Postorgasmic Illness Syndrome: Insights from Recent Literature on a Rare but Fascinating Disorder, 2025, Wdowiak et al

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Postorgasmic Illness Syndrome: Insights from Recent Literature on a Rare but Fascinating Disorder

Krystian Wdowiak, Agnieszka Maciocha & Julia Wąż

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Abstract
Post-orgasmic illness syndrome (POIS) is a rare condition characterised by flu-like and allergic symptoms that develop within hours of ejaculation and last for several days. This review explores current knowledge on POIS, including its symptoms, potential causes, and treatment approaches.

While primarily documented in men, recent reports suggest it may also occur in women, although this remains under-researched. Common symptoms include difficulty concentrating, extreme fatigue, irritability, and muscle weakness.

The exact cause of POIS remains unknown. Earlier theories suggested autoimmune or allergic mechanisms, but recent studies have proposed alternative explanations, such as chemical imbalances in the brain, dysregulated cytokine or neuroendocrine responses, or autonomic dysfunction. A more recent hypothesis is that an acute compression-derived proprioceptive axonopathy occurs in the muscle spindles of the bulbospongiosus and ischiocavernosus muscles.

POIS has a significant impact on mental health, with comorbid conditions such as depression, anxiety, and obsessive–compulsive disorder reported. In addition, 56% of sufferers also experience premature ejaculation.

As a literature review, this article summarizes existing research on POIS and its management. Treatment strategies vary depending on the hypothesised causes, including interventions such as antihistamines, SSRIs, benzodiazepines, niacin, NSAIDs, glucocorticoids, tramadol, nifedipine, alpha-blockers, testosterone therapy, surgery, and psychotherapy. However, the effectiveness of these treatments is variable, highlighting the need for further research to develop targeted therapies and improve patient outcomes.

Link (Sexuality and Culture) [Paywall]

 

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PsyPost: 'Rare post-orgasm illness causes days-long flu-like symptoms, but research into its cause remains limited'

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'A rare and poorly understood condition known as post-orgasmic illness syndrome, or POIS, causes a wide range of flu-like and allergic symptoms following ejaculation. These symptoms, which can include exhaustion, difficulty concentrating, and muscle weakness, often begin within minutes to hours after orgasm and can persist for several days. Although the condition has been largely observed in men, there is growing, albeit limited, evidence that it may also affect women. A new scientific review published in Sexuality & Culture offers the most up-to-date summary of what is currently known about POIS, highlighting its symptoms, possible causes, and a wide range of treatment attempts—none of which has proven universally effective.

The researchers conducted the review because POIS remains an under-recognized condition with no established diagnostic criteria in medical manuals and no agreed-upon treatment approach. Since it was first described in 2002, only a handful of studies have attempted to systematically explore its causes and potential treatments. The review authors aimed to provide a clearer overview of the scientific literature to help both clinicians and patients better understand the condition and guide future research efforts.'

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'The most widely accepted standards were developed by Dutch psychiatrist Marcel Waldinger and his team, based on reports from 45 male patients. These criteria include flu-like symptoms such as fatigue, feverishness, and irritability; onset of symptoms shortly after ejaculation; recurrence in nearly every ejaculation; and a duration of symptoms typically lasting between two and seven days.'

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'A particularly novel theory suggests that POIS results from minor nerve damage in the pelvic muscles responsible for ejaculation, similar to conditions that cause delayed muscle pain.'

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'In the 2020 Natale study, some of the more commonly used medications included antihistamines, selective serotonin reuptake inhibitors (commonly used to treat depression), and non-steroidal anti-inflammatory drugs. Of these, niacin and anti-inflammatory drugs appeared to be most effective for the highest number of participants, but still only helped a portion of those who tried them.'