Treatments for postorgasmic illness syndrome: a systematic review

Abstract Introduction Postorgasmic illness syndrome (POIS) is a rare, poorly understood condition that is characterized by feeling ill after orgasm. Despite its significant impact on quality of life, POIS remains poorly understood, and effective treatment options are limited without clear guidelines. Only 18% of sexual medicine experts report symptom improvement in more than 30% of the patients. Current treatments have been used to address the various presentations such as flu-like state, mood disturbances and/or irritability, as well as congestion and inflammation. Given the lack of standardized therapeutic approaches, there is a critical need to document and evaluate various treatments tried for POIS management. Objective This systematic review aims to evaluate current treatment modalities for POIS and compile solutions that have been studied and tested. Methods A search was conducted in June 2024 of 3 of the most relevant databases (PubMed, Embase, and Scopus) of clinical studies, randomized controlled trials, and case reports analyzing treatment modalities of patients with diagnosed POIS. Results Of 58 studies found, 14 matched our inclusion criteria. Our systematic review consists of 1 cross-sectional study, 1 cohort study, and 12 case reports. Two papers included female patients, and the rest studied only male patients. Eleven papers discussed pharmacologic treatment modalities, including antihistamines, ibuprofen, NSAIDs, hormone replacement therapy, steroids, SSRIs, alpha-blockers, beta-blockers, calcium channel blockers, and triptans. Two papers mentioned immune treatment, one being the intracutaneous injection of autologous semen and the other being intralymphatic immunotherapy with the injection of allergen-specific immunotherapy. One paper mentioned surgical treatment with bilateral epididymectomy and bilateral vasoligation. Conclusion The largest limitation to continued research is related to the rarity and low recognizability of POIS; however, POIS research is on the rise. Scientists across the world are collaborating to better understand the pathophysiology behind this condition and investigate treatment modalities to address the associated symptoms.