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Gül M, Fode M, Urkmez A, Capogrosso P, Falcone M, Sarikaya S, Sokolakis I, Morgado A, Morozov A, Albersen M, Russo GI, Serefoglu EC. A clinical guide to rare male sexual disorders. Nat Rev Urol 2024; 21:35-49. [PMID: 37670085 DOI: 10.1038/s41585-023-00803-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 09/07/2023]
Abstract
Conditions referred to as 'male sexual dysfunctions' usually include erectile dysfunction, ejaculatory disorders and male hypogonadism. However, some less common male sexual disorders exist, which are under-recognized and under-treated, leading to considerable morbidity, with adverse effects on individuals' sexual health and relationships. Such conditions include post-finasteride syndrome, restless genital syndrome, post-orgasmic illness syndrome, post-selective serotonin reuptake inhibitor (SSRI) sexual dysfunction, hard-flaccid syndrome, sleep-related painful erections and post-retinoid sexual dysfunction. Information about these disorders usually originates from case-control trials or small case series; thus, the published literature is scarce. As the aetiology of these diseases has not been fully elucidated, the optimal investigational work-up and therapy are not well defined, and the available options cannot, therefore, adequately address patients' sexual problems and implement appropriate treatment. Thus, larger-scale studies - including prospective trials and comprehensive case registries - are crucial to better understand the aetiology, prevalence and clinical characteristics of these conditions. Furthermore, collaborative efforts among researchers, health-care professionals and patient advocacy groups will be essential in order to develop evidence-based guidelines and novel therapeutic approaches that can effectively address these disorders. By advancing our understanding and refining treatment strategies, we can strive towards improving the quality of life and fostering healthier sexual relationships for individuals suffering from these rare sexual disorders.
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Affiliation(s)
- Murat Gül
- Department of Urology, Selcuk University School of Medicine, Urology, Konya, Turkey.
| | - Mikkel Fode
- Department of Urology, Copenhagen University Hospital - Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ahmet Urkmez
- Department of Urology, St. Elizabeth's Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Paolo Capogrosso
- Department of Urology, ASST Sette Laghi, Circolo and Fondazione Macchi Hospital, Varese, Italy
| | - Marco Falcone
- Department of Urology, Molinette Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Selcuk Sarikaya
- Department of Urology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ioannis Sokolakis
- 2nd Department of Urology, Aristotle University of Thessaloniki, Medical School Thessaloniki,Greece, Thessaloniki, Greece
| | - Afonso Morgado
- Department of Urology, Centro Hospitalar São João, Porto, Portugal
| | - Andrey Morozov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Giorgio Ivan Russo
- Urology section, Department of Surgery, University of Catania, Catania, Italy
| | - Ege Can Serefoglu
- Department of Urology, Biruni University, School of Medicine, Istanbul, Turkey
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2
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Duran MB, Rubin RS, Reisman Y, Serefoglu EC. Recognition and practice patterns of sexual medicine experts towards postorgasmic illness syndrome. Int J Impot Res 2023:10.1038/s41443-023-00753-x. [PMID: 37604984 DOI: 10.1038/s41443-023-00753-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023]
Abstract
Post-orgasmic illness syndrome (POIS) is a rare, but debilitating cluster of symptoms, occurring after ejaculation with unknown mechanism and uncertain treatment. To the best of our knowledge, this study, which is thought to be the first in the literature, is aimed to investigate the practice patterns of sexual medicine experts towards POIS. Worldwide sexual medicine experts were invited to participate anonymously in an online, open survey using SurveyMonkey between November 14, 2022, and January 15, 2023. In total 211 sexual medicine experts filled the survey. The majority of the participants were urologists (83.9%). Most participants stated that the available information about POIS was inadequate for both patients and physicians. 47.9% of the participants stated psychological disorder, 46.4% stated bio-psycho-social reasons for the responsibility for the pathophysiology of POIS. 56.4% of the participants stated that they would refer the patient for psychotherapy/sexual therapy to a sexologist, 41.7% would prefer antihistamine drugs to manage symptoms. Only 18% of participants reported symptom improvement in more than 30% of the patients. This survey study among sexual medicine experts from different parts of the world has developed representative estimates of knowledge, attitudes and practice patterns regarding POIS worldwide.
