Postorgasmic illness syndrome

The cause of POIS is unknown, but several theories have been proposed. Currently, the most accepted theory is that in men with POIS, it is an autoimmune or allergic disorder that causes an inflammatory reaction to a substance in a man’s own semen. In other words, a man might have an allergy to his own semen, leading to a hypersensitivity reaction (an exaggerated immune response). Other researchers have proposed that POIS may be caused by chemical imbalances in the brain, with psychological conditions being risk factors for developing the condition. In women, it has been hypothesized that an antigen triggering POIS symptoms might be produced by prostate-like tissue (known as Skene glands or ducts), which is localized around the upper wall of the vagina. Further research is needed to validate or refute current theories, and to explore additional possible causes of POIS.

A diagnosis of POIS may be based on the presence of the following criteria, which were proposed in 2011 based upon data from a study of only men:

• One or more associated symptoms
• Symptoms develop within seconds or a short time after ejaculation
• Symptoms always, or almost always, occur after ejaculation (after at least 90% of ejaculations)
• Symptoms last for approximately 2 to 7 days
• Symptoms resolve on their own within one week

One test that may be helpful for a diagnosis in men is a skin prick test, using a very diluted sample of the man's own semen. This test needs a doctor's supervision because it can cause POIS symptoms and may result in a severe reaction requiring hospitalization.

At this time, there are no proposed diagnostic criteria for women with symptoms of POIS.

We are not aware of cases in the medical literature in which POIS was inherited. However, little is known about the underlying cause of POIS, so whether genetic factors contribute to the condition is not currently known.

POIS is not a life-threatening condition, but it does have a significant impact on quality of life for affected men and their partners. A few different treatments have been attempted with some men reporting improvement of symptoms.

We are not aware of reliable information about the natural history of POIS and whether symptoms of POIS change over time. POIS was not described or defined in the medical literature until 2002, and it has rarely been reported since. While few cases have been recorded in medical journals, there is a growing number of self-reported cases in internet forums and social networking websites. It is possible that POIS is underrecognized and underdiagnosed.

There is currently limited information available on the treatment and management of POIS. There are not yet reports of treatments that have been used in women. Some men with symptoms of POIS have been treated with SSRIs, antihistamines, and benzodiazepines. Most people with POIS resort to decreased sexual activity, scheduling sexual activity for a time when symptoms can be coped with, or abstaining from sexual activity altogether.

One study used hyposensitization therapy to successfully treat two men with POIS. This type of therapy aims to decrease the immune response to an allergen by exposure, and is based on the theory that POIS is caused by an allergy to one's own semen. The men were inoculated every two weeks with increasing concentrations of their own semen. Although this therapy did not prevent symptoms entirely, both men reported a gradual improvement of symptoms over the treatment period.

The International Society for Sexual Medicine provides information about Postorgasmic illness syndrome.