ArticlePublisher preview available

Clinical experience with post-orgasmic illness syndrome (POIS) patients—characteristics and possible treatment modality

Authors:
Yacov Reisman at Flare Health
Yacov Reisman
  • Flare Health
Read publisher preview
Download citation
To read the full-text of this research, you can request a copy directly from the author.

Abstract and Figures

Post-orgasmic illness syndrome (POIS) is a rare condition that includes a cluster of post-ejaculatory symptoms with debilitating physical and psychological consequences. The prevalence and incidence of POIS remain unknown as well as the pathophysiology of the syndrome, and there are no well-studied recognized treatment modalities. The current retrospective observational study describes a series of 14 highly selected patients who were actively looking for medical help as POIS has a significant effect on patients and their partners. The aim is to increase knowledge about this syndrome and possible treatment modality. According to a standard protocol, patients have been systematically interviewed, had a physical examination, laboratory blood tests, and treatments. Mean age was 34.07 ± 6.65 years. The majority of patients had only one symptom in common—extreme fatigue. The most prevalent complaints were head pressure/heaviness, nose congestion and muscle tension; all patients suffered from more than 1 symptom. POIS started on average within 30 min of ejaculation and lasted for 3.5 days. The patients reported emotional and psychosocial burden of their symptoms, which also influence their partner and relationships. Immunoglobulin-E measurements did not show elevated levels and/or significant increase within 24 h after ejaculation. Silodosin, a highly selective alpha1A-blocker, which actually causes anejaculation, was effective treatment in 57% of the patients.
Figures - available from: International Journal of Impotence Research
This content is subject to copyright. Terms and conditions apply.
A preview of this full-text is provided by Springer Nature.
Learn more
Content available from International Journal of Impotence Research
This content is subject to copyright. Terms and conditions apply.
IJIR: Your Sexual Medicine Journal (2021) 33:556–562
https://doi.org/10.1038/s41443-020-0314-9
ARTICLE
Clinical experience with post-orgasmic illness syndrome (POIS)
patients—characteristics and possible treatment modality
Y. Reisman 1
Received: 26 March 2020 / Revised: 18 May 2020 / Accepted: 19 May 2020 / Published online: 29 May 2020
© The Author(s), under exclusive licence to Springer Nature Limited 2020
Abstract
Post-orgasmic illness syndrome (POIS) is a rare condition that includes a cluster of post-ejaculatory symptoms with
debilitating physical and psychological consequences. The prevalence and incidence of POIS remain unknown as well as the
pathophysiology of the syndrome, and there are no well-studied recognized treatment modalities. The current retrospective
observational study describes a series of 14 highly selected patients who were actively looking for medical help as POIS has
a significant effect on patients and their partners. The aim is to increase knowledge about this syndrome and possible
treatment modality. According to a standard protocol, patients have been systematically interviewed, had a physical
examination, laboratory blood tests, and treatments. Mean age was 34.07 ± 6.65 years. The majority of patients had only one
symptom in common—extreme fatigue. The most prevalent complaints were head pressure/heaviness, nose congestion and
muscle tension; all patients suffered from more than 1 symptom. POIS started on average within 30 min of ejaculation and
lasted for 3.5 days. The patients reported emotional and psychosocial burden of their symptoms, which also influence their
partner and relationships. Immunoglobulin-E measurements did not show elevated levels and/or significant increase within
24 h after ejaculation. Silodosin, a highly selective alpha1A-blocker, which actually causes anejaculation, was effective
treatment in 57% of the patients.
Introduction
In 2002, Waldinger and Schweitzer describe for the first
time two patients who suffer from post-ejaculation flu-like
symptoms and introduce the post-orgasmic illness syn-
drome (POIS) [1]. POIS is a rare sex-related condition that
affects men and includes a cluster of post-ejaculatory
symptoms with debilitating physical and psychological
consequences [2,3]. The presentation of POIS is highly
variable in the intensity, duration, type of symptoms, and
their order of appearance. All symptoms occur immediately
(e.g., seconds), soon (e.g., minutes), or within a few hours
after ejaculation and most of these symptoms last for 2 to
7 days [3]. A large number of the men included in the study
by Waldinger et al. [4] and Jiang et al. [5] reported lifelong
premature ejaculation (PE). Many of the patients avoided
sexual activity, including masturbation, dampening and
avoidance of sexual or intimate relationships to avoid the
symptoms. Furthermore, the symptoms that accompany
ejaculation may interfere with daily activities, such as work
or study, and may also have a negative impact on the
partner [6].
