Postorgasmic disease syndrome ( POIS ) is a syndrome in which men have chronic physical and cognitive symptoms soon after ejaculation in the absence of local genital reactions. The symptoms last up to one week. The cause and prevalence is unknown; it is considered a rare disease.
Video Postorgasmic illness syndrome
Signs and symptoms
The distinguishing characteristics of POIS are:
- the onset of rapid symptoms after ejaculation;
- absence of local genital reactions; and
- the presence of an extraordinary systemic reaction.
POIS symptoms, called "POIS attacks", may include the following combinations: cognitive dysfunction, aphasia, severe muscle pain throughout the body, severe fatigue, weakness, and flu-like or allergic symptoms, such as sneezing, itching, and nasal irritation. Additional symptoms include headaches, dizziness, dizziness, sensory and motor problems, intense discomfort, irritability, anxiety, gastrointestinal disturbances, desire for relief, susceptibility to nervous system pressure (eg the common cold), distressed mood, and difficulty communicating , remember words, read and store information, concentrate, and socialize. The affected person may also experience intense warmth or cold.
Symptoms begin soon after or within half an hour of ejaculation.
Symptoms can last for several days, sometimes up to a week.
In some men, the onset of POIS is in puberty, while in others, the onset occurs in the twenties. POIS that manifests from the first ejaculation in adolescence is called the main type ; POISs that begin in the future are called secondary types .
Many POIS patients report premature ejaculation for life, with intravaginal ejaculatory latency time (IELT) of less than one minute.
POIS has been called by a number of other names, including "post-cancer syndrome", "post-orgasm disease syndrome", "post-ejaculatory disease", and "post-sick orgasm syndrome".
Dhat syndrome is a condition, first described in 1960 in India, with symptoms similar to POIS. Dhat syndrome is considered a culture-bound psychiatric condition and treated with cognitive behavioral therapy along with anti-anxiety and antidepressant drugs.
Post-coital tristesse (PCT) is a feeling of melancholy and anxiety after intercourse that lasts anywhere from five minutes to two hours. PCT, which affects both men and women, occurs only after sexual intercourse and does not require orgasm to occur, and because the effect is more emotional than physiological. In contrast, POIS affects only men, mainly consisting of physiological symptoms triggered by ejaculation and which may last, in some people, up to a week. While PCT and POIS are different conditions, some doctors speculate that they may be related.
A more subtle and lingering symptom array after orgasm, which is not a POIS, may contribute to habituation between partners. They may appear as anxiety, irritability, increased sexual frustration, apathy, lethargy, poverty, dissatisfaction with a partner, or misery for days or weeks after intense sexual stimulation. Such phenomena may be part of the physiology of human marriage itself.
Maps Postorgasmic illness syndrome
Mechanism
The cause of POIS is unknown. Some doctors hypothesize that POIS is caused by an auto-immune reaction. Other doctors suspect hormone imbalance as the cause. While other causes have been proposed as well, no proposed cause seems to fully explain the disease.
Allergic hypothesis
According to one hypothesis, "POIS is caused by type-I and type-IV allergies in male semen". In particular,
Autologous seminal peptides or peptides released from impaired urethral layer cells, contact the inner urethral epithelial epithelium. During this contact, the antigen (s) of semen and/or semen are recognized and taken by dendritic cells in the epithelium. These cells then wander into the T-cell zones of the lymph nodes, where they present the seminal fluid antigen (s) to the na-T-cell and initiate a cascade of hypersensitivity reaction events.
POIS can also be caused by an auto-immune reaction not to the semen itself, but to other substances released during ejaculation, such as for cytokines.
The allergy hypothesis has been disputed. According to a study, "IgE-mediated cement allergy in men may not be a potential mechanism of POIS". A case report assumes that the skin test for autologous cement is negative.
Hypothesis of hormone
According to another hypothesis, POIS is caused by hormonal imbalance, such as low progesterone, low cortisol, low testosterone, increased prolactin, hypothyroidism, or low DHEA.
POIS can be caused by defects in the synthesis of neurosteroid precursors. In this case, the same care may not be effective for different patients. Different sufferers may have different missing precursors, which ultimately lead to deficiencies of certain same neurosteroids, causing the same symptoms.
Other possibilities
POIS can also be caused by hyperglycemia or by a chemical imbalance in the brain.
Sexual activity for the first time can set the stage for an associated asthma attack or may aggravate pre-existing asthma. Intense emotional stimulation during intercourse can lead to an autonomic imbalance with parasympathetic over reactivity, resulting in the release of mast cell mediators that can provoke post-pascainfeksi and/or rhinitis asthma in these patients.
Perhaps also, in different individuals, the causes of POIS differ. POIS can represent "different syndrome spectrum" causes.
None of the currently proposed causes for POIS explain the relationship between POIS and premature ejaculation for life.
Diagnosis
Generally there is no diagnostic criteria for POIS. One group has developed five initial criteria to diagnose POIS. This is:
POIS is susceptible to misinterpretation as a psychological factor such as hypochondriasis or somatic symptoms disorder.
Management
There is no standard method for maintaining or managing POIS. Patients should be thoroughly examined in an attempt to find the cause of their POIS symptoms, which are often difficult to determine, and which vary among patients. Once the cause is hypothesized, the right treatment can be tried. Sometimes, more than one treatment is tried, until it is found.
Affected individuals usually avoid sexual activity, especially ejaculation, or schedule it at times when they can rest and recuperate for several days afterwards. In the case of suspected post-coital tristesse (PCT), patients may be treated with selective serotonin reuptake inhibitors.
Other patients, suspected of POIS due to cytokine release, were successfully treated with nonsteroidal anti-inflammatory drugs (NSAIDs) just before and for one or two days after ejaculation. Patients take diclofenac 75 mg 1 to 2 hours before sexual activity with orgasm, and are continued twice daily for 24 to 48 hours.
One POIS patient with erectile dysfunction and premature ejaculation has significantly lower symptom severity at times when he is able to maintain a long erect penis to achieve vaginal penetration and ejaculation in his partner. Patients take tadalafil to treat erectile dysfunction and premature ejaculation. This increases the number of occasions in which she can ejaculate in her partner, and reduces the number of occasions in which she experiences POIS symptoms. These patients are considered to have Dhat syndrome rather than true POIS.
In one patient, the symptoms of POIS were so severe that he decided to undergo castration to release them. The symptoms of POIS are cured by castration.
Two patients, suspected of POIS due to auto-immune reactions to their own semen, were successfully treated with allergen immunotherapy with their own autologous semen. They were given several subcutaneous injections of their own semen for three years. Treatment with autologous sperm "may take 3 to 5 years before the reduction of clinically relevant symptoms will become apparent". A case report using a technique known as "Intralymphatic Immunotherapy", treatment has managed to improve 60-90% of symptoms. Patients received only five injections of autologous cement using this technique.
Treatment is not always successful, especially when the cause of POIS in certain patients has not been determined. In one patient, all normal routine laboratory tests, the following were tried, all without results: ibuprofen, 400 mg on demand; tramadol 50 mg one hour pre-coitus; and escitalopram 10 mg daily before going to bed for 3 months.
Epidemiology
POIS prevalence is unknown. POIS is listed as a rare disease by the American National Institutes of Health and the European Orphanet. Estimated undiagnosed and unreported.
Female
It is possible that a similar disease exists in women, although, by 2016, only one female patient is documented.
References
External links
Source of the article : Wikipedia
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