A new paper describes the story of one man suffering from one of the rarest allergic syndromes out there — one which, thankfully, has been put under control using simple over-the-counter medicine.
Do you suffer from allergies? I do, and I daresay they are very unpleasant. But a soon-to-be-published study makes me thank my lucky stars that I do not suffer from POIS: postorgasmic illness syndrome. This syndrome affects mostly men and causes patients to experience symptoms similar to hay fever or the flu such as fatigue, itchy eyes, stuffy or runny nose, and even memory problems, following ejaculation.
The condition, despite its potential to cause immense disruption to the 27-year-old patient’s quality of life, was successfully managed using commercially-available antihistamines.
An unusual reaction
Symptoms of POIS appear after nearly every orgasm, generally within a few seconds, although cases have been documented of its symptoms appearing a few hours after the fact. They can last between two to seven days and resemble mild to severe allergic reactions.
It is one of the rarest conditions affecting one’s sexual functions out there. According to The National Institutes of Health, less than 1,000 people in the whole of the USA are currently known to exhibit POIS. Moreover, according to the team documenting this patient’s story, fewer than 60 cases of POIS have ever been reported on in medical literature.
The paper reports that the otherwise healthy 27-year-old man first started experiencing his symptoms around the age of 18. He describes his symptoms as being flu-like, often accompanied by hives on his forearms after orgasm. He had sought the help of several medical providers over the years including an otolaryngologist (ear, nose, and throat doctor), an infectious diseases specialist, and multiple allergists. However, none of the could provide any solution that would actually be of help.
By the time he reached the team that documented his case, he had been actively abstaining from any kind of romantic relationship and sexual activity for quite some time. The man’s difficulties in finding help can be explained by the fact that POIS is extremely rare, so doctors may simply not know it exists to diagnose it.
However, what we do know is that the condition seems to be a type of hypersensitivity to one compound or another in a person’s ejaculation. POIS patients can, for example, test positive on skin prick tests where their semen is used as an allergen.
Exactly which compound causes this is not known, but it is possible that spermatozoa (sperm cells), which only contain half the genetic material found in other cells, register as foreign objects and trigger an outsized reaction from the immune system. But even sterile individuals have developed POIS, in which case some other compound of semen must be responsible.
For this case, the man explained that his first POIS episode happened after he had just recovered from a severe case of epididymitis — inflammation around a particular area of the scrotum. Such inflammation is typically caused by a urinary tract infection or sexually transmitted bacterial infection.The researchers documenting this case say it is possible that this infection caused the patient’s immune system to start recognizing his semen as a threat, leading to the emergence of his POIS.
“It’s like how tick bites can cause people to become allergic to meat by chemical association with [sugar molecule] Alpha gal (galactose-α-1,3-galactose),” our editor Zoe Gordon explained to me.
Although there is no official treatment for POIS, the doctors decided to test an antihistamine (a class of medicine used to treat the symptoms of many types of allergies) for the role. Although their first candidate didn’t work, they later switched to a common, over-the-counter version of fexofenadine (Allegra), taken daily. Additionally, they advised the man to gradually increase his frequency of orgasms.
This line of treatment worked, leading to a (self-reported) 90% decrease in symptoms for the man. He has since (quite enthusiastically, I assume) resumed sexual activity.
In closing, the doctors speculate that their first candidate drug didn’t produce results as its peak effects only last for a few hours. Fexofenadine, meanwhile, is long-lasting and non-sedative. Although for now this treatment option is effective, cheap, easy to take, and safe, the doctors recommend that more research is done to determine whether it is an optimal long-term treatment option for POIS.
“Our experience demonstrates the feasibility of treating a complex disease with a simple medication and hopefully will be replicated in future patients,” they conclude.
The paper “Post orgasmic illness syndrome successfully managed with antihistamine: A case report” will be published in the journal Urology Case Reports.