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Affiliation(s)
- Mesut Berkan Duran
- Department of Urology, Pamukkale University, School of Medicine, Denizli, Turkey
| | - Rachel S Rubin
- Department of Urology, Georgetown University, Georgetown, Washington, DC, 20007, USA
| | - Yacov Reisman
- Reuth Rehabilitation Hospital, Tel-Aviv, Israel
- Flare-Health, Amstelveen, The Netherlands
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey.
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3
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Zizzo J, F Sávio L, Ramasamy R, F N Lima T. Postorgasmic Illness Syndrome: An Update. Eur Urol Focus 2023; 9:22-24. [PMID: 36283946 DOI: 10.1016/j.euf.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/27/2022] [Indexed: 11/19/2022]
Abstract
Postorgasmic illness syndrome (POIS) is a rare condition affecting men who experience a cluster of flu-like and allergic symptoms after ejaculation. POIS can occur after intercourse, masturbation, or spontaneous ejaculation, and may persist for up to 7 d. Recurrent symptoms often negatively impact quality of life and sexual activity, leaving those affected with mental sequelae, diminished concentration, and mood changes. While it has been shown that various treatment options can alleviate symptoms in the short term, acute management remains controversial. In addition, follow-up data are severely lacking, resulting in the absence of established long-term management options for men suffering from POIS. This review highlights hallmark studies and the current state and promising developments surrounding clinical approaches to POIS. PATIENT SUMMARY: In this review, we discuss what is known about postorgasmic illness syndrome (POIS), a disease that causes flu-like symptoms in some men after ejaculation. Little research has been on POIS, so its causes, diagnosis, and appropriate treatments are poorly understood.
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Affiliation(s)
- John Zizzo
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Luís F Sávio
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Thiago F N Lima
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.
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Allain JS, Henriot B, Guillemot P, Menard S, Cador-Rousseau B, Jego P, Deshaye R, Azoyan L, Riller Q, Renaud A. [Confusion and drowsiness a 16 year-old man]. Rev Med Interne 2022; 43:566-569. [PMID: 35667918 DOI: 10.1016/j.revmed.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Affiliation(s)
- J-S Allain
- Médecine interne et immunologie clinique, pôle CVM, CH de Saint Malo, 1, rue de la Marne, 35400 Saint Malo, France; Unité d'investigation clinique, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France.
| | - B Henriot
- Médecine interne et immunologie clinique, CH de René Pleven, 74, rue Châteaubriand, 22100 Dinan, France
| | - P Guillemot
- Service de médecine du sport, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - S Menard
- Médecine du sport, clinique Saint Laurent, 320, avenue du Général Patton, 35700 Rennes, France; Fédération française de judo, jujitsu, kendo et disciplines associées, 21/25, avenue de la Porte Châtillon, 75014 Paris, France
| | - B Cador-Rousseau
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - P Jego
- Service de médecine interne et immunologie clinique, CHU de Rennes, 2, rue Henri-le-Guilloux, 35000 Rennes, France
| | - R Deshaye
- Service de médecine interne, Hôtel-Dieu, centre hospitalier universitaire, place Alexis Ricordeau, 44093 Nantes, France
| | - L Azoyan
- Service de médecine interne, centre hospitalier universitaire, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - Q Riller
- Service de médecine interne 2, hôpital de la Pitié-Salpêtrière, Sorbonne université, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Renaud
- Service de médecine interne, Hôtel-Dieu, centre hospitalier universitaire, place Alexis Ricordeau, 44093 Nantes, France
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5
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Chen T, Mulloy EA, Eisenberg ML. Medical Treatment of Disorders of Ejaculation. Urol Clin North Am 2022; 49:219-230. [DOI: 10.1016/j.ucl.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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6
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Quintana GR. Can Orgasms Be Disentangled Into Their Parts? A Response to McKenna (2021). Arch Sex Behav 2022; 51:699-702. [PMID: 34799833 DOI: 10.1007/s10508-021-02219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Gonzalo R Quintana
- Escuela de Psicología y Filosofía, Facultad de Ciencias Sociales y Jurídicas, Universidad de Tarapacá, 7-D, Arica, Chile.
