Postorgasmic illness syndrome
Post orgasmic illness syndrome (POIS) is a rare condition characterized by debilitating symptoms following orgasm that last for a few hours to several days. The phenomenon was first described in 2002.
Symptoms usually appear within half an hour of orgasm and resolve after a few days. The person experiences mental symptoms, physical symptoms, or both. Common mental symptoms include cognitive dysfunction, intense discomfort, irritability, anxiety, craving for relief, susceptibility to nervous system stresses (e.g. common cold), depressed mood, and difficulty communicating, remembering words, reading and retaining information, concentrating, and socialising. Physical symptoms include severe fatigue, mild to severe headache, and flu-like and allergy-like symptoms, such as sneezing, itchy eyes, nasal irritation, and muscle pain. Affected individuals may also experience intense warmth or cold.
Waldinger says this condition is prone to being erroneously ascribed to psychological factors or hypochondria. In a 2010 British Medical Journal case study, Dexter links a form of coital headache with POIS, and references a science forum in which thousands of sufferers (a number which is rapidly growing) have detailed their condition. Dexter's patient was found to have low progesterone.
Two people have been treated using hyposensitation techniques for semen allergies. One person, who had been symptomatic for 27 years, was treated norethisterone, half an hour before, and in the minutes just after orgasm.
Most recently, in early 2011, Professor Waldinger and collaborators further characterized POIS, proposed a specific immunological mechanism, and empirically supported their hypothesis on 45 Dutch Caucasian males. This study concluded that both Type-1 and Type-4 allergy to male's own semen contribute to symptoms of the illness.
Dexter speculates that POIS could be caused by a lack of progesterone, a powerful neurosteroid, or a defect in neurosteroid precursor synthesis. In the latter case, the same treatment may not be effective for different sufferers. Different sufferers may have different missing precursors, ultimately leading to a deficiency of the same particular neurosteroid, causing similar symptoms.
An array of more subtle, lingering symptoms after orgasm, which would not constitute POIS, may contribute to habituation between mates. They may show up as restlessness, irritability, increased sexual frustration, apathy, sluggishness, neediness, dissatisfaction with a mate, or weepiness  over the days or weeks after intense sexual stimulation. Such phenomena may be part of human mating physiology itself. Habituation to a mate can drive the search for novel mates (the Coolidge effect).
One researcher suggests that the symptoms may be produced by an autoimmune reaction against any of various hormones or other substances secreted during and after sex. Another suggests that chemical imbalances in the brain may cause the symptoms.
It is difficult to demonstrate a causal relationship based on patient reports.
Sexual activity for the first time may set the stage for an associated asthmatic attack or may aggravate pre-existing asthma. Intense emotional stimuli during sexual intercourse can lead to autonomic imbalance with parasympathetic over reactivity, thereby causing release of mast cell mediators that can provoke postcoital asthma and/or rhinitis in these patients’.
In the United States of America, POIS is recognized as a rare disorder by the National Institutes for Health (NIH), Office of Rare Diseases Research. It is also listed in the organizational database of the National Organization for Rare Disorders (NORD).
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- Waldinger MD, Meinardi M, Zwinderman A, Schweitzer, D. (April 2011). Postorgasmic Illness Syndrome (POIS) in 45 Dutch Caucasian Males: Clinical Characteristics and Evidence for an Immunogenic Pathogenesis (Part 1). The Journal of Sexual Medicine. doi:10.1111/j.1743-6109.2010.02166.x.
- Waldinger MD, Schweitzer DH (2002). "Postorgasmic illness syndrome: two cases". J Sex Marital Ther 28 (3): 251–5. doi:10.1080/009262302760328280. PMID 11995603.
- Dexter S (2010). "Benign coital headache relieved by partner’s pregnancies with implications for future treatment". British Medical Journal.
- Richard Balon, R. Taylor Segraves (2005). Handbook of sexual dysfunction. Informa Health Care. ISBN 978-0-8247-5826-4. Retrieved 2009-05-11.
- "The Naked Scientists". 2010.
- Waldinger MD, Meinardi M, Zwinderman A, Schweitzer, D. (April 2011). Hyposensitization Therapy with Autologous Semen in Two Dutch Caucasian Males: Beneficial Effects in Postorgasmic Illness Syndrome (POIS; Part 2). The Journal of Sexual Medicine. doi:10.1111/j.1743-6109.2010.02167.x.
- Burri AV, Spector TD. (June 2011). "An epidemiological survey of post-coital psychological symptoms in a UK population sample of female twins". Twin Res Hum Genet.
- "Dutch Doctor Identifies Post-Orgasmic Syndrome". Amsterdam. Reuters. 12 April 2002.
- Friedman, Richard A. (19 January 2009). "In the Brain, if Not the Mind". The New York Times. Retrieved 12 May 2009.
- Berger, Joanne M. (1 June 2002). "Allergic to sex? (Indications)". International Medical News Group.
- Ashok Shah (2001). "Asthma and sex". Indian J Chest Dis Allied Sci (medind.nic.in) 43: 135–137.
- "Postorgasmic illness syndrome | Disease | Overview". Office of Rare Diseases Research (ORDR-NCATS). Retrieved 2014-02-23.
- Post Orgasmic Illness Syndrome (P.O.I.S.) Forum National Organization for Rare Disorders
- Semen allergy suspected in rare post-orgasm illness (Reuters, January 17, 2011)
- Naked Scientist Forum (POIS topic)