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Postorgasmic illness syndrome

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Other Names:
POIS; Post orgasmic sick syndrome; Post-orgasmic illness syndrome
Categories:
Postorgasmic illness syndrome (POIS) is a rare condition in which a person develops flu-like and allergy symptoms after orgasm, whether with a partner, through masturbation, or spontaneously during sleep.[1][2][3] POIS typically is reported in males (after ejaculation), but females have rarely been reported to have symptoms of POIS.[1][3] Symptoms may develop within seconds, minutes, or hours after orgasm, and usually last for 2 to 7 days before going away on their own.[1][3][4] Possible symptoms vary from person to person, but more common symptoms include fatigue, weakness, headache, fever, mood changes, memory or concentration problems, stuffy nose, sore throat, and itching eyes.[1][4]

The underlying cause of POIS is not known.[3][4] Some scientists believe that in men, it is an autoimmune or allergic disorder that causes an inflammatory reaction to a substance in a man’s own semen. Others have proposed POIS may be caused by a chemical imbalance in the brain.[3] There is no standard treatment for POIS, but some men have been treated with SSRIs, antihistamines, and/or benzodiazepines.[3][4] POIS can cause severe distress in people with the condition and their partners.[3] Some people with POIS abstain from sexual activity or find that they need to schedule sex for a time when they can cope with the symptoms.[1][3]
Last updated: 2/25/2019
Signs and symptoms of POIS vary but may include:[4][5][6]
  • Fatigue
  • Fever
  • Nasal congestion
  • Irritability or mood disturbances
  • Poor concentration
  • Impaired memory
  • Itchy eyes
  • Muscle pain and weakness
  • Sweating
  • Incoherent speech
Symptoms may develop within seconds, minutes, or hours after orgasm and may last for 2 to 7 days before going away on their own.[4] Some men with POIS also experience lifelong premature ejaculation.[4][5][6]

The symptoms of POIS may be generalized, or may "cluster" in certain areas of the body (i.e. individual men report their symptoms only affect their head, eyes, nose, throat, or muscles). Clusters of symptoms that have been reported include:[2]
  • Cluster 1 (general cluster): extreme fatigue, palpitations, problems finding words, incoherent speech (dysarthria), concentration difficulties, becoming irritated, aversion to noises, light sensibility (photophobia), depressed mood
  • Cluster 2 (flu-like cluster): feeling feverish, extreme warmth, perspiration, shivering, feeling sick, feeling cold
  • Cluster 3 (head cluster): headache, foggy feeling in the head, heavy feeling in the head
  • Cluster 4 (eyes cluster): burning, red eyes; blurred vision; watery, itching eyes; painful eyes
  • Cluster 5 (nose cluster): congestion; watery, runny nose; sneezing
  • Cluster 6 (throat cluster): dirty taste in mouth; dry mouth; sore throat; tickling cough; hoarse voice
  • Cluster 7 (muscle cluster): muscle tension in back or neck; muscle weakness; muscle pain; heavy legs; stiff muscles
Last updated: 6/19/2017

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Showing of 17 |
Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Fatigue
Tired
Tiredness
[ more ] 		0012378
30%-79% of people have these symptoms
Abnormality of the nose
Nasal abnormality
0000366
Fever 0001945
Headache
Headaches
0002315
Hyperhidrosis
Excessive sweating
Increased sweating
Profuse sweating
Sweating
Sweating profusely
Sweating, increased
[ more ] 		0000975
Hypertension 0000822
Irritability
Irritable
0000737
5%-29% of people have these symptoms
Blurred vision 0000622
Delayed speech and language development
Deficiency of speech development
Delayed language development
Delayed speech
Delayed speech acquisition
Delayed speech development
Impaired speech and language development
Impaired speech development
Language delay
Language delayed
Language development deficit
Late-onset speech development
Poor language development
Speech and language delay
Speech and language difficulties
Speech delay
[ more ] 		0000750
Depressivity
Depression
0000716
Dysarthria
Difficulty articulating speech
0001260
Hoarse voice
Hoarseness
Husky voice
[ more ] 		0001609
Muscle stiffness 0003552
Muscle weakness
Muscular weakness
0001324
Palpitations
Missed heart beat
Skipped heart beat
[ more ] 		0001962
Photophobia
Extreme sensitivity of the eyes to light
Light hypersensitivity
[ more ] 		0000613
Xerostomia
Dry mouth
Dry mouth syndrome
Reduced salivation
[ more ] 		0000217
Showing of 17 |
Last updated: 7/1/2020
The cause of POIS is unknown, but several theories have been proposed. Currently, the most accepted theory is that in men with POIS, it is an autoimmune or allergic disorder that causes an inflammatory reaction to a substance in a man’s own semen.[3] In other words, a man might have an allergy to his own semen, leading to a hypersensitivity reaction (an exaggerated immune response).[4][6] Other researchers have proposed that POIS may be caused by chemical imbalances in the brain, with psychological conditions being risk factors for developing the condition. In women, it has been hypothesized that an antigen triggering POIS symptoms might be produced by prostate-like tissue (known as Skene glands or ducts), which is localized around the upper wall of the vagina.[3] Further research is needed to validate or refute current theories, and to explore additional possible causes of POIS.
Last updated: 2/25/2019
We are not aware of cases in the medical literature in which POIS was inherited. However, little is known about the underlying cause of POIS, so whether genetic factors contribute to the condition is not currently known.
Last updated: 6/19/2017
A diagnosis of POIS may be based on the presence of the following criteria, which were proposed in 2011 based upon data from a study of only men:[3][5]
  • One or more associated symptoms
  • Symptoms develop within seconds or a short time after ejaculation
  • Symptoms always, or almost always, occur after ejaculation (after at least 90% of ejaculations)
  • Symptoms last for approximately 2 to 7 days
  • Symptoms resolve on their own within one week
One test that may be helpful for a diagnosis in men is a skin prick test, using a very diluted sample of the man's own semen. This test needs a doctor's supervision because it can cause POIS symptoms and may result in a severe reaction requiring hospitalization.[2]

