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[John21]

(After writing this post and registering I noticed that the forum rules specify no sexual content. I was going to stop, but I did a search and found another post about it. I hope this type of discussion won't be deemed inappropriate.)


Hi. I would like to relate my very personal story of an unusual condition that I have been plagued with. I am close to 40 years old now, and ever since puberty I have had serious problems in the days immediately following ejaculation. My first symptom was acute back pain in the days following, at whatever age it was, perhaps around 14. After a few years it changed to an impaired cognitive condition, which I would describe as definite mental illness, in which thinking becomes very difficult, and it feels horrible in a way that can not be described. I'm sure specific neurotransmitters are depleted or something, but the cause of such a reaction is what I have never been able to understand. This has occurred following both nocturnal emissions and sexual activity. To minimize the problem I am not sexually active and try to avoid nocturnal emissions.


John 

[neilep]

John,

Just acknowledging to you that your post is welcomed and definitely appropriate,

I sincerely hope that in addition to Pauls post above that some helpful comments arrive here soon.!!

[B_Jim]

If you have contacted the International Society for Sexual Medicine, please give me news. I'm very interested of all informations but i think very few doctors or scientist know this problem.
---
My symptoms :
- 3 to 4 days (day 2 is the worst)
- derealisation/lethargy/drowsy/lack of concentration/can't focus/drowsiness
"i feel like sleeping" / "unawakened" state (severe cognition disorder)/aprosexia Days1,2
- communication/speak problems to find words (light cognition disorder)
- severe fatigue
- chills and sensible to cold (just after orgasm : dopamine ??) sweats/heats  (10 hours later and day2) => flu-like symptoms . Some guys here use the word "Hot flashes". Sometime not severe headaches, and knees pain.  My flulike symptoms aren't as severe as cases in dr Waldinger's study. The flu-like symptoms are very reduces when i don't eat sugar !! Day0-2
UP : about diarrheas and sugar : A 2006 animal study shows there is a correlation between inflammatory bowel disease and diet rich in saccharose. But I don't understand why diarheas are very severe some hours after orgasm if I eat saccharose.
- dizziness
- pale face
- diarrheas especially diarrheas some hours after ejaculation(update : seems to be healed with  sugar free diet )
- hypoglycemia (seems reduced with sugar free diet)
- sometimes knee pains (possible sign of inflammation)
- sometimes moderate headaches on D2 (not post coital headaches)
- anxiety/nervous
- muscle fasciculation
- restless, agited
- PE
- weaker immune system : easily catch a cold...
----------
More details :

After ejaculation i have moderate symptoms :  I feel cold and i'm sensitive to cold. Some hours later, i have typical diarrheas (2 to 6 hours later).
About 10-12 hours later, i have moderate flu-like symptoms. I feel hot, feverish and i have sweets and light headaches. Sometimes knees pain or joint pain. My flulike symptoms are not as severe as Dr Waldinger's case. The day after, i have severe concentration problems.
----

Update : Only suppression of sugar reduces symptoms.

Since october 2009, the endorphins theory became my favorite. (POIS = endorphins depletion ??)


________________________________

OTHER ARTICLES :

1/ Sex : triggers asthma
http://scienceblogs.com/effectmeasure/2009/01/flu_beats_sex.php

2/ Immune system and cold symptoms :
http://www.scienceagogo.com/news/20080926205246data_trunc_sys.shtml

3/ Compare flu/cold/allergic rhinitis/sinusitis to our POIS symptoms :
http://www.drgreene.org/body.cfm?xyzpdqabc=0&id=21&ref=1284&action=detail
Seems closer to "flu" ...

4/ Addison and flulike episodes
http://cat.inist.fr/?aModele=afficheN&cpsidt=20223571

5/ Cortocsteroids side effects
http://www.medscape.com/viewarticle/437182_5

 Abrupt withdrawal of corticosteroids is dangerous. When corticosteroids are rapidly tapered, patients may exhibit withdrawal symptoms such as headaches, myalgias, and fatigue. These symptoms reflect mild adrenocortical insufficiency and are usually transient. They may be prevented or lessened by a more gradual tapering of corticosteroids

Adrenocortical deficit is not only restricted to Addison. For example when stopping corticoids. I imagine a similar phenomenon for Pois flulike form.

6/ ISSM Update :
http://www.issm.info/v4/data/issmlist/digest21.asp#Post_Orgasmic_Illness_Syndrome

Post Orgasmic Illness Syndrome (Dr. Sarah Ashworth)

Dr. Ashworth had a case of an 18 years old male complaining of post orgasmic illness syndrome in the form of cognitive symptoms associated with anxiety and depression. Flouxetine was prescribed which had some effect with regard reducing the amount of nocturnal emissions he experiences but has had little effect regarding his other symptoms post orgasm. Dr. Moser had tried SSRI and Bupropion with limited success. Dr. Ashour suggested the trial of cymbalta or tramal. Dr. Boul thought it might be a form of General Anxiety Disorder (GAD) with the depersonalisation experienced in Panic Attacks which might be related to a past traumatic sexual experience.

