Case of post‐orgasmic illness syndrome associated with hypogonadism

Abstract

Introduction Post‐orgasmic illness syndrome is a rare condition that occurs after ejaculation and persists for 2–7 days and is characterized by flu‐like symptoms, which can significantly reduce quality of life. Case presentation A 21‐year‐old unmarried man was referred to our hospital due to flu‐like symptoms that developed after ejaculation by masturbation and persisted for about 2 days. The patient’s free testosterone level was slightly lower than normal. Nonsteroidal anti‐inflammatory drugs were initially administered and helped relieve headache and muscle pain. Thereafter, the patient was able to ejaculate three times a week. In addition, after administering testosterone enanthate once or twice a month, his general fatigue significantly improved, and he could ejaculate every day. Conclusion The pathophysiology of post‐orgasmic illness syndrome has not been fully elucidated. The treatments for this condition must be accurately selected according to pathophysiology.

Post‐orgasmic illness syndrome with positive intradermal test for autologous semen

“…Desensitization therapy and intralymphatic immunotherapy have been reported to be effective; however, these treatments are highly invasive and require a longer treatment period 11,13 . In some cases, antihistamines, nonsteroidal anti‐inflammatory drugs, and benzodiazepines have been reported to be effective 3,6,7 . In our patient, the symptoms, such as fatigue and malaise after ejaculation, were improved by treatment with antihistamines.…”

“…The age at diagnosis ranges from 20 to 60 years, but more than half of the patients experienced symptoms since their teens (Table 2). 3–12 Indeed, for our patient, it took 10 years from onset to diagnosis. This is because the symptoms of POIS are nonspecific and may have been overlooked due to a lack of awareness of the disease.…”

“…The second is the hypogonadism theory. In some cases of POIS with hypotestosteronemia, the symptoms were alleviated during all the cycles of regular hormone replacement therapy 6 …”

Post-orgasmic Illness Syndrome: A Closer Look

“…Likewise, the use of corticosteroids such as prednisone was also reported to have no good outcome. 11 Pierce et al gave an antihistamine in the form of cetirizine in the case of a 28 year-old man with POIS in New York, for four weeks of treatment reported symptoms of diarrhea and abdominal cramps which at that time was reported as one of the symptoms of POIS had improved but there was no improvement in other symptoms. Likewise, the use of diphenhydramine was reported to produce a better output.…”

“…This treatment was continued for up to 4 weeks and then replaced with a testosterone ointment preparation (Glowmin®; Daito Pharma, Tokyo, Japan), and the symptoms continues to improve. 11 A probiotic containing Bacillus coagulans and fructooligosaccharide, can be used to decrease the symptoms. 12 Many alternative therapies have been suggested to be effective in improving symptoms of POIS, including niacin, olive leaf, fenugreek, saw palmetto, and wobenzym.…”