At this time, there are no proposed diagnostic criteria for women with symptoms of POIS.
Last updated: 2/25/2019
There is currently limited information available on the treatment and management of POIS. There are not yet reports of treatments that have been used in women. Some men with symptoms of POIS have been treated with SSRIs, antihistamines, and benzodiazepines.[4] Most people with POIS resort to decreased sexual activity, scheduling sexual activity for a time when symptoms can be coped with, or abstaining from sexual activity altogether.[3] 

One study used hyposensitization therapy to successfully treat two men with POIS. This type of therapy aims to decrease the immune response to an allergen by exposure, and is based on the theory that POIS is caused by an allergy to one's own semen. The men were inoculated every two weeks with increasing concentrations of their own semen. Although this therapy did not prevent symptoms entirely, both men reported a gradual improvement of symptoms over the treatment period.[4][5][6]
Last updated: 2/25/2019
POIS is not a life-threatening condition, but it does have a significant impact on quality of life for affected men and their partners. A few different treatments have been attempted with some men reporting improvement of symptoms.

We are not aware of reliable information about the natural history of POIS and whether symptoms of POIS change over time. POIS was not described or defined in the medical literature until 2002, and it has rarely been reported since. While few cases have been recorded in medical journals, there is a growing number of self-reported cases in internet forums and social networking websites. It is possible that POIS is underrecognized and underdiagnosed.[7]
Last updated: 6/19/2017

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

  • The International Society for Sexual Medicine (ISSM) has a Provider Directory, a public service for those who wish to locate a Sexual Medicine Provider in their area. The inclusion of a provider is not an endorsement of the skills and abilities of the provider by ISSM.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Postorgasmic illness syndrome. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

  1. What is post-orgasmic illness syndrome (POIS)?. International Society for Sexual Medicine (ISSM). https://www.issm.info/sexual-health-qa/what-is-post-orgasmic-illness-syndrome-pois/. Accessed 2/25/2019.
  2. Waldinger MD. Post orgasmic illness syndrome (POIS). Translational Andrology and Urology. 2016; 5(4):602-606. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001999/.
  3. Nguyen HMT, Bala A, Gabrielson AT, Hellstrom WJG. Post-Orgasmic Illness Syndrome: A Review. Sexual Medicine Reviews. January, 2018; 6(1):11-15. https://www.ncbi.nlm.nih.gov/pubmed/29128269.
  4. Althof SE, McMahon CG. Contemporary Management of Disorders of Male Orgasm and Ejaculation. Urology. July, 2016; 93:9-21. https://www.ncbi.nlm.nih.gov/pubmed/?term=26921646.
  5. Farley SJ. Postorgasmic illness syndrome. Nat Rev Urol. March 2011; 8(3):121. https://www.ncbi.nlm.nih.gov/pubmed/21513019.
  6. Waldinger MD, Meinardi MM, Schweitzer DH. Hyposensitization therapy with autologous semen in two Dutch caucasian males: beneficial effects in Postorgasmic Illness Syndrome (POIS; Part 2). J Sex Med. April 2011; 8(4):1174-1176. https://www.ncbi.nlm.nih.gov/pubmed/21241454.
  7. Jiang N, Xi G, Li H, Yin J.. Postorgasmic Illness Syndrome (POIS) in a Chinese Man: No Proof for IgE-Mediated Allergy to Semen. J Sex Med. March 2015; 12(3):840-845. https://www.ncbi.nlm.nih.gov/pubmed/?term=25630453.