I am wondering whether it would be possible to post a query on your list or if you could provide me with any further information - particularly practitioners who know something about Post-Orgasmic Illness Syndrome.

I am about to conduct a mental health assessment on an 18 year old young man who has given me prior information that he believes that he suffers from POIS. Certainly the symptoms he describes seems to fit with the examples I have just read on your forum. The symptoms he lists are as follows:

Lack of concentration
Lack of cognition
Disorientation
Brain fog <-- most important
Absentmindedness
Confusion
Shortened attention span
Depersonalization
De-realization
Exhaustion (physically and mentally)
Word finding difficulties
Tongue tied
Inability to comprehend/retain what is read
Impairment of speech and/or reasoning (forming thoughts into words)
Inability to calculate numbers
Depression
Anxiousness

Any advice I could give him about how to get help would be appreciated. He finds his symptoms so troublesome that he has abstained from sexual behavior including masturbation for some time and states, "If I did not have a single orgasm in the rest of my life I would be so happy."

He tells me he has seen two GPs, neither of whom had heard of the syndrome and has subsequently been prescribed Fluoxetine 20mg which has had some effect with regard reducing the amount of nocturnal emissions he experiences but has had little effect regarding his other symptoms post orgasm.

Hope you can help and best wishes, Sarah

Sarah Ashworth

I do believe POIS exists, but there is no data on what the underlying problem is or how to treat it. Many of the individuals are quite disturbed about it (understandably), but it is not clear how to help them. I have used SSRI’s to help decrease sexual urges. I have had some limited success with Bupropion. I am also interested in what others have tried.

Sincerely,

Charles Moser, PhD, MD, FACP

Dear all

Yes it exists But the symptoms vary beteen patients. I do believe its a sort of neurotransmitters depletion??? but regarding this case it points to an AD or ADHD background of the pt. Pls check and if not; trial of Dual action anti depressants may help Cymbalta 60 mg. or Tramal 50 mg PRN in very limited range.

Shedeed Ashour

Dear Sarah

The symptoms of post orgasmic illness syndrome, and the ones you describe for your young clients, sound very much like most of the symptoms of General Anxiety Disorder (GAD) with the depersonalisation experienced in Panic Attacks.

My immediate thoughts, particularly with a young inexperienced client, would be around potential past traumatic sexual experiences i.e., early masturbatory trauma - being caught in the act, being ridiculed by a partner, or abused. Indeed, it could be a form of PTSD but it would appear that there haven’t been any long term studies to identify if the episodes intensify or change. The client could also have fears of such things as losing control, sexually transmitted diseases, inadequacy, and there is also a possibility of confusion over sexual identity.

Medication for the physical symptoms will assist your client in engaging in therapy and exploring any underlying psychological issues.

Hope this is of assistance.

Lori Boul PhD

I disagree. Studies show an evidence there is a problem with endogenous opioid system with derealisation disorders.

Study show a link between DHEA/cortisol ratio and derealisation state (neurobiology of dissociative disorders @2005)
Study show there is some evidence for dysregulation of endogenous opioid systems in depersonalization. (An open trial of naltrexone in the treatment of depersonalization disorder @2005)

[demografx]

Hi John,

I'm really happy that you posted (and others replied).I've had POIS symptoms (no myalgia)for decades! I thought testosterone injections would help, but that turned out to only work very modestly (and exacerbating the need to have sex!).

I'm lost and extremely disappointed having this problem. I don't want to curtail sex, even though I know it creates this awful 4+ days misery.

Let's keep in touch!

[demografx]

Hello B_Jim!............MANY thanks for your reply, I've contacted numerous physicians, sex researchers and many others over the years with my symptoms....and I usually get blank stares..."Gee, I never heard of THAT!" Thank you, Dr. send me a bill. Sorry to be so sarcastic, but I'm beyond desperate! (I'm 61 and actively hunting a solution for 25+ years)

I tried to contact you, Jim_B, but I can't figure out those crazy codes to copy (I haven't a clue how I finally made it here to TNS!)

Getting in touch with Dr Waldinger has been enormously frustrating. I succeeded once, then the email kept changing.

As you asked me to note, my most recent post-orgasmic symptoms just ended, and included 4 days of extreme exhaustion, depression, foggy cognition, burning FINGERTIPS - all 10 (this has included dermatitis, numbness and heat).

JIM_B AND EVERYONE: Since I'm unable to contact you here because I can't copy those cryptic messages (UdHk?)I would love to start a correspondence: let's gang up on this crazy syndrome!!

