How to Manage Post Orgasmic illness Syndrome Symptoms

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. Post orgasmic 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.

Is there a link between POIS and masturbation?

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!