Due to lack of awareness about the syndrome and a
limited number of studies, the prevalence and incidence of
POIS remain unknown. A few hypotheses about the
aetiology of POIS have been proposed, among others an
immunological or autoimmune mechanism (supported by
skin-prick test results of autologous semen), a disorder of
cytokine response, and consumption of endogenous mole-
cules that act on the opioid receptors, but the condition is
not well understood [4,5,7,8]. As a consequence, there is
no accepted effective treatment.
In 2011, Waldinger et al. [4] proposed preliminary
diagnostic criteria, which have recently been adapted by
Strashny [9]. Three of these criteria are considered mini-
mum for diagnosis [9]. The preliminary diagnostic criteria
are as follows:
1. One or more symptoms from among these seven
symptom clusters:
*Y. Reisman
reisman@flare-health.nl
1Flare-Health, W.H. Keesomlaan 12, 1183 DJ Amstelveen,
The Netherlands
1234567890();,:
1234567890();,:
Content courtesy of Springer Nature, terms of use apply. Rights reserved
... A total of 5 different analgesics were trialed across 4 studies: 1 cohort study of 14 patients, 15 and 3 case report articles. 9,10,16 While there is some limited data for improvement of symptoms with analgesics, overall this class was shown to have little utility in treating POIS. ...
... 10 Ibuprofen, a COX-1 inhibitor, was assessed in a cohort study of 14 patients with POIS symptoms distributed throughout the 7 symptom clusters. 15 In the study, 7 patients were given Ibuprofen, of whom only 2 patients experienced relief of their POIS symptoms. 15 When combined with indomethacin, a COX-1 and COX-2 inhibitor with a relatively low COX-1 to COX-2 isoform ratio, 20 ibuprofen provided minor improvement in a 48-year-old female's head-cluster symptoms. ...
... 15 In the study, 7 patients were given Ibuprofen, of whom only 2 patients experienced relief of their POIS symptoms. 15 When combined with indomethacin, a COX-1 and COX-2 inhibitor with a relatively low COX-1 to COX-2 isoform ratio, 20 ibuprofen provided minor improvement in a 48-year-old female's head-cluster symptoms. 9 However, indomethacin alone did not provide any improvement in head-cluster symptoms for a 54-year-old woman. ...
Treatments for postorgasmic illness syndrome: a systematic review
Article
Full-text available
  • May 2025
  • J SEX MED
Introduction Postorgasmic illness syndrome (POIS) is a rare, poorly understood condition that is characterized by feeling ill after orgasm. Despite its significant impact on quality of life, POIS remains poorly understood, and effective treatment options are limited without clear guidelines. Only 18% of sexual medicine experts report symptom improvement in more than 30% of the patients. Current treatments have been used to address the various presentations such as flu-like state, mood disturbances and/or irritability, as well as congestion and inflammation. Given the lack of standardized therapeutic approaches, there is a critical need to document and evaluate various treatments tried for POIS management. Objective This systematic review aims to evaluate current treatment modalities for POIS and compile solutions that have been studied and tested. Methods A search was conducted in June 2024 of 3 of the most relevant databases (PubMed, Embase, and Scopus) of clinical studies, randomized controlled trials, and case reports analyzing treatment modalities of patients with diagnosed POIS. Results Of 58 studies found, 14 matched our inclusion criteria. Our systematic review consists of 1 cross-sectional study, 1 cohort study, and 12 case reports. Two papers included female patients, and the rest studied only male patients. Eleven papers discussed pharmacologic treatment modalities, including antihistamines, ibuprofen, NSAIDs, hormone replacement therapy, steroids, SSRIs, alpha-blockers, beta-blockers, calcium channel blockers, and triptans. Two papers mentioned immune treatment, one being the intracutaneous injection of autologous semen and the other being intralymphatic immunotherapy with the injection of allergen-specific immunotherapy. One paper mentioned surgical treatment with bilateral epididymectomy and bilateral vasoligation. Conclusion The largest limitation to continued research is related to the rarity and low recognizability of POIS; however, POIS research is on the rise. Scientists across the world are collaborating to better understand the pathophysiology behind this condition and investigate treatment modalities to address the associated symptoms.