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Wrotynska-Barczynska J, Swat E, Berger A, Pawelczyk L, Jedrzejczak P. Intensified Hyposensitization Is an Effective Treatment of Postorgasmic Illness Syndrome (POIS). Sex Med 2022; 10:100474. [PMID: 35038623 PMCID: PMC9023242 DOI: 10.1016/j.esxm.2021.100474] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Postorgasmic illness syndrome (POIS) is an extremely rare urogenital disease which significantly and negatively impacts the functioning and sexual activity. Aims A 34-year-old male presented with POIS symptoms and confirmed the allergic component of the POIS. Intensified immunotherapy with autologous semen was recommended. Methods The treatment lasted 14 months and included 20 visits. Modified and intensified subcutaneous immunotherapy in both forearms significantly shortened the therapy and improved the outcome, with high-tolerance and no adverse effects or hyperactive responses. Main Outcome Measure Improvement in POIS symptoms through the use of intensified immunotherapy with autologous semen. Results The improvement was significant enough to allow for higher sexual activity, and gradual resumption of private and professional activity. Conclusion Intensified immunotherapy with autologous semen seems an effective and safe option for treating patients with suspected immune-allergenic POIS. To the best of our knowledge, this has been the first such intensive and effective allergen-specific immunotherapy of POIS. Wrotynska-Barczynska J, Swat. Swat E, Berger A, et al. Intensified Hyposensitization Is an Effective Treatment of Postorgasmic Illness Syndrome (POIS). Sex Med 2022;10:100474.
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Affiliation(s)
- Joanna Wrotynska-Barczynska
- Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Edyta Swat
- Department of Pulmonology and Allergology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Anna Berger
- Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Leszek Pawelczyk
- Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Piotr Jedrzejczak
- Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
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Hamdi G, Ben Ammar H, Charaa O, Brahmi L, Maamri A, Zalila H. The first Tunisian case of postorgasmic illness syndrome: A case report. Clin Case Rep 2021; 9:e05120. [PMID: 34824857 PMCID: PMC8605164 DOI: 10.1002/ccr3.5120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/01/2021] [Accepted: 11/06/2021] [Indexed: 11/11/2022] Open
Abstract
Postorgasmic illness syndrome (POIS) is a rare and singular syndrome. About fifty cases have been reported in the medical literature. Through a clinical observation, we illustrate the first case diagnosed in Tunisia and the difficulties in the etiological diagnosis and the therapeutic management of this syndrome. Given the shortage of cases reported in the literature, the syndrome of POIS remains poorly identified and subsequently misdiagnosed. The clinical diagnosis is relatively simple, yet etiological and therapeutic questions remain to overcome.
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Affiliation(s)
- Ghada Hamdi
- Faculty of Medicine of TunisTunis El Manar UniversityTunisTunisia
- Psychiatry DepartmentRazi HospitalManoubaTunisia
| | - Hanen Ben Ammar
- Faculty of Medicine of TunisTunis El Manar UniversityTunisTunisia
- Psychiatry DepartmentRazi HospitalManoubaTunisia
| | - Oumaima Charaa
- Faculty of Medicine of TunisTunis El Manar UniversityTunisTunisia
- Psychiatry DepartmentRazi HospitalManoubaTunisia
| | - Lina Brahmi
- Faculty of Medicine of TunisTunis El Manar UniversityTunisTunisia
- Psychiatry DepartmentRazi HospitalManoubaTunisia
| | - Amira Maamri
- Faculty of Medicine of TunisTunis El Manar UniversityTunisTunisia
- Psychiatry DepartmentRazi HospitalManoubaTunisia
| | - Haifa Zalila
- Faculty of Medicine of TunisTunis El Manar UniversityTunisTunisia
- Psychiatry DepartmentRazi HospitalManoubaTunisia
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9
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Sonkodi B, Kopa Z, Nyirády P. Post Orgasmic Illness Syndrome (POIS) and Delayed Onset Muscle Soreness (DOMS): Do They Have Anything in Common? Cells 2021; 10:cells10081867. [PMID: 34440637 PMCID: PMC8392034 DOI: 10.3390/cells10081867] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/09/2021] [Accepted: 07/21/2021] [Indexed: 12/16/2022] Open
Abstract
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.
