[underwater]

Demo--
I feel your enthusiasm and joy coming through the computer screen.
I think it's going to be incredibly motivational for all.
You know, it's a breath of fresh air to feel your confidence.
You have shown that it takes three to tango: Levitra, Testosterone and Patches.
This is a great lesson. Mix and Match. This is what I just started doing a few days ago. It used to just be neurotransmitter balancing, but now I've added an anti inflammatory focus. I could be wrong, but due to my amped up, anxiety/depression end of the scale (rather than extreme brain fog/fatigue), I have not yet focused directely on testosterone, prolactin etc. I may have to change, but since my GAD symptoms are identical to POIS, I'm on this path right now. We'll see. But I am now much more open to change and the need to be radically flexible. GRACIAS!

[rob58]

Demo:
Just a practical issue. Given that you have not experienced a poor outcome just being on testosterone, with the right delivery mechanism, is it possible that there is no need for Levitra as part of your cure?  I guess that is a question about the minimal effective set of medications.

[demografx]

Demo:
Just a practical issue. Given that you have not experienced a poor outcome just being on testosterone, with the right delivery mechanism, is it possible that there is no need for Levitra as part of your cure?  I guess that is a question about the minimal effective set of medications.

Before I answer this, I thought of your last post about depletion/replenishment this morning as I was reading the Rx info sheet on the T-patches. The Rx sheet stated the obvious, that "T helps the body to produce sperm". I think I can "feel" that happening in my body. I could "feel" the emptiness before when it would take forever to "fill up." But, who knows, maybe my imagination is running wild? []

Rob, not exactly sure about the first part of your post above, "not a poor outcome on T only".

But I can answer the Levitra part, yes you're absolutely right, it's possible there is no need for Levitra. But it scares me what I need to do to find out! ("O" = POIS = "death"?) How quickly I've become spoiled! But in all honesty, 30 years of this, I'm surprised that I'm not locked up somewhere!

Well, science demands an answer so I guess I'll have to try it. But not just now. []

[demografx]

Demo--
I feel your enthusiasm and joy coming through the computer screen.
I think it's going to be incredibly motivational for all.
You know, it's a breath of fresh air to feel your confidence.
You have shown that it takes three to tango: Levitra, Testosterone and Patches.
This is a great lesson. Mix and Match. This is what I just started doing a few days ago. It used to just be neurotransmitter balancing, but now I've added an anti inflammatory focus. I could be wrong, but due to my amped up, anxiety/depression end of the scale (rather than extreme brain fog/fatigue), I have not yet focused directely on testosterone, prolactin etc. I may have to change, but since my GAD symptoms are identical to POIS, I'm on this path right now. We'll see. But I am now much more open to change and the need to be radically flexible. GRACIAS!

Underwater, thanks, your welcoming post is a heckuva great way to start the day!

I wasn't sure if I should take what you wrote literally about "3". I look at the T-patches as "1" product. But either way, we're saying the same thing.

I feel so ignorant for not recognizing the combination effect for 2 years!

But then again, it takes most of us a while to catch on to the fact that POIS is related to sex the day/night before.

Thanks again, Underwater!

[demografx]

I don't know if I am cured, but I am going to say that the "waiting" technique is definitely working for me.  []

Great, GC.

Maybe that's all you need to work on.

Good luck!

[demografx]

It used to just be neurotransmitter balancing, but now I've added an anti inflammatory focus. I could be wrong, but due to my amped up, anxiety/depression end of the scale (rather than extreme brain fog/fatigue), I have not yet focused directely on testosterone, prolactin etc. I may have to change, but since my GAD symptoms are identical to POIS, I'm on this path right now. We'll see. But I am now much more open to change and the need to be radically flexible. GRACIAS!

FWIW, Underwater, the testosterone also helps uplift my mood quite a bit. The literature confirms this. Just as a start, find out if you're low in some hormonal areas. But several people here at the forum were right that several types of T-tests are needed: previously, my GP and my urologist didn't do that and erroneously found me to be "normal" in T! The more detailed tests (not a big deal at all, just one small blood sample) confirmed the deficiency. And that deficiency might - just maybe - contribute to GAD?