View
... Other drugs used in the pharmacotherapy of POIS include corticosteroids, tramadol, nifedipine and alpha-blockers (Hamdi et al., 2021;Huang et al., 2022;Mashal, 2016;Pierce et al., 2020;Reisman, 2021). Each of these drugs has shown some efficacy in treating POIS, but they have been used in isolated cases, making it difficult to conclude their true efficacy (Hamdi et al., 2021;Huang et al., 2022;Mashal, 2016;Pierce et al., 2020;Reisman, 2021). ...
... Other drugs used in the pharmacotherapy of POIS include corticosteroids, tramadol, nifedipine and alpha-blockers (Hamdi et al., 2021;Huang et al., 2022;Mashal, 2016;Pierce et al., 2020;Reisman, 2021). Each of these drugs has shown some efficacy in treating POIS, but they have been used in isolated cases, making it difficult to conclude their true efficacy (Hamdi et al., 2021;Huang et al., 2022;Mashal, 2016;Pierce et al., 2020;Reisman, 2021). ...
Postorgasmic Illness Syndrome: Insights from Recent Literature on a Rare but Fascinating Disorder
Article
Full-text available
  • May 2025
  • Sex Cult
Post-orgasmic illness syndrome (POIS) is a rare condition characterised by flu-like and allergic symptoms that develop within hours of ejaculation and last for several days. This review explores current knowledge on POIS, including its symptoms, potential causes, and treatment approaches. While primarily documented in men, recent reports suggest it may also occur in women, although this remains under-researched. Common symptoms include difficulty concentrating, extreme fatigue, irritability, and muscle weakness. The exact cause of POIS remains unknown. Earlier theories suggested autoimmune or allergic mechanisms, but recent studies have proposed alternative explanations, such as chemical imbalances in the brain, dysregulated cytokine or neuroendocrine responses, or autonomic dysfunction. A more recent hypothesis is that an acute compression-derived proprioceptive axonopathy occurs in the muscle spindles of the bulbospongiosus and ischiocavernosus muscles. POIS has a significant impact on mental health, with comorbid conditions such as depression, anxiety, and obsessive–compulsive disorder reported. In addition, 56% of sufferers also experience premature ejaculation. As a literature review, this article summarizes existing research on POIS and its management. Treatment strategies vary depending on the hypothesised causes, including interventions such as antihistamines, SSRIs, benzodiazepines, niacin, NSAIDs, glucocorticoids, tramadol, nifedipine, alpha-blockers, testosterone therapy, surgery, and psychotherapy. However, the effectiveness of these treatments is variable, highlighting the need for further research to develop targeted therapies and improve patient outcomes.
View
... Post-orgasmic illness syndrome (POIS) POIS is an underrecognized but debilitating condition marked by flulike symptoms following ejaculation [8]. While its pathophysiology remains unclear, proposed mechanisms include autonomic dysregulation, immune responses, and psychological factors [9,10]. A global survey of sexual medicine experts highlighted widespread clinical uncertainty: over 65% of respondents believed available information was insufficient, and treatment practices varied significantly [8]. ...
... Psychotherapy, antihistamines, and SSRIs are commonly attempted, though reported success rates remain low. This lack of consensus and poor therapeutic outcomes underscore the urgent need for clinical guidelines and further research [9,10]. ...
View
... Understandably, over 80% (80.7%) reported that their symptoms negatively affected their relationships. The results of this study support previously assumed ideas about POIS and show that it affects numerous aspects of patients' lives [20]. To our knowledge and following an in-depth search of current medical literature, there has not been a study focused on the psychosocial aspects of POIS to date, although there is previous literature that has mentioned some of the psychosocial impacts that POIS patients have described feeling [17]. ...
