Post-orgasmic Illness Syndrome - Causes, Diagnosis, and Treatment

Introduction:

Post-orgasmic illness syndrome is a rare urogenital disorder (sexual disorder) or, in lay terms, a post-ejaculation disorder in which the person becomes sick after ejaculation or receiving an orgasm. It is also a rare orgasmic disorder with limited studies. There is no single treatment for it, and the condition subsides after some time. However, there are still chances of recurrence in people with such symptoms.

What Is Post-orgasmic Illness Syndrome?

Post-orgasmic illness syndrome (POIS) is when unusual flu-like symptoms occur post-ejaculation (orgasms) during either sexual intercourse, masturbation, or orgasms that occur during sleep (sexsomnia). Studies show men are more commonly affected by post-orgasmic illness syndrome than females. However, females are also affected by it. These flu-like symptoms can occur immediately or 20 to 30 minutes after the event.

What Causes Post-orgasmic Illness?

Studies have not found a definite cause for post-orgasmic illness syndrome. Still, various theories explain why people experience flu-like symptoms after achieving orgasms.

• Autoimmune Reaction - While the reason remains unknown, researchers believe it is an autoimmune inflammatory reaction (autoimmune allergy reaction) to a substance in a man's semen. Researchers believe specific cytokines are known to be released in the male seminal fluid (semen) due to the autoimmune reaction that triggers the post-orgasmic illness. The release of these cytokines is due to specific antigens in the seminal fluid in the case of males. In the case of females, it is associated with the female prostatic tissues around the vagina.

• Hormonal Imbalance - Some theories also suggest hormonal imbalance (low cortisol, low testosterone levels) to be the reason.

• Neurological Association - Ongoing studies believe a chemical imbalance in the brain could be the causative factor for post-orgasmic illness. Since it occurs after the release of certain hormones (such as oxytocin and serotonin), it is thought to have a neurological association. While a few other theories also suggest this disorder may involve the endogenous μ- opioid receptors (receptors present in the brain and spinal cord).

What Are the Signs and Symptoms of POIS?

Diagnosis of post-orgasmic illness syndrome mainly depends on the symptoms. Symptoms of post-orgasmic illness syndrome differ from person to person, but usually, one experiences the same symptoms after each orgasmic episode. Among men, these symptoms vary in intensity, duration, and frequency. These symptoms occur within minutes to a few hours and disappear within a week. However, signs that persist for more than a week could prove to be serious.

• General Symptoms- Extreme fatigue, exhaustion, palpitations, problems finding words, incoherent speech, dysarthria, concentration difficulties, quickly irritated, cannot stand noise, photophobia, negative thoughts, and mood swings.

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• Flu-like Symptoms- A person can experience extreme temperatures, feverish, extreme warmth and sweating, and even feel extremely cold, sick, and shivering.

• Head- Headaches usually start with mild heaviness in the head and severe headaches.

• Eyes- Burning, red injected eyes, blurred vision, watery, irritating, itching eyes, painful eyes

• Nose- Nose congestion, blocked nose, breathing difficulties, watery or runny nose, sneezing.

• Oral- Tasteless feeling on consuming any food, dirty taste in the mouth, dry mouth. There are rare incidences when people vomit with post-orgasmic illness syndrome, but it is not a ruling-out factor.

• Throat- Sore throat, tickling cough, heaviness in the voice.

• Muscle- Muscle tension behind the neck, muscle weakness, pain in muscles, heavy legs, stiff muscles.

How Is Post-orgasmic Syndrome Diagnosed?

Along with the noticeable signs and symptoms, a skin prick test is usually done to confirm the diagnosis.

• Skin Prick Test- A skin prick test may be performed to diagnose post-orgasmic illness syndrome. Under the supervision of a doctor, this test can trigger symptoms of post-orgasmic illness syndrome and should be treated immediately in a hospital.