[Limejuice]

Today I bought a cortisol reducing suppliment called Phosphatidylserine.  I've never tested for cortisol but have an incling that its high (I feel stressed and CounterPoint's is high - he has the same type of POIS).  The best next step would be to get it tested but I will try this in the intern.

With thyriod hormone and cortisol reduction, maybe thats my POIS cure!

[Counterpoints]

Today I bought a cortisol reducing suppliment called Phosphatidylserine.  I've never tested for cortisol but have an incling that its high (I feel stressed and CounterPoint's is high - he has the same type of POIS).  The best next step would be to get it tested but I will try this in the intern.

With thyriod hormone and cortisol reduction, maybe thats my POIS cure!

Hi Limejuice,
Good luck !.  I tried Phosphatidylserine (PS) for a little while.  I'm not sure if it helped too much or not.  I hope it works for you.  If you do have a tumor, either in your pituitary, adrenal gland, or elsewhere (ectopic) causing excess cortisol release, I don't think PS supplementation will help very much.

My current POIS theories. 

1) I think there may be something wrong with our pituitary glands or adrenal glands.  At the beginning of this thread,
there was much discussion of dopamine and prolactin.  We were (or at least I was) trying to understand the neurochemistry of orgasm.  And the available information suggests that dopamine decreases and prolactin increases.  From that information, we tried to formulate various theories.  For instance, there is an article showing that dopamine depletion causes POIS-like cognitive symptoms.

Now, the pituitary regulates prolactin levels.  So it is possible that the pituitary has an important role in our response to orgasm (even beyond prolactin).  But the pituitary also communicates with the adrenal gland, affecting cortisol levels.  So abnormal cortisol levels could indicate a problem with the pituitary.  Now, high cortisol HAS been linked to anxiety, distress, and many cognitive symptoms.  Just look up Cushings (http://www.csrf.net/page/the_basics.php).  But perhaps there is more to it than high cortisol? Maybe high cortisol is merely an indication that something is wrong with the pituitary... and this more general malfunction is also affecting our response to orgasm (dopamine levels, etc.).   Abnormal prolactin levels could also be an indication of some kind of pituitary malfunction... but maybe the prolactin levels themselves are not a major cause of the symptoms?  (I actually have normal prolactin levels, as well as normal FSH And LH). 

In short, in different cases, we might be getting different signals that something is wrong with the pituitary.  And the 'different signals' would account for moderate variations in symptoms, but all with the same stimulus (orgasm).

Pyropeach mentioned there was a growth found on his pituitary (I'd definitely recommend cortisol testing).  Demografx has an empty selum.  And I got very high cortisol levels on a 24 hr urine test.  And we all have post-orgasm symptoms.  The link?  Pituitary.

2) The alternative (which I think is possibly more likely), is that we have a tumor (somewhere -- possibly pituitary or adrenal), which is being either chemically or physically stimulated by orgasm/ejaculation.  Amongst other things, this could cause cortisol release.

3) (Less likely).  Orgasm is causing inflammation of some type.  Maybe this results in a natural overproduction of cortisol?

Also: A regular brain MRI will often NOT show a pituitary growth.  You need a specific MRI of the pituitary, with gadolinium enhancement.  Even then, I read that there is a decent chance it may not show.

I haven't had time to organise these thoughts.. but I hope you find them helpful.  I'd like to again encourage people to consider a 24 hr urine cortisol test.  (And prolactin, FSH, LH, TSH, T3, T4).

[demografx]

With thyriod hormone and cortisol reduction, maybe thats my POIS cure!

Limejuice, best wishes!!!!!

[demografx]

My current POIS theories. 

1) I think there may be something wrong with our pituitary glands or adrenal glands. 

2) The alternative (which I think is possibly more likely), is that we have a tumor (somewhere -- possibly pituitary or adrenal), which is being either chemically or physically stimulated by orgasm/ejaculation. 

I was shocked with the pituitary revelations of my bloodwork and Brain MRI, as you cited.

