Postorgasmic illness syndrome (POIS) affects men in a variety of distressing ways, researchers report in a new Journal of Sexual Medicine study. And while some treatments have provided a degree of relief, no one treatment has done so consistently.
POIS is considered rare by experts, but it could be underreported. It causes a range of symptoms following orgasm, such as fatigue, muscle weakness, fever, congestion, itchy eyes, and a runny nose. Some people with POIS feel as though they have the flu. Others become irritable or have trouble concentrating or speaking.
POIS has not been widely studied, but previous research by Waldinger et al. suggested five diagnostic criteria:
- Symptoms described above, which may be categorized into clusters:
general, flu-like, head, eye, nose, throat, and muscles.
- Symptoms begin within hours of orgasm.
- Symptoms happen over 90% of the time.
- Symptoms last for 2 to 7 days.
- Symptoms resolve “spontaneously.”
The current paper added to the literature by describing the experiences of 302 men who were participants in a large, international forum for people with POIS. The men hailed from 61 countries on 6 continents. Most were Caucasian. The authors used the criteria from Waldinger, et al. to guide their research.
Each man completed a 30-item survey, providing information about his POIS symptoms, his disease course, and the ways POIS has affected his life. The participants’ average age was 32.6 years. They started having POIS symptoms at an average age of 19.1 years.
Highlights of the findings include the following:
- About 85% of the men started having POIS symptoms within hours of orgasm. For around 40%, symptoms began within 30 minutes.
- About three-quarters of the men had symptoms after orgasm about 90% to 100% of the time.
- Approximately 61% of the men said their symptoms lasted between 2 and 7 days.
- Over half said their symptoms disappeared spontaneously. For 22%, symptoms resolved gradually, and 24% of the men weren’t sure.
- On average, the men met 3.8 of Waldinger et al.’s 5 diagnostic criteria. Most met at least 3 criteria, and a quarter of the men met all five.
- The most common symptoms were “difficulty concentrating” (affecting 84% of the men), “extreme fatigue” (83%), “irritability” (74%), and “muscle weakness” (70%). Sixty-five percent said they had “significant or severe” pain.
- Men who fell into the “head” and “throat” clusters tended to have more severe symptoms.
- Premature ejaculation, erectile dysfunction, allergies, depression, and generalized anxiety disorder were reported comorbidities.
In addition, over 70% of the men said they avoided masturbation or rearranged their daily schedule to manage POIS symptoms. About 62% said they avoided having sexual intercourse.
Just over half of the men had seen a doctor for POIS. Patients tried a variety of treatments, including antihistamines, selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, niacin, and non-steroidal anti-inflammatory drugs. Some men tried vitamins, herbal products, and supplements.
About half the men taking antihistamines saw their symptoms improve. Niacin and non-steroidal anti-inflammatory drugs worked well for about three-quarters of their users.
The researchers explained that their results are preliminary. However, they also noted differences in onset age. Over half the men started having POIS symptoms between the age of 10 and 17. For the rest of the group, symptoms began when they were aged 18 to 59.
“Perhaps this reflects primary and secondary disease presentations where the syndrome presents at first ejaculation and later in adulthood, respectively,” the authors wrote.
They called for further study for a better understanding of POIS and for treatment development.
The Journal of Sexual Medicine
Natale, Caleb, BA, et al.
“Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample”
(Full-text. Published: September 30, 2020)