Postorgasmic illness syndrome

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Postorgasmic illness syndrome (POIS) is a condition characterized by debilitating symptoms following orgasm that last for a few hours to several days.[1][2] The phenomenon was first described in 2002.[3]

Contents

[edit] Symptoms

Symptoms usually appear within half an hour of orgasm and resolve after a few days.[2][3]

One can experience mental symptoms, physical symptoms, or both. Common mental symptoms include cognitive dysfunction, intense discomfort, irritability, anxiety, craving for relief, susceptibility to nervous system stresses (e.g. cold), depressed mood, and difficulty communicating, remembering words, reading and retaining information, concentrating, and socialising.[2][3][4] Physical symptoms include severe fatigue, mild to severe headache, and flu-like and allergy-like symptoms, such as sneezing, itchy eyes, nasal irritation, and muscle pain.[2][3] Affected individuals may also experience intense warmth.[1]

[edit] Diagnosis

Waldinger says this condition is prone to being erroneously ascribed to psychological factors or hypochondria.[1] In a 2010 British Medical Journal case study, Dexter links a form of coital headache with POIS, and references a science forum in which hundreds of sufferers (a number which is rapidly growing) have detailed their condition.[2][4] Dexter's patient was found to have low progesterone.[2] Others on the referenced forum have tested low in testosterone, high in cortisol, and a contrast enhanced dedicated pituitary MRI has found pituitary abnormalities in three cases: a pituitary microadenoma was found in two, and a partially empty sella in the other.

[edit] Management

Dexter's patient, who had been symptomatic for 27 years, was completely treated by 5 to 10 mg doses of norethisterone, half an hour before, and in the minutes just after orgasm.[2]

Affected individuals typically avoid sexual activity,[1] especially orgasm, or schedule it for times when they can rest and recover for several days afterwards.[3]

One physician has treated two people, whose primary symptoms were intense depressed mood, with a class of antidepressants known for causing sexual dysfunction.[5]

[edit] Pathophysiology

Dexter speculates that POIS could be caused by a lack of progesterone, a powerful neurosteroid, or a defect in neurosteroid precursor synthesis. In the latter case, the same treatment may not be effective for different sufferers. Different sufferers may have different missing precursors, ultimately leading to a deficiency of the same particular neurosteroid, causing similar symptoms.

One researcher suggests that the symptoms may be produced by an autoimmune reaction against any of various hormones or other substances secreted during and after sex.[6] Another suggests that chemical imbalances in the brain may cause the symptoms.[5]

It is difficult to demonstrate a causal relationship based on patient reports.[7]

[edit] Epidemiology

POIS could affect between 0.25%-1% of the population, or possibly more.[8]

[edit] See also

[edit] References

  1. ^ a b c d Waldinger MD, Schweitzer DH (2002). "Postorgasmic illness syndrome: two cases". J Sex Marital Ther 28 (3): 251–5. doi:10.1080/009262302760328280. PMID 11995603. http://www.informaworld.com/smpp/content~db=all~content=a713847004?words=waldinger. 
  2. ^ a b c d e f g Dexter S (2010). "Benign coital headache relieved by partner’s pregnancies with implications for future treatment". British Medical Journal. http://casereports.bmj.com/content/2010/bcr.10.2009.2359.short?rss=1. 
  3. ^ a b c d e Richard Balon, R. Taylor Segraves (2005). Handbook of sexual dysfunction. Informa Health Care. ISBN 9780824758264. http://books.google.com/?id=oVbn7A3BtEUC&pg=PA241&dq=Postorgasmic+Illness+Syndrome. Retrieved 2009-05-11. 
  4. ^ a b "The Naked Scientists". 2010. http://www.thenakedscientists.com/forum/index.php?topic=6576.0. 
  5. ^ a b Friedman, Richard A. (19 January 2009). "In the Brain, if Not the Mind". The New York Times. http://www.nytimes.com/2009/01/20/health/views/20mind.html. Retrieved 12 May 2009. 
  6. ^ "Dutch Doctor Identifies Post-Orgasmic Syndrome". Reuters. Amsterdam. 12 April 2002. 
  7. ^ Berger, Joanne M. (1 June 2002). "Allergic to sex? (Indications)". International Medical News Group. 
  8. ^ Rasmussen BK, Olesen J (1992). "Symptomatic and nonsymptomatic headaches in the general population.". Neurology 42 (6): 1225–31. PMID 1603351. 

[edit] External links

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