of de-labelling penicillin allergy in adults using direct oral challenge: a systematic review. JAC Antimicrob. Resist. 2021; 3(1): dlaa123. https://dx.doi.org/10.1093/jacamr/dlaa123
  49. Siemons S., Vleugels M., van Eijndhoven H. Evaluation of nickel allergic reactions to the Essure micro insert: theoretical risk or daily practice? J. Minim. Invasive Gynecol. 2017; 24(1): 140-4. https://dx.doi.org/10.1016/j.jmig.2016.09.001
  50. Jeimy S., Ben-Shoshan M., Abrams E.M., Ellis A.K., Connors L., Wong T. Practical guide for evaluation and management of beta-lactam allergy: position statement from the Canadian society of allergy and clinical immunology. Allergy Asthma Clin. Immunol. 2020; 16(1): 95. https://dx.doi.org/10.1186/s13223-020-00494-2
  51. Presti M.P., Druce H.M. Hypersensitivity reactions to human seminal plasma. Ann. Allergy. 1989; 63(6 Pt 1): 477-80.
  52. Czarnobilska M., Bulanda M., Czarnobilska E., Dyga W., Mazur M. The role of the basophil activation test in the diagnosis of drug-induced anaphylaxis. Diagnostics (Basel). 2024; 14(18): 2036. https://dx.doi.org/10.3390/diagnostics14182036
  53. Bennett M.R., Mathioudakis A.G., Wu J., Chu M.M.H., Tontini C., Thomas I. et al. Performance characteristics of basophil activation tests for diagnosing penicillin allergy: a meta-analysis. J. Allergy Clin. Immunol. Pract. 2024; 12(3): 714-23.e5. https://dx.doi.org/10.1016/j.jaip.2023.11.004
  54. Бычкова Н.В. Активация базофилов: теоретические аспекты и применение в диагностике аллергических заболеваний. Медицинская иммунология. 2021; 23(3): 469-82. [Bychkova N.V. Basophil activation: theoretical aspects and use in the diagnosis of allergic diseases. Medical Immunology. 2021; 23(3): 469-82 (in Russian)]. https://dx.doi.org/10.15789/1563-0625-BAT-2174
  55. Testera-Montes A., Ariza A., Sola-Martinez R.A., Aranda C.J., Bentabol-Ramos G., Sanchez-Torralvo D. et al. Investigation of the diagnostic accuracy of basophil activation test for allergic phenotypes of rhinitis. Allergy. 2025; 80(3): 738-49. https://dx.doi.org/10.1111/all.16390
  56. Bergmann M.M., Santos A.F. Basophil activation test in the food allergy clinic: its current use and future applications. Expert Rev. Clin. Immunol. 2024; 20(11): 1297-1304. https://dx.doi.org/10.1080/1744666X.2024.2336568
  57. Eberlein B. Basophil activation as marker of clinically relevant allergy and therapy outcome. Front. Immunol. 2020; 11: 1815. https://dx.doi.org/10.3389/fimmu.2020.01815
  58. Бычкова Н.В. Новая номенклатура аллергических заболеваний и реакций гиперчувствительности. Цитокины и воспаление. 2024; 21(1): 5-21. [Bychkova N.V. New nomenclature of allergic diseases and hypersensitivity reactions. Cytokines and Inflammation. 2024; 21(1): 5-21 (in Russian)]. https://dx.doi.org/10.17816/CI635046

Received 08.07.2025

Accepted 18.08.2025

About the Authors

Nataliya V. Bychkova, Dr. Sci. (Bio), Leading Researcher at the Laboratory of Clinical Immunology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(495)438-11-83, BNV19692007@yandex.ru,
https://orcid.org/0000-0002-6907-2817
Lubov V. Krechetova, Dr. Med. Sci., Head of the Laboratory of Clinical Immunology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(495)438-11-83, L_krechetova@oparina4.ru,
https://orcid.org/0000-0001-5023-3476
Elena A. Mezhevitinova, Dr. Med. Sci., Leading Researcher, Scientific and Outpatient Department, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4, mejevitinova@mail.ru, https://orcid.org/0000-0003-2977-9065
Maria A. Kepsha, Junior Researcher, Physician, Scientific and Outpatient Department, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation, 117997, Russia, Moscow, Ac. Oparin str., 4, m_kepsha@oparina4.ru, https://orcid.org/0000-0002-4201-1360
Corresponding author: Nataliya V. Bychkova, BNV19692007@yandex.ru

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