Post-orgasmic illness syndrome and its effects on self esteem and relationships: a survey
Article
Full-text available
  • Jun 2025
Post-Orgasmic Illness Syndrome (POIS) is a rare medical condition characterized by a range of distressing physical and cognitive symptoms that occur following ejaculation in affected individuals. Little is known about the complex interaction between self-esteem and relationship factors that affect those living with POIS. This study investigated the impact of POIS on intimate relationships and feelings of isolation and stigmatization, including questions related to personal and partner control over symptoms. Furthermore, it aims to provide a clinical framework for addressing the psychosocial concerns of this patient population and their partners. Eighty-three patients (76.3% white, 37.5% with Bachelor’s degree, 73.8% middle income or higher) with POIS completed the Sexual Dysfunction Attribution Scale (SDAS) as part of the larger survey study. Surveys were distributed via social media, online groups, and forums including the subreddit: “POIS”, Twitter, and “POISCENTER” and were completed between 05/21/24–06/09/24. Descriptive, exploratory, and demographic data of the participants are provided from this survey. Patients with POIS were likely to report feeling no personal control over their symptoms (81.9%), feeling that their symptoms would “always be present” (96.4%), and feeling that they were personally to blame for their sexual dysfunction (60.2%). Overall, 80.7% reported that their symptoms negatively affected their relationships, and 37.3% reported not having sex within the past year. Our results can help providers to understand the experiences of patients with POIS and equip them to recommend the appropriate resources. Further research may use advanced analytical and qualitative techniques to better elucidate this population’s challenges.
View
... The autonomic dysregulation theory suggests that the sympathetic nervous system is dysregulated in POIS. This is supported by the partial success of alpha-blocker treatment (reported success rates: 57-100% of cases) [8,9]. ...
A Role for IgE in Post-Orgasmic Illness Syndrome: Successful Omalizumab Treatment in Absence of Positive Skin Test to Self Semen
Article
Full-text available
  • Dec 2024
Patient: Male, 22-year-old Final Diagnosis: Post-orgasmic illness syndrome Symptoms: Abdominal pain • concentration difficulty • dysuria • fatigue • flu like symptoms • itch • lethargy • malaise • rhinorrhea Clinical Procedure: — Specialty: Immunology Objective Rare disease Background Post-orgasmic illness syndrome (POIS) is a rare disease with an unknown etiology and pathophysiology. Several publications have previously reported successful results with various treatments, including antihistamines, selective serotonin reuptake inhibitors, and non-steroidal anti-inflammatory drugs. Here, we report the successful treatment of POIS with omalizumab in a patient with negative skin tests for self-semen with complete resolution of symptoms. So far, there has been only 1 previous report of omalizumab treatment for this syndrome. Case Report A 22-year-old man with constitutional, neurological, gastrointestinal, and allergic-like symptoms after ejaculation presented to our clinic. The patient had a negative intradermal test for self-semen, normal tryptase levels (pre- and post-ejaculation), and elevated total IgE. Several treatments had been prescribed. The most efficient combination treatment prior to omalizumab included high-dose antihistamines plus anti-inflammatory medications (steroidal or non-steroidal). This regimen alleviated some but not all his symptoms. Due to the nature of the symptoms, we hypothesized that IgE and mast cells could be involved in the pathophysiology of POIS in this patient. He was started on omalizumab, with complete resolution of symptoms. After 7 months, a treatment cessation attempt resulted in recurrence of the symptoms. Currently, while on omalizumab, the patient is symptom-free and feels comfortable engaging in sexual activity. Conclusions Omalizumab may be considered for the treatment of POIS in patients with allergy-like symptoms and symptoms that cannot be controlled with other medications, even in the absence of a positive skin test to semen. Lower doses may be ineffective.
View
... However, despite these treatments, complaints continued. In the study by Reisman et al., it was reported that 57.1% of patients receiving silodosin responded [12]. In parallel with this information, we initiated silodosin treatment. ...
