Post-orgasmic Illness Syndrome: A Case Report.

Post-orgasmic illness syndrome (POIS) is a rare condition characterized by debilitating symptoms following ejaculation. We present a case of a 25-year-old male with flu-like symptoms post-ejaculation since age 17. Despite minimal relief from conventional treatments, a comprehensive evaluation led to the diagnosis of POIS and successful management with niacinamide therapy. The presentation of flu-like symptoms following ejaculation in this case raises several questions regarding the underlying pathophysiology. While the exact cause of his symptoms remains elusive, the resolution achieved with niacinamide therapy underscores the importance of considering alternative treatment modalities in complex cases. The role of varicocele in symptom manifestation, if any, also warrants consideration, as varicocele has been associated with male infertility and testicular dysfunction.

Post-Orgasmic Illness Syndrome Successfully Treated with Omalizumab: A Case Report.

Post-orgasmic illness syndrome (POIS) is a rare disorder associated with a debilitating symptoms post-ejaculation associated with significant impairment in quality of life. The mechanism of the disease is unclear, but hypersensitivity to semen and/or seminal fluid has been postulated. We present a case of POIS successfully treated with omalizumab suggesting a possible role for this therapy in POIS treatment and management.

Post-orgasmic illness syndrome with positive intradermal test for autologous semen.

Post-orgasmic illness syndrome (POIS) is a rare disease characterized by flu-like symptoms persisting for 2-7 days after ejaculation. POIS has been chiefly attributed to allergic reactions to autologous seminal plasma. However, the exact pathophysiology remains unclear, and there is no effective treatment. We present the case of a 38-year-old man with a 10-year history of recurrent episodes of flu-like symptoms of 1-week duration after ejaculation. The patient was diagnosed with irritating bowel syndrome because of fatigue, myalgia, and lateral abdominal pain. After starting infertility treatment and increasing the frequency of intercourse with his wife, the patient noticed these symptoms after ejaculation. Based on these episodes and symptoms, POIS was suspected. To diagnose POIS, a skin prick test and an intradermal test were performed using his seminal fluid, with the latter yielding a positive result. The patient was diagnosed with POIS, and treatment with antihistamines was continued. Due to its rarity, POIS is often underdiagnosed and underreported; however, the skin test can be a valid diagnostic tool. In this case, the intradermal test result was positive according to the broadly accepted criteria for POIS. Although quality of life is often severely affected in patients with POIS, a lack of a clear understanding of the pathogenesis of POIS prevents early diagnosis. To make diagnoses earlier, it is undoubtedly important to take a detailed medical history and perform skin allergy tests, although the latter requires further validation.

Post orgasmic illness syndrome successfully managed with antihistamine: A case report.

Post orgasmic illness syndrome (POIS) is increasingly being recognized as a debilitating cause of sexual dysfunction in males. It is often misdiagnosed due to its unfamiliarity to providers, resulting in numerous potentially unnecessary tests and treatments. Currently, there is no known single most effective treatment, but several case reports suggest desensitization, hormonal therapy, and other treatment modalities may be useful. However, these treatments are experimental in nature and have not been evaluated in placebo-controlled trials. We report on the use of a simple over-the-counter antihistamine in the management of POIS.

Post Orgasmic Illness Syndrome (POIS) and Delayed Onset Muscle Soreness (DOMS): Do They Have Anything in Common?

Post orgasmic illness syndrome is a rare, mysterious condition with an unknown pathomechanism and uncertain treatment. The symptoms of post orgasmic illness syndrome last about 2-7 days after an ejaculation. The current hypothesis proposes that the primary injury in post orgasmic illness syndrome is an acute compression proprioceptive axonopathy in the muscle spindle, as is suspected in delayed onset muscle soreness. The terminal arbor degeneration-like lesion of delayed onset muscle soreness is theorized to be an acute stress response energy-depleted dysfunctional mitochondria-induced impairment of Piezo2 channels and glutamate vesicular release. The recurring symptoms of post orgasmic illness syndrome after each ejaculation are suggested to be analogous to the repeated bout effect of delayed onset muscle soreness. However, there are differences in the pathomechanism, mostly attributed to the extent of secondary tissue damage and to the extent of spermidine depletion. The spermidine depletion-induced differences are as follows: modulation of the acute stress response, flu-like symptoms, opioid-like withdrawal and enhanced deregulation of the autonomic nervous system. The longitudinal dimension of delayed onset muscle soreness, in the form of post orgasmic illness syndrome and the repeated bout effect, have cognitive and memory consequences, since the primary injury is learning and memory-related.

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.

Post orgasmic illness syndrome: what do we know till now?

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.

CONTEXTE: Les dysfonctions péri-orgasmiques sont très rares et nous disposons de peu d'informations sur leurs diagnostic et traitement. L'une de ces affections est le syndrome de la maladie post-orgasmique (SMPO), qui se manifeste par un groupe de symptômes handicapants affectant les hommes durant les secondes, minutes ou heures après l'éjaculation. Le but de cet article est de faire une revue approfondie de la littérature sur le SMPO, afin d'élucider sa physiopathologie et son diagnostic pour mieux gérer cette maladie rare. RÉSULTATS: Nous avons réalisé une revue de la littérature actualisée sur Pubmed en utilisant les termes suivants: "orgasm illness", "post-orgasmic" and "postorgasmic illness syndrome". Les références des 17 publications identifiées ont également été examinées pour inclure 8 autres articles pertinents dans les résultats.Le SMPO est défini par 5 critères diagnostiques préliminaires et le critère 1 comprend 7 groupes de symptômes. Les hypothèses physiopathologiques comprennent: un phénomène immunologique (le plus pertinent), un sevrage des opioïdes endogènes, une réponse neuroendocrine, une dérégulation transitoire du système nerveux autonome, une hypersensibilité et des désordres des cytokines. Les diagnostics différentiels incluent: la prostatite chronique, l'orgasmolepsie, la céphalée orgasmique bénigne, l'éternuement et la rhinorrhée, la dysphorie post-coïtale, l'asthme post-coïtal et la rhinite. Les traitements n'ont été que symptomatiques par antihistaminiques, anti-inflammatoires non stéroïdiens, inhibiteurs sélectifs de la recapture de la sérotonine et benzodiazépines. Un essai thérapeutique de désensibilisation avec du sperme autologue a été couronné de succès. CONCLUSION: Le SMPO est une maladie rare sous-diagnostiquée, probablement à cause de sa physiopathologie peu claire, conduisant à un manque d'options thérapeutiques. Des études supplémentaires sont nécessaires pour étudier la prévalence, la physiopathologie et la prise en charge de cette maladie débilitante.

Orgasmic migraine aura: Report of two cases.

BACKGROUND: Paroxysmal neurological symptoms occurring with sex cause considerable anxiety and sometimes have a serious cause. Thunderclap headache is the most well-known and requires urgent investigation at first presentation for subarachnoid haemorrhage and other significant pathologies. After exclusion of underlying causes, many prove to be primary headache associated with sexual activity. Orgasmic migraine aura without headache is not currently recognised as a clinical entity. CASE REPORTS: We report two patients with acephalgic orgasmic neurological symptoms fulfilling the criteria for migraine aura. CONCLUSIONS: The incidence of acephalgic orgasmic migraine aura is unknown. It should be considered as part of the differential of paroxysmal sex-related neurological symptoms, and clinically differentiated from fixed deficits, reversible cerebral vasoconstriction syndrome and post-orgasmic illness syndrome.

Post-Orgasmic Illness Syndrome: A Review.

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 2018;6:11-15.

Post orgasmic illness syndrome (POIS).

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.