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Update: I have been abstinent for a long time but recently had an orgasm and did not have any POIS. Prior to this event I was taking some supplements, the most significant of which might have been Black Elderberry extract capusules. When I first started it I experienced sensations in the pubic region (under the skin), something akin to occasional vibrations. I don't know what was going on but I wondered if it might be the reaction of the Elderberry fighting a latent virus of some kind. It perhaps sounds odd but Elderberry is purported to be an anti-viral, among other things. So I stayed on it until the sensations went away and then went off it. Then a few weeks later I started it again prior to orgasm and then continued on it for a couple of weeks. During this time I did not experience any of my prior POIS symptoms. I am considering the Elderberry to be the most likely cause of the positive results. I will also mention the other supplements I have been on during this time in case they are significant: turmeric capsules and ALA (alpha lipoic acid). The turmeric is taken for general health, and the ALA was being taken for potential benefits of chelating heavy metals from my system. This was because I did a heavy metals urine test last fall and was told I have statistically elevated levels of mercury and lead (relative to the general population) .
I started with Sambucol Black Elderberry Syrup which is 1.83 grams of concentrate taken 4 times a day. After that I changed to a capusle supplement of 1g concentrate taken 4 times per day.