Rare Condition Misdiagnosed as Gastritis
A new case report published in MAR Gastroenterology (May 2025) documents the first known patient with postorgasmic-illness-syndrome (POIS) in Libya. The study, titled “From Pleasure to Pain: A Case Report of Post-Orgasmic Illness Syndrome Mimicking Gastritis”, was authored by Ashraf M. Rajab and colleagues.
The 50-year-old male patient initially presented with stomach pain and dyspepsia, which doctors believed to be gastritis. However, further investigation revealed a clear pattern: his symptoms—fatigue, muscle pain, headaches, brain fog, and gastric discomfort—appeared within one hour of ejaculation and lasted up to a week.
A Decade of Symptoms
The man had suffered from these recurring episodes for over ten years, since his marriage. His past medical history included cured hepatitis C and a duodenal ulcer, but laboratory tests, hormone panels, and semen analysis were all normal. This made the diagnosis of postorgasmic-illness-syndrome the most plausible explanation.
Treatment Attempts and Partial Success
The physicians explored several treatment strategies.
- Cetirizine (antihistamine, 10 mg) improved his gastrointestinal symptoms.
- Silodosin (alpha-blocker, 8 mg) combined with cetirizine reduced overall severity but did not eliminate symptoms.
- NSAIDs (diclofenac sodium, 75 mg twice daily) showed no effect.
Other potential treatments—such as corticosteroids, PDE inhibitors, or calcium channel blockers—were discussed but not pursued, either due to side effects or low blood pressure.
Psychological Dimension
Beyond the physical symptoms, the patient also struggled with feelings of guilt related to masturbation during adolescence, which he associated with his illness. This highlights the need for psychological support. Cognitive-behavioral therapy (CBT) was recommended, but access to specialized care in Libya proved difficult.
The patient also considered vasectomy as a possible solution, underlining the psychological burden of living with postorgasmic-illness-syndrome.
Importance of Awareness
This case illustrates several key points:
- Postorgasmic-illness-syndrome remains underdiagnosed, particularly in conservative societies where sexual health is a taboo subject.
- Doctors should be aware that POIS can mimic other conditions such as gastritis.
- Treatment requires a multidisciplinary approach, combining urology, immunology, and psychiatry.
- There is a critical need for more research into both the causes and effective therapies for POIS.
Conclusion
The Libyan case study not only adds to the growing global documentation of postorgasmic-illness-syndrome, but also underlines its complex interplay between physical and psychological health. For patients, early recognition and a holistic treatment strategy may significantly improve quality of life.
Source
Rajab A.M., Younus M.S. (2025). From Pleasure to Pain: A Case Report of Post-Orgasmic Illness Syndrome Mimicking Gastritis. MAR Gastroenterology, 4(2).
🔗 Read the full study on ResearchGate