Postorgasmic illness syndrome

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In men, postorgasmic illness syndrome (POIS) is a rare disease[s 1] characterized by severe muscle pain throughout the body and other symptoms immediately following ejaculation. The symptoms last for a few hours to several days.[n 1] The phenomenon was first described in 2002.[s 2][1]

Postorgasmic illness syndrome
Classification and external resources
MeSH D004542, D012735
Orphanet 279947

Signs and symptoms[edit]

Symptoms usually appear within half an hour of orgasm and resolve after a few days.[2][s 2] The person may experience a combination of mental and physical symptoms. 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.[3][2][s 2][w 1] Physical symptoms include severe fatigue, weakness, mild to severe headache, and flu-like and allergy-like symptoms, such as sneezing, itchy eyes, nasal irritation, and muscle pain.[2][s 2][s 3] Affected individuals may also experience intense warmth or cold.[1][3]

Diagnosis[edit]

Waldinger says this condition is prone to being erroneously ascribed to psychological factors or hypochondria.[1] 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.[2][w 1] Dexter's patient was found to have low progesterone.[2]

Pathophysiology[edit]

In 2011, Waldinger further characterized POIS, proposed a specific immunological mechanism, and supported their hypothesis on 45 Dutch Caucasian males. This study concluded that both Type-1 and Type-4 allergy to a male's own semen contribute to symptoms of the illness.[3]

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[o 1] 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.[m 1] Another suggests that chemical imbalances in the brain may cause the symptoms.[m 2]

It is difficult to demonstrate a causal relationship based on patient reports.[s 4]

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’.[8]

Management[edit]

Affected individuals typically avoid sexual activity,[1] especially orgasm, or schedule it for times when they can rest and recover for several days afterwards.[s 2]

Two people have been treated using hyposensitation techniques for semen allergies.[4] One person, who had been symptomatic for 27 years, was treated with norethisterone, half an hour before, and in the minutes just after orgasm.[2]

Epidemiology[edit]

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.[s 1]

See also[edit]

Notes[edit]

  1. ^ Post orgasmic illness syndrome is described in the following peer-reviewed papers: Waldinger (2002),[1] Dexter (2010),[2] Waldinger (2011a),[3] Waldinger (2011b),[4] Farley (2011),[5] Puerta (2013),[6] and Jiang (2015).[7]

References[edit]

Peer-reviewed papers[edit]

  1. ^ a b c d e Waldinger MD, Schweitzer DH (May 2002). "Postorgasmic illness syndrome: two cases.". J Sex Marital Ther. 28 (3): 251–5. doi:10.1080/009262302760328280. PMID 11995603. 
  2. ^ a b c d e f g Dexter S (Feb 2010). "Benign coital headache relieved by partner's pregnancies with implications for future treatment.". BMJ Case Rep. doi:10.1136/bcr.10.2009.2359. PMID 22315637. 
  3. ^ a b c d Waldinger MD, Meinardi MM, Zwinderman AH, Schweitzer DH (Apr 2011). "Postorgasmic Illness Syndrome (POIS) in 45 Dutch caucasian males: clinical characteristics and evidence for an immunogenic pathogenesis (Part 1).". J Sex Med. 8 (4): 1164–70. doi:10.1111/j.1743-6109.2010.02166.x. PMID 21241453. 
  4. ^ a b Waldinger MD, Meinardi MM, Schweitzer DH (Apr 2011). "Hyposensitization therapy with autologous semen in two Dutch caucasian males: beneficial effects in Postorgasmic Illness Syndrome (POIS; Part 2).". J Sex Med. 8 (4): 1171–6. doi:10.1111/j.1743-6109.2010.02167.x. PMID 21241454. 
  5. ^ Farley SJ (Mar 2011). "Postorgasmic illness syndrome.". Nat Rev Urol. 8 (3): 121. PMID 21513019. 
  6. ^ Puerta Suárez J, Cardona Maya W. (Oct 2013). "Postorgasmic illness syndrome: semen allergy in men.". Actas Urol Esp. 37 (9): 593. doi:10.1016/j.acuro.2013.03.002. PMID 23684345. 
  7. ^ Jiang N, Xi G, Li H, Yin J (Mar 2015). "Postorgasmic illness syndrome (POIS) in a Chinese man: no proof for IgE-mediated allergy to semen.". J Sex Med. 12 (3): 840–5. doi:10.1111/jsm.12813. PMID 25630453. 
  8. ^ Shah A (Jul 2001). "Asthma and sex." (PDF). Indian J Chest Dis Allied Sci. 43 (3): 135–7. PMID 11529431. 

Secondary sources[edit]

  1. ^ a b "Postorgasmic illness syndrome". Genetic and Rare Diseases Information Center (GARD). National Institutes of Health. 2015. Retrieved 30 July 2015. 
  2. ^ a b c d e Balon R, Segraves RT, ed. (2005). Handbook of Sexual Dysfunction. Taylor & Francis. ISBN 9780824758264. 
  3. ^ Wylie KR, ed. (2015). ABC of Sexual Health. John Wiley & Sons. p. 75. ISBN 9781118665565. 
  4. ^ Berger, Joanne M. (1 June 2002). "Allergic to sex? (Indications)". Family Practice News. International Medical News Group. [citation needed]

Media[edit]

  1. ^ "Dutch Doctor Identifies Post-Orgasmic Syndrome". Reuters Health (Amsterdam). Reuters. April 12, 2002. Retrieved 30 July 2015. 
  2. ^ Friedman, Richard A. (January 19, 2009). "Sex and Depression: In the Brain, if Not the Mind". The New York Times. Retrieved 30 July 2015. 

Websites[edit]

  1. ^ a b "Post Orgasmic Illness Syndrome (POIS)". The Naked Scientists. 18 Feb 2007. Retrieved 30 July 2015. 

Non-POIS-related[edit]

  1. ^ Burri AV, Spector TD (Jun 2011). "An epidemiological survey of post-coital psychological symptoms in a UK population sample of female twins.". Twin Res Hum Genet. 14 (3): 240–8. doi:10.1375/twin.14.3.240. PMID 21623654. 

External links[edit]