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Affiliation(s)
- Balázs Sonkodi
- Department of Health Sciences and Sport Medicine, University of Physical Education, 1123 Budapest, Hungary
- Correspondence:
| | - Zsolt Kopa
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (Z.K.); (P.N.)
| | - Péter Nyirády
- Department of Urology, Semmelweis University, 1082 Budapest, Hungary; (Z.K.); (P.N.)
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Natale C, Gabrielson A, Tue Nguyen HM, Dick B, Hellstrom WJG. Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample. J Sex Med 2020; 17:2229-2235. [PMID: 33008782 DOI: 10.1016/j.jsxm.2020.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/24/2020] [Accepted: 08/30/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Postorgasmic illness syndrome (POIS) is a rare syndrome of unknown etiology where patients experience distressing physical and psychological after ejaculatory sequelae. AIM To better characterize the epidemiology, symptomatology, disease course, and treatment of POIS, with specific interest placed on examining relationships between disease presentation and measures of disease burden. METHODS A 30-item questionnaire was distributed to an online community of patients with POIS from June 2019 to January 2020. We assessed diagnostic criteria and clusters of symptomatology described in prior studies. Outcome measures include self-reported measures of symptom severity, disease burden, and behavioral changes. Statistical correlations were assessed with Pearson's chi-squared (χ2) and ordinal regression analyses. OUTCOMES The main outcome measures of this study are self-reported measures of symptom severity, disease burden, and behavioral changes. RESULTS The sample consisted of 302 men (mean age: 32.6 ± 11.4 years, mean age of onset: 19.1 ± 7.8 years) with 89% satisfying ≥3 diagnostic criteria. Common symptoms were difficulty concentrating (254, 84%), extreme fatigue (250, 83%), irritability (225, 74%), and muscle weakness (212, 70%). Common symptom clusters were general (219, 72%), muscle (137, 45%), and head (93, 31%). Common behavioral modifications were avoiding masturbation (215, 71%), schedule changes (213, 71%), and abstinence (186, 62%). Head and throat symptom clusters demonstrated worse disease burden outcomes. Professional medical advice was sought by 51% of participants. Attempted treatments included pharmacotherapy, vitamins, supplements, and herbs with variable efficacy. CLINICAL IMPLICATIONS This study further characterizes POIS, including how patients respond to the condition, how it is treated in the community, and presentations that may be associated with more severe disease. STRENGTHS & LIMITATIONS This is the largest study to date that concerns patients suffering from POIS and includes a diverse, global population. Limitations include that the survey was only administered in English and within 1 online community, that results were self-reported, and that the response rate was low (32%). CONCLUSIONS Characterizing symptom cluster, but not number of diagnostic criteria, may offer prognostic value, and investigation to elucidate pathophysiology and potential treatments for POIS is necessary. Natale C, Gabrielson A, Tue Nguyen HM, et al. Analysis of the Symptomatology, Disease Course, and Treatment of Postorgasmic Illness Syndrome in a Large Sample. J Sex Med 2020;17:2229-2235.
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Affiliation(s)
- Caleb Natale
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Andrew Gabrielson
- Johns Hopkins School of Medicine, James Buchanan Brady Urological Institute, Baltimore, MD, USA
| | | | - Brian Dick
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Wayne J G Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA.