Postorgasmic illness syndrome benefiting from omalizumab and antidepressant: a case report
Article
Full-text available
  • Dec 2024
  • J Med Case Rep
Background Postorgasmic illness syndrome is characterized by flu, rhinitis, conjunctivitis, loss of appetite, muscle weakness, and fatigue after ejaculation, lasting 2–7 days. The multidisciplinary treatment approach, incorporating omalizumab and antidepressants, has rarely been documented in literature. Case presentation In this article, we present the case of a 33-year-old single Turkish male with postorgasmic illness syndrome, characterized by typical clinical symptoms and a positive autologous semen test. Notably, his serum estrogen and progesterone levels were elevated. The patient’s Beck anxiety score was 42 points, the depression scale score was 37, and suicidal thoughts. Fresh autologous semen taken at the hospital was diluted with 0.9% saline, and prick and intradermal skin tests were performed. Conclusion The patient’s symptoms improved significantly with the combination of omalizumab and escitalopram. This case not only provides a new perspective on the management of postorgasmic illness syndrome but also highlights the potential roles of allergic, psychiatric, and endocrinological mechanisms in the etiology and treatment of this complex condition.
View
... To date, about sixty cases of POIS have been reported in the medical literature, but its prevalence, incidence, and treatment modality remain unknown [98][99][100][101][102][103][104][105][106]. The condition develops in both circumcised and uncircumcised men, at medium age, 34.07 ± 6.65 years, and with any exposure to sexual activity. ...
Exploration of Immunology Current challenges in the modern male immune system
Article
Full-text available
  • Dec 2024
Cite this article: Klimov V, Klimov A. Current challenges in the modern male immune system. Explor Immunol. 2024;4:780-92. https://doi. Abstract The tripartite network, including the nervous, immune, and endocrine systems, plays a significant role in regulatory and effector processes in the male body. On the one hand, males perform their reproduction function by generating spermatozoa in conditions of self-tolerance maintenance because most spermatozoa antigens ("sequestrated antigens") are unknown to the immune system. On the other hand, in everyday life, a male body encounters hostile external infections, some of which colonize the skin and barrier surfaces and present a cancer threat to male genital tracts. This is human papillomavirus (HPV), the "silent killer". Therefore, the male immune system has to function in a contradictory situation using either active immune responses, self-tolerance mechanisms, or both simultaneously. This review focused on the functional organization of the male immune system, including its coordination with the nervous and endocrine systems, and immune processes at the level of the whole organism, as well as on obvious changes, which have currently happened. The male immune system should function in conditions of the strong influence of testosterone and biosocial impulses coming from the nervous system. In the last century, researchers obtained data showing a decrease in the male reproduction function because of a stable negative dynamic of spermatozoa count and quality. Nowadays, depressing statistical indicators of male fertility have been published. 15% of couples are unable to conceive a child, where 50% of the causes of infertility relate to males, and up to 15% of male infertility cases are due to immunological disorders. It can be assumed that the male immune system starts to function when self-tolerance is partially lost, and the previous balance has been destroyed. Furthermore, sperm allergy has become a new topic in male immunology.
View
Review of recent data on disorders of ejaculation and orgasm in men: recommendations from the Fifth International Consultation on Sexual Medicine
Article
  • Apr 2025
Introduction Disorders of ejaculation and orgasm (DEO) in men are poorly understood and can pose a substantial burden to men and their sexual partners. Objectives Under the aegis of the International Consultation on Sexual Medicine, a multinational, multidisciplinary panel of experts was convened to review the world literature and generate a consensus on management of DEO in men. This document represents a summary of the panel’s report on physiology of ejaculation and orgasm, mental health conditions, and specific DEO that are not related to the timing of climax (ie, premature and delayed ejaculation). Methods Narrative review of existing literature and consensus recommendations from the expert panel. Results The processes of ejaculation and orgasm are complex and include neuronal and hormonal factors as well as psychological and interpersonal dynamics. Care of the patient presenting with a potential DEO centers on sensitive history taking and selective testing. Declines in semen volume may occur naturally with age and can be seen in the context of medical or surgical therapies. Pain with ejaculation/orgasm has a myriad of potential etiologies and may be part of a complex chronic pelvic pain syndrome; assessment for related diagnoses that may be contributory is warranted. Hematospermia can be distressing but is often benign; management when indicated is geared toward detecting potentially reversible etiologies. Climacturia is a troublesome condition of urine loss common after prostate surgeries; Behavioral and physical therapy and surgical intervention may be of value in these cases. Management strategies for anhedonic orgasm and post-orgasmic illness syndrome are not well established. Dhat is a complex syndrome oftentimes centered around pathological fear of semen loss that is best managed with a sensitive and culturally appropriate focus. Conclusions An understanding of the processes of ejaculation and what is known about DEO can aid clinicians and researchers in providing optimal care.