But my 75%+ cure (4th "O" in 4 days yesterday with only mild and quickly disappearing symptoms) also may point to Rob's depletion/replenishment theory ( [1] testosterone = efficient sperm replacement and [2] nitric oxide from Levitra, re-stimulating oxytocin, which has been depleted).

Counterpoints, is the above compatible with your pituitary/adrenal theory or completely different?

[martin88]

My current POIS theories. 

1) I think there may be something wrong with our pituitary glands or adrenal glands. 

2) The alternative (which I think is possibly more likely), is that we have a tumor (somewhere -- possibly pituitary or adrenal), which is being either chemically or physically stimulated by orgasm/ejaculation. 

I was shocked with the pituitary revelations of my bloodwork and Brain MRI, as you cited.

But my 75%+ cure (4th "O" in 4 days yesterday with only mild and quickly disappearing symptoms) also may point to Rob's depletion/replenishment theory (testosterone = efficient sperm replacement) and nitric oxide from Levitra stimulating oxytocin depletion.

Counterpoints, is the above compatible with your pituitary/adrenal theory or completely different?

I think testosterone is able to regulate the hypophysis.

Also I can remember the following : a long time ago my pois was decreased for a time (It could be for a lot of reasons) and I was feeling exactly the same thing you feel, like if sperm was rebuilded very quickly after an orgasm. I even had one semen loss at this time, during the day, without arousal, 4 days after an orgasm. This happened only one time. At the same time, I suddenly started to have more pilosity in a few months. The only thing that was not improved was endurance, even if physical strength (muscular tonus) was better. My ability to feel good after breathing exercises was also improved, this makes me think about what Underwater was saying about oxygenation.

Counterpoints, what about ACTH which is secreted by hypophysis to stimulate adrenals ? I think you were tested for this. Thanks for your suggestion for the 24h urine test for cortisol. Do you think it's enough, at first, to do the blood test ? It should show at least a tendency.

[demografx]

Martin, maybe there is something after all to the Taoists who claim semen retention = strength (among other things).

[Counterpoints]

My current POIS theories. 

1) I think there may be something wrong with our pituitary glands or adrenal glands. 

2) The alternative (which I think is possibly more likely), is that we have a tumor (somewhere -- possibly pituitary or adrenal), which is being either chemically or physically stimulated by orgasm/ejaculation. 

I was shocked with the pituitary revelations of my bloodwork and Brain MRI, as you cited.

But my 75%+ cure (4th "O" in 4 days yesterday with only mild and quickly disappearing symptoms) also may point to Rob's depletion/replenishment theory ( [1] testosterone = efficient sperm replacement and [2] nitric oxide from Levitra, re-stimulating oxytocin, which has been depleted).

Counterpoints, is the above compatible with your pituitary/adrenal theory or completely different?

People with high cortisol problems often have low testosterone.  (As can people with pituitary problems, I think).  So yes, it fits in.  I actually have quite a high (but healthy) level of testosterone though. 

[Counterpoints]

Counterpoints, what about ACTH which is secreted by hypophysis to stimulate adrenals ? I think you were tested for this. Thanks for your suggestion for the 24h urine test for cortisol. Do you think it's enough, at first, to do the blood test ? It should show at least a tendency.

As far as I understand, the hypothalamus releases CRH, which stimulates the anterior pituitary (Adenohypophysis) to release ACTH, which stimulates the adrenal glands to produce cortisol. 

My ACTH actually tested somewhat normal.  (14 pmol/L, ref: <15 pmol/L.  This goes with the 740 nmol/L reading).  As far as AM cortisol blood test vs. 24 hr urine... not sure.  The reference for an AM blood test is 150-690 nmol/L.  I have tested AM cortisol 3 times.  (560, 590, 740 nmol/L).  So two of these three times were "in reference"... but for my age, quite high, I think.  Nonetheless, I think they would have been disregarded by 90% of physicians -- even though it is very common amongst people with cushings and other cortisol problems to only test high-normal on the blood samples.

