Postorgasmic illness syndrome (POIS) in two patients responding to sertraline: a case report, 2026, Herder

Dolphin

Dolphin

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Postorgasmic illness syndrome (POIS) in two patients responding to sertraline: a case report​

Thalia Herder, MD ,
Rikus Knegtering, MD, PhD ,
Nynke Boonstra, MD, PhD ,
Kor Spoelstra, MD, PhD
The Journal of Sexual Medicine, Volume 23, Issue 4, April 2026, qdag049, https://doi.org/10.1093/jsxmed/qdag049
Published:

11 March 2026
Article history

postorgasmic illness syndrome, sertraline, selective serotonin reuptake inhibitors, ejaculation disorders, case report, sexual health
Issue Section:
Complications and Cases
Collection: ISSM Journals

Postorgasmic illness syndrome (POIS) is characterized by a constellation of flu-like, cognitive, and somatic symptoms that may manifest in both women and men subsequent to orgasm or ejaculation.1 These symptoms can profoundly impair quality of life and sexual functioning, with substantial impact on self-esteem, intimate relationships, and overall psychosocial functioning. Frequently, this leads to avoidance of sexual activity and relational distress.1 The diagnostic criteria most often applied were those proposed by Waldinger et al.2:

  1. Occurrence of one or more characteristic symptom clusters (general, flu-like, head, eye, nose, throat, or muscle symptoms).
  2. Symptom onset within a few hours after ejaculation, whether through intercourse, masturbation, or spontaneous emission.
  3. Symptoms occur consistently or in most ejaculations.
  4. Symptoms last 2-7 days before spontaneously resolving.
  5. The symptoms cannot be better explained by another medical condition.

Continues here:
 
Dolphin said:
I've seen men with ME/CFS online say that orgasming sets them back.
Click to expand...
In the case of ME/CFS it can obviously be very difficult to determine whether it is something about the orgasm itself (which could be any one of a host of things happening in the brain or elsewhere) or the associated exertion (even when it occurs as a nocturnal emission, which, anecdotally, do seem to be quite frequent for males with ME/CFS). I do wonder about the potential connection to PEM however. I have a family member with POIS, and some (but not all) of his symptoms resemble my experience of PEM. The key differences are in timing (for him, the onset is most often within minutes of orgasm, though sometimes hours later - I don't know if it has even been as long as 24 hours or more as would be typical for PEM) and in the suddenness of onset - his most common experience is that it hits all at once, which certainly can happen with PEM, but is not certainly not universal. Still very intriguing.
 
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