Post Orgasmic Illness Syndrome (POIS)

[Michael Scally MD]

Post-Orgasmic Illness Syndrome: History and Current Perspectives

Post-orgasmic illness syndrome is a rare disorder causing a debilitating cluster of flu-like and allergic type symptoms that occur within seconds, minutes or hours after ejaculation. Symptoms occur after intercourse, masturbation or spontaneous ejaculation and last from 2 to 7 days. The condition is chronic and follows a primary pattern occurring in adolescence and a secondary acquired pattern with onset later in life. The true incidence is unknown as the condition is likely under-reported and under-diagnosed. The pattern of symptoms suggests an allergic or auto-immune etiology; however, the exact pathophysiology is unknown and there is no effective treatment. Men suffering from post-orgasmic illness syndrome describe emotional trauma and significant impairment of their quality of life.

Paulos MR, Avelliino GJ. Post-orgasmic illness syndrome: history and current perspectives. Fertil Steril. 2020;113(1):13-15. doi:10.1016/j.fertnstert.2019.11.021 https://www.fertstert.org/article/S0015-0282(19)32560-9/fulltext

 

[Michael Scally MD]

Case of Post-Orgasmic Illness Syndrome Associated with Hypogonadism

Introduction: Post-orgasmic illness syndrome is a rare condition that occurs after ejaculation and persists for 2-7 days and is characterized by flu-like symptoms, which can significantly reduce quality of life.

Case presentation: A 21-year-old unmarried man was referred to our hospital due to flu-like symptoms that developed after ejaculation by masturbation and persisted for about 2 days. The patient's free testosterone level was slightly lower than normal. Nonsteroidal anti-inflammatory drugs were initially administered and helped relieve headache and muscle pain. Thereafter, the patient was able to ejaculate three times a week. In addition, after administering testosterone enanthate once or twice a month, his general fatigue significantly improved, and he could ejaculate every day.

Conclusion: The pathophysiology of post-orgasmic illness syndrome has not been fully elucidated. The treatments for this condition must be accurately selected according to pathophysiology.

Takeshima T, Kuroda S, Yumura Y. Case of post-orgasmic illness syndrome associated with hypogonadism. IJU Case Rep. 2020;3(5):189-191. Published 2020 Jul 1. doi:10.1002/iju5.12184 Error - Cookies Turned Off

 

[Michael Scally MD]

Primary Headache Associated with Sexual Activity

Highlights
· Sexual headache mimics life-threatening causes, but it is benign, and treatable.
· Patients may have difficulty of explaining the problem.
· Apart from medication, counseling and facilitation matter in managing.

Primary headache associated with sexual activity is an infrequent kind of headache mostly seen in the male gender and initiates during the third decade. Although the pathophysiology is still unknown, it is a benign type of headache and must be reminded of the differential diagnosis of the secondary headache.

Thirteen patients were diagnosed and assessed by their clinical and demographic data. The mean age was 37.07 ± 7.67. Headache was usually localized at the bilateral occipital area or diffuse, starting with a severe ache and sudden explosive intensity in association with pre orgasm in eight patients and orgasm in five patients with a mean VAS score of 7.8 ± 1.2. The mean duration was 21.53 ± 15.32 min. Five patients had a history of migraine, three had arterial hypertension, and two were diagnosed as primary thunderclap headache with sudden beginning and high-intensity ache.

Herein, we present our cases to highlight the importance of differential diagnosis. Patients may have difficulty explaining the problem; therefore, their sexual activity could be limited. Apart from pharmacological prevention, counseling plays an essential role in managing.

Ari BC, Mayda Domac F, Ulutas S. Primary headache associated with sexual activity: A case series of 13 patients. J Clin Neurosci. 2020 Sep;79:51-53. doi: 10.1016/j.jocn.2020.07.068. Epub 2020 Aug 4. PMID: 33070917. https://www.jocn-journal.com/article/S0967-5868(20)31432-6/fulltext

 

[Michael Scally MD]

Postorgasmic Illness Syndrome: Potential New Treatment Options For A Rare Disorder

A 28-year-old man presented with a chief complaint of a lifelong history of postejaculatory symptoms. The patient described myalgia, fatigue, lethargy, and gastrointestinal symptoms beginning immediately after orgasm. He complained of experiencing painful abdominal cramping, diarrhea, bloating with black stools, flatulence, and loss of appetite.

He also reported an initial inability to fall asleep independent of time of orgasm followed by intense fatigue and somnolence in the days following orgasm. He reported normally sleeping 8 h per night, but would sleep for periods of up to 14 h after orgasm.

He further complained of intense dry mouth and lips with halitosis, and right-sided eye redness and dryness. Aside from the eye symptoms, which resolved after 24 h, his symptoms collectively persisted for up 2 weeks following orgasm.

He stated that the severity of his symptoms were directly correlated with the number of orgasms he experienced in succession, increasing in intensity with each orgasm. The symptoms occurred regardless of whether ejaculation was due to masturbation, spontaneous ejaculation, or sexual intercourse. He denies experiencing his symptoms in any other situations. He is single and sexually active with female partners. …

Pierce H, Fainberg J, Gaffney C, Aboukhashaba A, Khan A, Kashanian J. Postorgasmic illness syndrome: potential new treatment options for a rare disorder. Scand J Urol. 2020 Feb;54(1):86-88. doi: 10.1080/21681805.2019.1704861. Epub 2019 Dec 27. PMID: 31878818. https://www.tandfonline.com/doi/abs/10.1080/21681805.2019.1704861?journalCode=isju20