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Takeshima T, Kuroda S, Yumura Y. Case of post-orgasmic illness syndrome associated with hypogonadism. IJU Case Rep 2020; 3:189-191. [PMID: 32914071 PMCID: PMC7469847 DOI: 10.1002/iju5.12184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/02/2020] [Indexed: 01/23/2023] Open
Abstract
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.
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Affiliation(s)
- Teppei Takeshima
- Department of Urology, Reproduction Center Yokohama City University Medical Center Yokohama Japan
| | - Shinnosuke Kuroda
- Department of Urology, Reproduction Center Yokohama City University Medical Center Yokohama Japan
| | - Yasushi Yumura
- Department of Urology, Reproduction Center Yokohama City University Medical Center Yokohama Japan
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12
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Reisman Y. Clinical experience with post-orgasmic illness syndrome (POIS) patients-characteristics and possible treatment modality. Int J Impot Res 2021; 33:556-62. [PMID: 32472106 DOI: 10.1038/s41443-020-0314-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 11/08/2022]
Abstract
Post-orgasmic illness syndrome (POIS) is a rare condition that includes a cluster of post-ejaculatory symptoms with debilitating physical and psychological consequences. The prevalence and incidence of POIS remain unknown as well as the pathophysiology of the syndrome, and there are no well-studied recognized treatment modalities. The current retrospective observational study describes a series of 14 highly selected patients who were actively looking for medical help as POIS has a significant effect on patients and their partners. The aim is to increase knowledge about this syndrome and possible treatment modality. According to a standard protocol, patients have been systematically interviewed, had a physical examination, laboratory blood tests, and treatments. Mean age was 34.07 ± 6.65 years. The majority of patients had only one symptom in common-extreme fatigue. The most prevalent complaints were head pressure/heaviness, nose congestion and muscle tension; all patients suffered from more than 1 symptom. POIS started on average within 30 min of ejaculation and lasted for 3.5 days. The patients reported emotional and psychosocial burden of their symptoms, which also influence their partner and relationships. Immunoglobulin-E measurements did not show elevated levels and/or significant increase within 24 h after ejaculation. Silodosin, a highly selective alpha1A-blocker, which actually causes anejaculation, was effective treatment in 57% of the patients.
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Pierce H, Fainberg J, Gaffney C, Aboukhashaba A, Khan A, Kashanian J. Postorgasmic illness syndrome: potential new treatment options for a rare disorder. Scand J Urol 2019; 54:86-88. [PMID: 31878818 DOI: 10.1080/21681805.2019.1704861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Hudson Pierce
- Department of Urology, Weill Cornell Medicine-New York Presbyterian, New York, NY, USA
| | - Jonathan Fainberg
- Department of Urology, Weill Cornell Medicine-New York Presbyterian, New York, NY, USA
| | - Christopher Gaffney
- Department of Urology, Weill Cornell Medicine-New York Presbyterian, New York, NY, USA
| | - Ahmad Aboukhashaba
- Department of Urology, Weill Cornell Medicine-New York Presbyterian, New York, NY, USA
| | - Aleem Khan
- Department of Urology, Weill Cornell Medicine-New York Presbyterian, New York, NY, USA
| | - James Kashanian
- Department of Urology, Weill Cornell Medicine-New York Presbyterian, New York, NY, USA
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Bolanos J, Morgentaler A. Successful treatment of Post-orgasmic illness syndrome with human chorionic gonadotropin. Urol Case Rep 2019; 29:101078. [PMID: 31832334 PMCID: PMC6889685 DOI: 10.1016/j.eucr.2019.101078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022] Open
Abstract
Post-orgasmic illness syndrome (POIS) is an uncommon condition in which men experience debilitating symptoms following orgasm, including anxiety, weakness, and lassitude. The etiology is unknown, and treatment challenging. We present a 25y man with POIS since puberty. He dreaded ejaculation due to his subsequent symptoms. Multiple prior treatments had failed. Blood tests revealed testosterone (T) deficiency. hCG was prescribed. At 6 weeks T levels normalized with near-complete resolution of symptoms. This successful result argues for hormonal investigation in men with POIS, and a trial of hCG or T therapy if total or free T is low or borderline.
