A new study from Portugal (preprint) presents two detailed case reports on Postorgasmic-Illness-Syndrome (POIS), providing important insights into the clinical heterogeneity, therapeutic challenges, and psychosocial burden of the condition.
The paper describes two men with POIS who developed not only physical symptoms such as extreme fatigue, muscle-related complaints, and cognitive symptoms after ejaculation, but in one case also significant psychiatric distress. Symptoms occurred regardless of the type of orgasm and led to substantial impairments in quality of life.
49-year-old man (secondary POIS):
- Symptoms following every ejaculation (muscle stiffness, genital burning, severe fatigue)
- Extensive medical investigations without evidence of an organic cause
- Treatment: fluvoxamine (50 mg), cyclobenzaprine (10 mg), psychological support, and sexual counseling
- Psychosocial adaptations (e.g., changes in sexual positions), resulting in symptomatic improvement in quality of life, but no complete remission
18-year-old man (primary POIS since puberty):
- Pronounced fatigue, cognitive impairment, irritability, and abdominal symptoms after orgasm
- Repeated psychiatric hospitalizations following severe behavioral deterioration (agitation and aggressiveness)
- Treatment with an antidepressant and an antipsychotic, along with psychological care
- Partial improvement, but persistent and significant impairment
Key findings
- POIS can present with a wide range of severity, from predominantly physical symptoms to severe psychiatric burden.
- Multidisciplinary care (medical, psychological, and sexual medicine–based) can lead to symptomatic improvement and better quality of life.
- Despite extensive diagnostic workups, no organic or allergic causes were identified.
- Recurrent and distressing symptoms led to social withdrawal, avoidance behavior, and psychological distress.
Interpretation
For affected individuals, these case reports illustrate that POIS can vary greatly in presentation and may include both physical and psychological symptoms. Importantly, the findings emphasize that symptoms are real and should be taken seriously even when routine medical investigations are unremarkable. The study further suggests that pharmacological treatment alone is often insufficient and that a multidisciplinary approach—including psychological and sexual medicine support—may be beneficial. At the same time, the cases demonstrate that complete symptom remission is rarely achieved, highlighting the need for patience and individually tailored management strategies.
The study calls for greater clinical awareness and further research to improve understanding of the causes, diagnosis, and treatment of POIS.
Limitation
The article is currently available as a preprint (as of December 2025), meaning it has not yet undergone peer review and should be considered a preliminary scientific contribution.
Source
The preprint “Post-Orgasmic Illness Syndrome: Clinical Presentation, Psychosocial Impact, and Management Challenges Based on Two Case Reports” is freely available on Preprints.org.