• Changing Sexual Habits- Along with other investigations, men are asked to change their masturbation or intercourse habits right before the first genital sensations of a forthcoming ejaculation. In most cases, men notice an improvement in the symptoms of POIS (post-orgasmic illness syndrome) with these changes.

What Is the Treatment for Post-orgasmic Illness Syndrome?

Since the cause of post-orgasmic illness syndrome is unclear, a single definitive treatment option is not successful for all. Understanding the cause is essential to help the person to get rid of the current signs and symptoms as soon as possible. Treatment and management of post-orgasmic illness syndrome include:

1. Sexual Abstinence - People are often recommended to avoid indulging in any kind of sexual activity (avoidance of sex) known to give them any sexual pleasure and orgasms until the symptoms subside. Some may require periodic sexual abstinence instead of complete sexual abstinence. Additionally, it can be equally frustrating to adapt to sexual abstinence, but some people may require additional professional counseling and therapy.

2. Scheduling Sexual Activities - At times when sexual abstinence may not be a preferred choice or people may lack self-control. In such situations, sexual activities are often scheduled and planned under the coverage of prior medications to avoid allergic reactions and flu-like symptoms.

3. Medications-

• Non-steroidal Anti-inflammatory Drugs - In patients where the release of cytokines causes post-orgasmic illness, medications like NSAIDs (non-steroidal anti-inflammatory drugs) are prescribed just two-three hours before the orgasmic event and to be continued for a couple of days after the event.

  • Patients with erectile dysfunction and premature ejaculation are treated for these conditions first.

  • In cases where the cause is unknown, essential medications are given to relieve the signs and symptoms. For example, Ibuprofen (when the symptoms occur), Diclofenac (before sexual events), Tramadol (pre-intercourse), and Escitalopram (for months) are given. The doses of these medications depend on the severity and intensity of the signs and symptoms.

• Antihistamine Medications- Histamine is a hormone or a chemical transmitter, an essential protein involved in local immune responses, regulates stomach acid production, and acts as a mediator in allergic reactions. Antihistamine medications hence help in reducing allergic symptoms.

• Desensitization - Patients with autoimmune reaction as the causative factor for POIS are given multiple subcutaneous injections of their semen to make them immune and reduce the allergic responses for two to three years.

• Testosterone Patches - In people where hormonal imbalance may be the causative factor, such as low testosterone levels, testosterone patches that slowly release testosterone hormones are given to the patient. This also suppresses cytokine release and activates the immune system.

• Vitamin Supplements - Niacin (vitamin B3 or nicotinic acid) is known to improve immunity and reduce the body’s allergic responses.

• Serotonin Supplements - Serotonin supplements are given (happy hormone or feel-good hormone) to reduce the symptoms of mental illness such as frustration, anxiety, mood swings, and depression.

4. Exercise and Diet - Exercise and workout activities are trigger factors to release endorphins (happy hormones). In addition, people should follow a healthy diet to avoid sugar, significantly reduce fatty and greasy foods, and limit the consumption of processed foods. The combination of increased exercise and improved diet is the most common factor in those who have significantly improved their symptoms.

5. Surgery in Severe Cases - Severe cases of post-orgasmic illness syndrome, for example, in cases where:

• People with severe flu-like symptoms take a long time to subside.

• When medications do not help.

• Unsuccessful sexual abstinence (difficulty avoiding indulging in sexual activities).

The condition can affect the person's overall health and sometimes worsen the underlying conditions. In such cases, doctors may recommend surgical removal of the testes or ovaries. However, in cases where medications, desensitization, and sexual abstinence is successful, surgeries are mostly avoided.

Conclusion:

The most important thing is to practice safe masturbation and safe sex and to include an adequate recovery period between sexual acts (at least 15 to 30 minutes). One must not hesitate to seek help, especially when suffering from conditions such as post-orgasmic illness syndrome (POIS). Immediate professional help, such as consulting a sex therapist or medications from qualified doctors, may improve the condition and limit suffering.