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Raj Singh MD
August 27, 2023

Treat Post orgasmic illness syndrome (POIS)

post-orgasmic illness syndrome [POIS]

What is Post orgasmic illness syndrome?

When male sexual health is discussed mostly it is about men with erectile dysfunction, premature ejaculation, and delayed ejaculation. Postorgasmic illness syndrome (POIS) is a rare and poorly understood medical condition in which people experience a range of physical, cognitive, and emotional symptoms following sexual activity, particularly orgasm that can significantly affect the quality of life and can cause significant emotional distress. Most men have such extreme fatigue post-ejaculation that they start to avoid sexual activity completely.

When do symptoms appear?

The symptoms usually begin within minutes to hours after orgasm and can last for several days.

What are the symptoms of Postorgasmic illness syndrome?

Symptoms of POIS can vary widely from person to person, but may include:

  • Flu-like symptoms such as fatigue, fever, chills, muscle aches, and headaches
  • Cognitive symptoms such as brain fog, difficulty concentrating, memory problems, and irritability
  • Allergic-like symptoms such as itching, sneezing, and nasal congestion
  • Gastrointestinal symptoms such as diarrhea and abdominal pain
  • Skin symptoms such as rash and flushing

What causes Postorgasmic illness syndrome?

The exact cause of POIS is not known, but it is believed to be related to an allergic or autoimmune reaction to substances released during orgasm.

Can females develop post-orgasmic illness syndrome?

Although the syndrome has been reported in females after orgasm, primarily most of the data and case reports come from male patients.

This syndrome develops as a result of ejaculation and symptoms can appear after masturbation or after wet dreams.

What is the typical age to develop this syndrome?

Based on the available data, symptoms typically appear during the teenage years.

How is this syndrome diagnosed?

There is no single diagnostic test. This is a clinical diagnosis based on symptoms. At HEALOR™ we typically order tests that include a complete blood count, comprehensive metabolic panel, total and free testosterone levels, TSH to check thyroid, estrogen levels, sedimentation rate, and C-reactive protein to measure for inflammation.

Is there a link between low testosterone levels and post-orgasmic illness syndrome?

Individuals suffering from this syndrome tend to have low to borderline low testosterone levels. There is a higher incidence of autoimmunity in testosterone deficiency possibly from the over-activation of T lymphocytes. It is possible that individuals who are predisposed to low testosterone levels may have a higher incidence of this syndrome. This is further supported by the fact that raising testosterone levels either by Testosterone replacement therapy or by using testosterone boosters such as Ashwagandha, Boron, Zinc, or adrenal support vitamins in these individuals tends to improve symptoms.

Would vasectomy help with post-orgasmic illness syndrome?

POIS is considered to be from a hypersensitivity reaction to semen and unfortunately, vasectomy does not help with the symptoms.

How to treat symptoms of post-orgasmic illness syndrome?

There is currently no known cure for POIS, but treatments may Include strategies to reduce allergy and inflammation.

  • Medications such as antihistamines such as fexofenadine, diphenhydamine.
  • Corticosteroids. (we do not recommend this due to side effects)
  • Testosterone boosters such as HCG or certain supplements Ashwagandha, Boron, Zinc, or adrenal support vitamins.
  • Clomiphene Citrate 25 mg daily in the morning.
  • SSRI such as citalopram (May work by causing delayed ejaculation or anorgasmia)

Newer Treatment options for Post orgasmic illness syndrome

Omalizumab for Post orgasmic illness syndrome

Omalizumab is monoclonal antibody that is approved for use in allergic asthma, chronic rhinosinusitis, IgE mediated food allergies and works by lowering IgE and downregulates mast cells thereby reducing allergic response to the allergen. Since POIS is postulated to be an allergic disorder this has been tested in POIS and other allergy mediated disorders. The data is limited to case reports only and no controlled trials have been conducted. Omalizumab for POIS represents a new frontier in treatment options for POIS and should be explored further. Barriers to use are weekly injections, and cost of the drug ( $2000-$3000/week).

We generally do not recommend testosterone therapy (TRT) in young males as it can cause infertility by causing testicular atrophy. If testosterone therapy is to be utilized we recommend adding clomiphene citrate to prevent testicular atrophy and preserve fertility.

Do you suffer from post-orgasmic illness syndrome (POIS)? Our primary care doctors in Las Vegas at HEALOR™ can help!

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13 comments on “Treat Post orgasmic illness syndrome (POIS)”

  1. Are you only in the US or in other countries too? Interested to know home remedies that can help handle this situation.

    1. Hi SB, I just wanted to say a big thank you for your comment. It's so amazing to know that we have visitors from all around the world who trust us. Although we are based in the US we have clients all over the world who use our virtual consultations to stay connected. It's truly a global community!

      Now, let's talk about something really exciting - raising testosterone levels and its impact on post orgasmic illness syndrome. This is an area where we've seen some incredible results! It turns out that boosting testosterone levels can really make a difference in managing the symptoms of this syndrome.

      At our clinic, we've developed a range of treatment regimens that specifically focus on increasing the natural production of testosterone in the body. We believe that by encouraging the body's own testosterone production, we can provide a more sustainable and long-term solution for our clients.

