Postorgasmic illness syndrome (POIS) is a rare syndrome of unknown etiology where patients experience distressing physical and psychological after ejaculatory sequelae.
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.
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.
The main outcome measures of this study are self-reported measures of symptom severity, disease burden, and behavioral changes.
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.
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.
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%).
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.

BACKGROUND: 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.
METHODS: 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.
CONCLUSIONS: The pathophysiology of post-orgasmic illness syndrome has not been fully elucidated. The treatments for this condition must be accurately selected according to pathophysiology.