On the other hand, my 24 hr urine cortisol 515 nmol/d (ref: 30-220 nmol/d) is an obvious indicator of a problem.  What first caused me to worry about cortisol was a PM cortisol blood test I had (430 nmol/L, ref: 50-300 nmol/L). 

So, in short, I'm not sure.  I think if you get an AM blood test, and the result is < 300 nmol/L, a 24 hr urine test probably won't show anything.  It seems what's happening with me, is that cortisol is getting high during the night, when for most people it would be at its lowest.

(To those who don't know what a 24 hr urine test is, it's not a big deal.  You go to a lab, they give you a container.  You wake up the next morning.  You disregard your first "sample", and write down the time.  You continue to "collect" until 24 hours after the time you wrote down.  The container should be in the fridge when it is not being used for collection.  After the 24 hours, you give the container to the lab). 

I would like to note that my cortisol has been highest when I am symptomatic.  There seems to be a clear correlation between symptoms and cortisol levels.

[Finally]

Some have had positive results from taking Levitra.  Levitra is a PDE5 inhibitor.  PDE5 is released  "at orgasm".  In men it resuts in the inability to get an erection right after ejaculation-the refractory period.
There are subforms of PDE5 some of which only effect the Corpus Cavernos um(Sp) of the Penis while others can effect blood vessels of the Brain, other smooth muscle tissues and the liver and heart.  The lack of blood flow through capillaries to the brain will result in dizziness, brain fog and mental fatigue.
The Wikipedia listing of pde5 and Pde5 inhibitors has some interesting links.
Other than Cialis, PDE5 inhibitors are are deactivated by food particularly fats.  That may explain why sometimes they seem to have a less effect after a while.           

[CertainlyPOIS]

I doubt weight could hav anything to do with these. I am considered obsese,but i exericese a moderated amount. is there anybody who is pretty fit and still has these problem.

[CertainlyPOIS]

How long those it take for blood test to get done, i have not seen any results since two weeks i went to doctor.

[demografx]

Some have had positive results from taking Levitra.  Levitra is a PDE5 inhibitor.  PDE5 is released  "at orgasm".  In men it resuts in the inability to get an erection right after ejaculation-the refractory period.
There are subforms of PDE5 some of which only effect the Corpus Cavernos um(Sp) of the Penis while others can effect blood vessels of the Brain, other smooth muscle tissues and the liver and heart.  The lack of blood flow through capillaries to the brain will result in dizziness, brain fog and mental fatigue.
The Wikipedia listing of pde5 and Pde5 inhibitors has some interesting links.
Other than Cialis, PDE5 inhibitors are are deactivated by food particularly fats.  That may explain why sometimes they seem to have a less effect after a while.           

Thanks, Finally! That explains a lot of what I have been thinking about.

Maybe it also explains why Cialis - which didn't work at all - was such a disaster for my POIS. It certainly appears to work differently than Levitra.

This forum is great: free consultation!!! []

[demografx]

The only big step I've made is the result of my 24 hr urine cortisol test.

Counterpoints, I'm taking a cortisol AM blood test. Not comprehensive I know, but it's a start. If nothing else, it may contribute to our forum databases.

I'll post results here in about 27 days from now. Plus re-exams of prolactin, testosterone, etc.

I'm still pinching myself to see if I'm truly awake with this new treatment!

[Counterpoints]

I doubt weight could hav anything to do with these. I am considered obsese,but i exericese a moderated amount. is there anybody who is pretty fit and still has these problem.

YES, this is an important observation.  People with Cushings, and cortisol problems, have trouble losing weight, despite good efforts to lose it (exercise and diet). 

When did you start gaining weight?  Are you still gaining weight, or is your weight stable?  Is fat disproportionately in face, collar bone, and stomach areas?  Do you have thin skin anywhere?  Do you have insomnia?  Do you have stretch marks? Do you bruise easily?  All important questions when trying to figure out whether cortisol could be part of the issue.

I am not obese. (My total height/weight ratio is pretty good).  I would probably be considered fit.  But I do show some of these signs.