      At home you can try ashwagandha. This powerful herb has been used for centuries in traditional medicine and has shown promising results in boosting testosterone. Another supplement we recommend is shilajit, which has been used in Ayurvedic medicine for its testosterone-boosting properties. You can also try other adrenal support supplements.

      All the best!

  2. HI,

    I am from India, male person with age of 36years and had the masturbation habit like doing alternative days from last 18 years.

    1. Initially no side effects but from the 2nd year start facing memory and concentration issues.
    2. Same phase continued for several years then started facing heat, cold, cramps after doing the masturbation. So far 10 years masturbation phase completed.
    3. Now started seeing fivers with elevated WBC count of 16K, low vitamins(b12, D) but not able to stop habit because of mental compulsion and with 6 months of homeo treatment able recover but still WBC count at 12k
    4. Still habit continued because of mental compulsion and feel the heat symptoms for 2 days and if i give pause for 4-5 days things were back to normal but allways WBC count at 15-17K when ever i tested occasionally. This is for the last 8 years
    5. From last 30 days starting seeing itching and fiver symptoms along with WBC at 17k and using the anti-histamines for itching.
    6. From last 10 days stopped doing masturbation and feeling recovered from fatigue, memory, concentration but still facing itching and fiver symptoms with WBC at 17K.

    Why WBC count not reduced even after 10 days and any suggestions to reduce them along with itching and fiver symptoms.

    1. Hi Ethan,
      Thank you for a very detailed timeline of issues that you have been facing. Elevated white blood cell count and associated fevers generally suggest an underlying infection or an autoimmune process. My recommendation would be to get an autoimmune panel to look for autoimmune diseases and also see a hematologist for a possible bone marrow biopsy as persistent elevated white blood count for several years can suggest an underlying bone marrow disorder. we also see itching, fever and elevated blood count in a bone marrow disorder called chronic myeloid leukemia or CML. This is something that definitely needs to be excluded. You need to see a qualified doctor like an internal medicine physician or a blood specialist like a hematologist to investigate this further. I hope you feel better and all the best to you. Please do post your response once you have seen the specialist.

      1. Good day doctor! I'm currently suffering from this same fate POIS, following your responses to some comments I really appreciate your efforts.
        Doctor please, my question are:
        1. can one actually stop this masturbation habits? If the answer is yes, please 🙏 what are the ways out?

        2. Can one continuing experiencing this POIS when married? 😔😔

        1. Hi Thanks for the comment. You have to explore the reasons behind the compulsive masturbation habits. Is it to relive stress, anxiety or lack of sexual satisfaction with partner. I would recommend spoeaking with a therapist or joining support groups. Porn is another big reason for this habit. I posted a video a while back that you might find helpful https://youtu.be/IRJ5ML6HYuA?si=2KoRHgyGwMHHyYPE
          POIS is related to ejaulation and being married or single unfortunately won't change that fact. Having a healthy open conversation with the partner is the best way to address this

  3. I read the information on Omalizumab a drug administered by infection to treat Post Orgasmic Illness Syndrome.
    However the side effects can cause heart troubles, nausea and dizziness. What is your experience so far?

    1. Hi henry, Thanks for the comment. Omalizumab is monoclonal antibody that is approved for use in asthma and works by lowering IgE and downregulates mast cells thereby reduce allergic response to the allergan. Since POIS is postulated to be an allergic disorder this has been tested in POIS and other allergy mediated disorders. There is liomited data and only few case reports has been published. I have no experiece using omalizumab for POIS however I am excited for this new treatment option for POIS.

  4. Good Day,

    I'm so happy I found this website and glad to know I am not alone. I've been suffering from POIS since having covid in 2020. I take multi vitamins, b6 b12 Coenzyme Complex along with Tumeric Curcumin and vitamin c. The urologist told me to take a clartin or allegra before the orgasm and he prescribed Diclofenac which I take with Clartin or allegra. After the orgasm I have taking Bromelain vitamins along with Diclofenac, and also a b6 b12 coenzyme vitamin. It does help however the next day I am still fatigue and have mood swings. It's anything will get me irritated.

    I've tried eating dark chocolate the night before and that does stabiliz my mood the next day however with eating sugar so late I am still tired and fatigue. Takkng a nap the next day really helps. Is there anything healthy that I can take to help with the mood swings and fatigue? I'm a little cautious with Ashwagandha only because I am a sober and drug free guy in recovery and I don't want to take anything that alters my mood. If that make sense? Any suggestions

    1. Thanks for your comment. Based on limited information about your medical history, I do not see any issue using Ashwagandha. Other option would be a trial of buspirone to improve fluctuations in mood.

      1. Thank you so much Dr. Raj! I wish I could meet with you as doctor to go over my medical history. And to smooth out these symptoms but not sure if my insurance will cover. I am in the USA in Washington DC.

        I will check out Ashwagandha. Is it best to be taking directly after ejaculation or the next day?

        1. We have many out of state patients and certain insurance plans do cover out of state visits based on necessity. We also have cash pay memberships that can be used. Please call or text 702-362-2273 and our team can assist you. Ashwagantha is to be used daily

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