View
Management Strategies for Ejaculatory Dysfunction: Algorithms and Recent Advances
Chapter
  • Mar 2025
Ejaculatory disorders are the most common disorders of sexual function in the male. The various ejaculatory disorders include early ejaculation (previously premature ejaculation), delayed/anejaculation, retrograde ejaculation, painful ejaculation, and postorgasmic illness syndrome. The approach to the management of ejaculatory dysfunction is multifaceted, encompassing psychological, pharmacological, surgical, and newer therapies. Psychotherapy, including cognitive behavioural therapy and sex therapy, has proven effective in addressing the underlying psychological factors contributing to ejaculatory dysfunction. In the recent years, despite the significant advancements achieved in medical management of ejaculatory dysfunctions, like selective serotonin reuptake inhibitors, topical sprays, and creams, due to the poor realization of the mechanisms causing these dysfunction, there are no specific medications that can completely reverse the disorders. There are still no FDA-approved medications for the management of these disorders except for early ejaculation. Furthermore, emerging therapies, including selective dorsal neurectomy, glans penis augmentation, etc., offer innovative options for patients who do not respond to conventional treatments. This chapter emphasizes the importance of integrated management strategies for ejaculatory disorders by incorporating algorithms and recent advances. The chapter also aims to offer practical tips in guiding the healthcare professionals for a systematic and customized approach toward management of ejaculatory disorders.
View
Choice of Drugs in Ejaculatory Dysfunction
Chapter
  • Mar 2025
Ejaculatory dysfunction is a term that describes a spectrum of debilitating diseases that impacts the quality of life of men affected. This spectrum comprises a range of symptoms and the most common subtypes encountered can be summarized as premature ejaculation (PE), delayed ejaculation (DE), anejaculation, retrograde ejaculation (RE), painful ejaculation, post-orgasmic illness syndrome (POIS), and many others. Diagnosis is challenging considering patient hesitancy for medical care seeking, high variety in presenting symptoms, and lack of consensus in diagnosing criteria. There are many treatment modalities that target each subtype of the spectrum and can broadly be categorized into psychological therapy, pharmacologic treatment, local therapies, surgical treatments, and combinations of these. In this chapter, we aim to provide background and review the current and emerging treatment modalities for each subtype of ejaculatory dysfunction.
View
Post orgasmic illness syndrome: What do we know till now?
Article
Full-text available
  • Dec 2019
Background: Peri orgasmic dysfunctions are very rare and little information exists on their diagnosis and treatment. One of these conditions is post-orgasmic illness syndrome (POIS), manifesting by a debilitating cluster of symptoms affecting men within seconds, minutes, or hours after ejaculation. The aim of this article is to do a thorough literature review about POIS, in order to elucidate the pathophysiology, the diagnosis and the management of this rare disease. Results: Updated literature review on Pubmed was done, using the following terms: "orgasm illness", "post-orgasmic" and "postorgasmic illness syndrome". The references of the 17 identified publications were also reviewed for additional 8 relevant articles that were all included in the results.POIS has 5 preliminary diagnostic criteria and criterion 1 has 7 described clusters. Pathophysiological hypotheses include: immunological phenomenon (most relevant), opioid-like withdrawal, neuroendocrine response, transient deregulation of the autonomic nervous system, hypersensitivity and disordered cytokines. Differential diagnoses include: chronic prostatitis, orgasmolepsy, benign orgasmic cephalgia, sneezing and rhinorrhea, postcoital dysphoria, post-coital asthma and rhinitis. Patients have been symptomatically treated with antihistamines, non-steroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, and benzodiazepines. A trial of hyposensitization therapy with autologous semen was successful. Conclusion: POIS is a rare condition that is underdiagnosed, most probably because of its unclear pathophysiology leading to a lack of treatment options. Further studies are warranted to investigate the prevalence, pathophysiology, and management of this debilitating condition.