[paul.fr]

There is another similar discussion here: http://www.thenakedscientists.com/forum/index.php?topic=2734.0
You may find it interesting.

[Cox]

Hi everone,

I was somewhat pleased to discover that I wasn't the only person to suffer from this infliction. I am a 30 year old male from the UK, who has suffered from this post ejaculation depression for a number of years. The main symptoms I get include extreme tiredness, depression "brain fog" and flushing. It has ruined a number of my relationships and has further increased my depressive state. I too have tried seeking medical advice to no avail.
Conversely, I am upset to see that this condition doesn't seem to be recognised. It is evidently a problem, which is more common than one might suspect.
Out of interest - do those of you who suffer from this also have (clinical) depression? And do you know if any of your family members suffered from the same condition (if you are like me you probably haven't asked)!
How is the medication working out by the way?
Keep in touch everyone - I really feel that we need to explore this further!!

TTFN

Rob 

 

[Cox]

That's sounds interesting keep us posted!!

Thanks 

Rob

[demografx]

I also find that keeping the mind O-F-F these symptoms of POIS helps. I tend to obsess quite a bit on the symptoms, especially the dry fingertips. Wish me luck, I just started another POIS cycle this morning and I'm not taking Levitra (I'm hoping that the peak testosterone level I'm on will help). But if I don't improve by tomorrow morning I'm taking L. Again, don't copy what I do, let me be the "guinea pig" !

[B_Jim]

mellivora >> Your case is close to mine.

Dr Waldinger said my symptoms do match POIS symptoms. However, I see there seem to be quite a variety of POIS symptoms and I don't have all of them.

Yeah, he said to me "it might be POIS". But i don't have myalgias. It's not a clear "flu-like" state for me.

The most frustrating aspect is the mental fog, extreme tiredness and reduced capacity to think clearly.

Exactly ! I have the same symptoms.

Derealization/confusion seems to be the right word

In the beginning (10+yrs ago) this could last as much as a month after orgasm!

Your case is very severe.

a pressure in my head that made it feel like my eyes were bulging out.

Not me.

r.

Needless to say this has had a detrimental effect on my social life and my work. I don't get the muscle pain some people describe but I can get loose stools (used to be diarhoea but usually not that bad now)

Me too.
I have specificly severe diarrhoea in the hours following orgasm.

. Two things have helped me. The first was when I learned about Dr Waldinger's research and that there was actually a name for the condition and it was recognised (all be it by few doctors). That makes it easier to talk about and of course there's the knowledge you're not alone.

Me too.

Mellivora, The role of serotonin seems to be clear in post-orgasm mental frog, probably dopamine too. Serotonin controls the quantity of circulating information, each seconds, between memory and conscience.



 

[demografx]

POIS symptom abatement progress. Levitra seems to have a continuing effect. Possibly the testosterone too, but in combination. In the first day or two of symptoms, to combat lethargy: I increased my caffeine consumption (btw, I am a caffeine addict FWIW; I'm also on ADD stimulants; and I just tried a vitamin supplement that seems to work, called "5-HOUR ENERGY" available at convenience stores such as 7-11. If unavailable, their distributor can be reached at 1-888-960-9495. No, this is not a commercial LOL.

Best wishes, everyone, for much success. Please keep posting, telling me you're alive and well!

[bobsie]

I am a 57 yo male that has just experienced a very similar episode.

My last two ejaculations created a very strange experience for me.  I became very confused and "punch drunk", similar to what has been described above.  The confusion lasted 4 to 5 hours but eventually dissipated.

The first time this happened was four weeks ago, my wife thought I was having a stroke, and rushed me to the ER in a state of mental confusion.  They kept me overnight for tests; CT, MRI, EEG and Holter Monitor.  Nothing abnormal except my BP was sky high 156/117.  I seemed to come out after 4 or 5 hours. 

I didn't connect the problem with ejaculation until it happened to me again, last weekend.  Both times was I was masterbating.  I have never experienced anything like this before.  Now I'm afraid to have intercourse with my wife and began browsing and found this.  No sure what to do next.   

[B_Jim]

Thanks Bobsie for your post. A lot of us have this problem since many years so maybe your problem is different or temporary. But you will see next times if you recover your energy. I wish it to you.
Thanks a lot Tracy for your great post. Yes, dopamine is a key of the problem, and your experience with Abilify seems to prove it. But maybe dopamine could be regulated with inhibitors (serotonin/Gaba) to slow down the catecholamines's turn-over after orgasm. Have you tested benzodiazepine meds ?
Your experience with Abilify is very interesting because it's very specific and atypic antipsychotic. You should talk about this with your doctor, maybe he could compare what you feel after orgasm and after taking this med.