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Affiliation(s)
| | - Abraham Morgentaler
- Men's Health Boston, Beth Israel Deaconess Medical Center, Harvard Medical School, Chestnut Hill, MA, USA
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Martin-Tuite P, Shindel AW. Management Options for Premature Ejaculation and Delayed Ejaculation in Men. Sex Med Rev 2019; 8:473-485. [PMID: 31668585 DOI: 10.1016/j.sxmr.2019.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/06/2019] [Accepted: 09/21/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Many men experience distressing issues regarding the timing of orgasm and ejaculation, such as premature ejaculation (PE) and delayed ejaculation (DE). Despite being highly prevalent, both PE and DE are poorly understood and present a management challenge for sexual medicine specialists. AIM To summarize existing data on the medical management of PE and DE. METHODS A comprehensive literature review pertaining to the management of PE and DE was conducted using PubMed and clinicaltrials.gov for data published up until May 2019. Our focus was on double-blind, placebo-controlled trials and meta-analyses of such studies. MAIN OUTCOME MEASURE Peer-reviewed studies on treatment options for PE and DE were critically analyzed for results and methodological rigor. RESULTS The peer-reviewed data on PE management continue to evolve. Psychotherapy, pharmacotherapy, and procedural interventions have all been associated with some degree of efficacy. A strong evidence base supports the off-label use of selective serotonin reuptake inhibitors and local anesthetics in PE given consistent increases in ejaculation latency time. Education and mental health assessments remain important components of PE management despite a dearth of peer-reviewed data on these interventions. Numerous treatment strategies have been evaluated for DE; limited data support psychotherapy, pharmacotherapy, and/or penile vibratory stimulation as management options. CONCLUSION A number of management options for PE or DE exist but none has been formally approved by the US Food and Drug Administration. New and novel treatments would be of great value in managing issues regarding the timing of ejaculation/orgasm. Martin-Tuite P, Shindel AW. Management Options for Premature Ejaculation and Delayed Ejaculation in Men. Sex Med Rev 2020; 8:473-485.
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Affiliation(s)
| | - Alan W Shindel
- Department of Urology, University of California, San Francisco, CA, USA.
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De Amicis K, Costa PR, Figo DD, De Lima CMF, Castro FFM, Kalil J, Santos KS, Galvão CES. Immunophenotypical Characterization of a Brazilian POIS (Post-Orgasmic Illness Syndrome) Patient: Adding More Pieces to Puzzle. J Sex Marital Ther 2019; 46:227-233. [PMID: 31612795 DOI: 10.1080/0092623x.2019.1677835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Post-orgasmic illness syndrome (POIS) is a rare condition characterized by post-ejaculatory symptoms. Here is reported the first Brazilian POIS patient. Immunological investigation did not confirm the previous hypothesis of a hypersensitivity reaction. Cell immunophenotyping comparing healthy individuals produced evidence of abnormalities not associated to clinical manifestations. The patient was submitted to specific immunotherapy with transient clinical response and was referred to a psychologist but did not demonstrate clinical improvement of symptoms. Therefore, etiology of POIS remains unclear.
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Affiliation(s)
- Karine De Amicis
- Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Priscilla Ramos Costa
- Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Daniele Danella Figo
- Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Fabio Fernandes Morato Castro
- Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Serviço de Imunologia Clinica e Alergia, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Institute for Investigation in Immunology (III), INCT, Sao Paulo, Brazil
| | - Jorge Kalil
- Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Laboratorio de Imunologia, Instituto Do Coraçao, Hospital Das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Institute for Investigation in Immunology (III), INCT, Sao Paulo, Brazil
| | - Keity Souza Santos
- Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Laboratorio de Imunologia, Instituto Do Coraçao, Hospital Das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Institute for Investigation in Immunology (III), INCT, Sao Paulo, Brazil
| | - Clovis Eduardo Santos Galvão
- Serviço de Imunologia Clinica e Alergia, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
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