View
First assessment of the validity of the only diagnostic criteria for postorgasmic illness syndrome (POIS)
Article
Full-text available
  • Sep 2019
Postorgasmic illness syndrome (POIS) is a rare condition that affects men and about which little is known. According to Waldinger and colleagues, men with POIS fulfill three or more of five preliminary diagnostic criteria regarding symptoms, time to onset, setting, duration, and spontaneous disappearance. We conducted a self-report study to assess, for the first time, the validity of these criteria. One hundred and twenty-seven men with self-reported POIS have completed the survey, making this the largest study of such men to date. Almost all respondents fulfill a majority of the criteria for POIS; a large minority fulfills all five criteria. Almost all respondents always experience symptoms after ejaculating in at least one ejaculatory setting (sex, masturbation, or nocturnal emission), though only a small majority fulfill the criterion that symptoms occur after all ejaculations because a large minority always experience symptoms in one setting but not always in another. The most common symptom cluster from the criteria, involving fatigue, irritation, and concentration difficulties, is always experienced by 80% of respondents. Median symptom severity is 8 on a 0–10 scale. While almost all men with POIS fulfill a majority of the preliminary diagnostic criteria, there is room for refining some of the criteria. More about the data: https://sites.google.com/view/the-pois-survey
View
Postorgasmic Illness Syndrome: What do we know so far?
Article
Full-text available
  • Sep 2018
Post-orgasmic illness syndrome (POIS) is rare condition that is characterized by transient flu-like symptoms and cognition disorders that occur shortly after ejaculation and last for 2-7 days. There are about 50 cases of POIS in the literature. The prevalence and incidence of POIS are still unknown due to a paucity of studies. The exact pathogenesis of POIS remains unknown; the most acceptable hypothesis is an autoimmune/allergic process. We made a literature search via PubMed for publications from 2002 to 2018 with the "post orgasmic illness syndrome" medical subject heading term to analyze current data regarding symptoms, burden, pathophysiology, and to discuss potential management options for POIS. POIS is diagnosed by five preliminary diagnostic criteria. It is categorized into two types: primary and secondary. There is the concomitance between POIS and PE. The autoimmune/allergy hypothesis is the most accepted hypothesis explaining POIS pathogenesis. A competing hypothesis involves a disorder of endogenous μ-opioid receptors. Patients with POIS have been symptomatically treated with antihistamines, selective serotonin reuptake inhibitors, and benzodiazepines. A trial of hyposensitization therapy with autologous semen was successful. A trial of nonsteroidal anti-inflammatory medication helped in a single case report but failed to successfully treat other patients with POIS.
View
Intralymphatic Immunotherapy With Autologous Semen in a Korean Man With Post-Orgasmic Illness Syndrome
Article
Full-text available
  • Mar 2018
Post-orgasmic illness syndrome (POIS) is a very rare disease characterized by local allergic symptoms and transient flu-like illness that nearly always occur after masturbation, coitus, or spontaneous ejaculation and last for 2 to 7 days. In a previous case report, 2 patients with POIS received hyposensitization therapy composed of multiple subcutaneous injections of autologous semen that resulted in a gradual decrease of symptoms. However, this procedure requires patients to endure pain and discomfort during frequent subcutaneous injections and preceding masturbations to obtain the autologous semen used for therapy. Recent studies have suggested that intralymphatic immunotherapy is a promising new method of allergen-specific immunotherapy against allergic diseases, showing a faster onset and longer duration of therapeutic effects after only several intralymphatic injections. We report on a case of a Korean man with POIS who received intralymphatic immunotherapy that alleviated POIS-related symptoms and in whom the existence of semen-specific immunoglobulin E was confirmed using immunoglobulin E immunoblotting and enzyme-linked immunosorbent assay. Kim TB, Shim YS, Lee, SM, et al. Intralymphatic Immunotherapy With Autologous Semen in a Korean Man With Post-Orgasmic Illness Syndrome. Sex Med 2018;X:XX–XX.
