Post ejaculation illness rare but distressing, finds study

Post -orgasmic illness syndrome (POIS) is a rare disorder with debilitating physical and psychological sequela. It is a poorly understood condition and is characterized by extreme fatigue, heart palpitations, muscle pain, incoherent speech, and problems concerning concentration.

Post-orgasmic illness syndrome (POIS) is a rare cluster of postejaculatory symptoms first described by Waldinger and Schweitzer¹ in 2002. They published a case report of 2 men who exhibited flulike symptoms, such as myalgias, fatigue, and intense warmth, and local allergic signs, such as sore throat, postnasal drip, skin erythema, and a burning sensation in the eyes that occurred shortly after ejaculation.Till now about 50 cases of the disorder have been reported in the medical literature but the researchers feel that it is fairly under reported. condition.

Caleb Natale, of Tulane University in New Orleans, and colleagues carried out a study to gather data about the symptomatology, disease course, comorbid conditions, precipitating factors, associated behavioral changes, prevalent treatments and basic demographic data within an online community of patients suffering from POIS.They presented their findings in a presentation at the Sexual Medicine Society of North America fall meeting.

The researchers conducted an online survey among men regarding Post -orgasmic illness syndrome.In total of 180 men who responded to the survey, 18.2% reported that their symptoms occurred almost immediately (within 1 minute) after ejaculation, while 56.7% and 85%, respectively, reported symptoms beginning within 30 minutes and 6 hours, post-ejaculation.Also, 76.2% of responders reported symptoms after 90% to 100% of ejaculations, and 61.9% reported that their symptoms persisted for 2 to 7 days.

The survey was completed by 92 members of the online community. Symptoms were reported following masturbation with ejaculation in 91 respondents (98.9%), sexual intercourse with ejaculation in 71 respondents (77.2%) and nocturnal emission in 58 respondents (63.0%). Symptoms occurred always or nearly always (90-100% of the time) in 76 respondents (82.6%). The onset of symptoms was rapid: onset within 30 minutes in 50 respondents (54.3%) and within six hours in 75 respondents (81.5%). Symptoms tended to peak within 12 hours - two days and last for two - seven days. The most common symptoms were difficulty concentrating (81 respondents, 88.0%), extreme fatigue (79 respondents, 85.9%) and muscle weakness (71 respondents, 77.2%). There was a vast array of reported symptoms. Difficulty concentrating and fatigue were often cited as the most distressing and disruptive symptoms. To avoid a post-ejaculatory reaction, 63 respondents (68.5%) avoided sexual intercourse frequently or always and 69 respondents (75.0%) avoided masturbation frequently or always. Negative impacts to romantic life was reported frequently or always in 74 respondents (80.4%). Pain or discomfort was reported as significant or severe in 67 respondents (72.8%).

The most commonly reported comorbidities included premature ejaculation (47 respondents, 51.1%), depression (22 respondents, 23.9%) and generalized anxiety disorder (19 respondents, 20.7%). Medical advice was sought by 56 respondents (60.9%); 47 of these respondents (83.9%) were seen by a generalist and 36 (64.3%) by a urologist.

Although the mechanism driving the disorder is not known, one hypothesis is that it an autoimmune or allergic disorder triggered by an inflammatory reaction to a man's own seminal fluid.In a 2011 review of 45 suspected POIS cases, Marcel Waldinger, MD, PhD, then of HagaZiekenuis in The Hague, the Netherlands, and colleagues hypothesized that "POIS is caused by Type-1 and Type IV allergy to the males' own semen, as soon as it is triggered by ejaculation." Waldinger, who was among the first to describe the disorder, died in 2019.

Other theories suggest the cause to be related to chemical imbalances in the brain, neuroendocrine response, or disordered cytokines.

Well over half of the respondents (55.6%) sought medical help for the condition, with 86% consulting a generalist and 61% eventually consulting a urologist. Common treatments included antihistamines (35 respondents, 38.0%), and SSRIs (20 respondents, 21.7%), while other treatments included NSAIDs, other antidepressants and supplements.

The researchers concluded that POIS is a distressing condition that has variable symptomatology but with a relatively constant syndrome onset of less than twelve hours and duration of two - seven days. Respondents to the survey indicated considerable disruption to their lives in addition to physical pain and discomfort. Many respondents sought medical treatment, although treatment is neither

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