Diarrhea from oral sex

Dear Alice,

My boyfriend and I have been exploring oral sex for a couple months — but I've only just noticed that when I swallow I seem to experience a bout of diarrhea within a couple hours of doing so. Is it normal to have diarrhea from swallowing ejaculate?

Dear Reader,

The prevalence of diarrhea, nausea, or other stomach-related issues caused by contact with semen isn't fully understood, partially because people may not openly discuss concerns related to oral sex. There are a few potential causes and strategies for figuring out which one might apply, as well as some potential solutions.

One possible cause could be an allergic reaction to a protein found in seminal fluid. This allergy is known as seminal plasma protein allergy (SPPA). Allergic reactions can diminish or worsen over time with more exposure and can indeed include nausea or diarrhea. Inflammation or irritation of other body parts exposed to semen can also occur. If the cause is found to be an allergic reaction, histamine blockers may be one of the treatment options your health care provider can prescribe.

Another possible cause could be related to anxiety or other emotional issues that sometimes come up for people during sex. In other words, certain sexual situations can be "triggers." A trigger can be a smell, a tactile feeling, a sound, or any experiential situation that brings something from the past into the present moment. For some, triggers can produce emotional and/or physical reactions. Talking to a counselor or other mental health professional may help if you  think this may be the issue.

It could also be that the timing of your stomach upset is coincidence. Are there any other factors that might be coming into play here — new stressors, foods you are trying, or other changes in your diet? Do you experience episodes of diarrhea outside of the times you swallow?

Have you thought about what you might do if the cause turns out to be something without an easy fix? Someone famous once said "To swallow or not to swallow: That is the question." (That might not be the exact quote, but still). If you continue to experience the diarrhea, you may want to consider the pros and cons of swallowing. There are some alternatives if you decide swallowing is not worth the symptoms, including using condoms, spitting (which would involve keeping a receptacle nearby), or switching to manual masturbation when he is nearing orgasm (which would involve a signaling system of some kind). Some people really enjoy their partner's semen in their mouths while others swallow because they feel pressure from their partner to do so. Even if he really, really enjoys it, the answer to the above question is entirely up to you.

No matter what the cause might be, investigating this issue further with your health care provider may be a good idea.

Last updated Mar 04, 2015
Originally published Mar 11, 2011

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