View
Post-Orgasmic Illness Syndrome: A Review
Article
Full-text available
  • Nov 2017
Introduction: Post-orgasmic illness syndrome (POIS) is a rare but debilitating cluster of postejaculatory symptoms affecting men. It is a chronic disorder manifesting as a constellation of flulike and allergic symptoms within seconds, minutes, or hours after ejaculation. POIS can be followed by mental sequelae such as diminished concentration and irritability. POIS negatively affects the life of patients by limiting sexual encounters, dampening romantic prospects, creating internal struggles to avoid eroticism, and affecting patients' schedules. First described in 2002, the prevalence and incidence of POIS are still unknown owing to a paucity of studies but is likely under-reported. There are approximately 50 cases of POIS in the literature. Despite the debilitating effects of POIS, the pathophysiology of POIS is still not well elucidated. Aim: To provide an update on the current literature on POIS, provide updated information on the pathophysiology of POIS, and discuss potential management options. Methods: Comprehensive review of literature pertaining to POIS. Main outcome measures: The symptoms, classification, pathophysiology, diagnostic considerations, and management of POIS were reviewed. Results: There are 5 preliminary diagnostic criteria for diagnosing this condition. POIS is categorized as primary or secondary. The autoimmune-allergy hypothesis is the most accepted hypothesis explaining the pathogenesis of POIS. A competing hypothesis involves a disorder involving endogenous μ-opioid receptors. Another hypothesis invokes impairment of the cytokine and neuroendocrine responses. There are no known treatment modalities for POIS; patients have been symptomatically treated with antihistamines, selective serotonin reuptake inhibitors, and benzodiazepines. A trial of hyposensitization therapy with autologous semen was successful. A trial of non-steroidal anti-inflammatory medication helped 1 patient described in a single case report, but failed to successfully treat other patients. Conclusions: POIS is a rare condition that is underdiagnosed and under-reported. Further studies are warranted to investigate the prevalence, pathophysiology, and treatment of this debilitating condition. Nguyen HMT, Bala A, Gabrielson AT, Hellstrom WJG. Post-Orgasmic Illness Syndrome: A Review. Sex Med Rev 2017;X:XXX-XXX.
View
The epidemiology of premature ejaculation
Article
Full-text available
  • Aug 2016
Vast advances have occurred over the past decade with regards to understanding the epidemiology, pathophysiology and management of premature ejaculation (PE); however, we still have much to learn about this common sexual problem. As a standardized evidence-based definition of PE has only recently been established, the reported prevalence rates of PE prior to this definition have been difficult to interpret. As a result, a large range of conflicting prevalence rates have been reported. In addition to the lack of a standardized definition and operational criteria, the method of recruitment for study participation and method of data collection have obviously contributed to the broad range of reported prevalence rates. The new criteria and classification of PE will allow for continued research into the diverse phenomenology, etiology and pathogenesis of the disease to be conducted. While the absolute pathophysiology and true prevalence of PE remains unclear, developing a better understanding of the true prevalence of the disease will allow for the completion of more accurate analysis and treatment of the disease.
View
View
Post orgasmic illness syndrome (POIS)
Article
  • Aug 2016
Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or masturbation. Two subtypes are distinguished: Primary and secondary POIS. It also occurs before or after a man has been sterilized. POIS is an invalidating most probably auto-immune disease leading to much distress in males and their partners. It is characterized by five criteria. Its symptoms are described by seven clusters. However, the manifestation of these symptoms varies from one male to the other but is relatively constant in the person himself. Among men the symptoms vary in intensity, durations and sort of symptoms. POIS is a chronic disorder that manifests itself in POIS "attacks" that occur within a few minutes to a few hours after ejaculation, and disappear spontaneously after 3 to 7 days. POIS is not associated with increased total serum IgE concentrations. On the contrary, there are indications that POIS is triggered by specific cytokines that are released by an auto-immune reaction to the man's seminal fluid. Indirect clinical evidence suggests that the antigen (Ag) triggering the POIS systemic reaction is not bound to spermatozoa but to seminal fluid produced by prostatic tissue. In addition, POIS may also occur-although rarely-in females. In those cases, it is hypothesized that the Ag is associated with female prostatic tissue around the vagina.
View
View
View