In a recent case study, doctors describe the unfortunate tale of a man who developed an allergy-like reaction to his own orgasms. The bizarre and rare affliction left him unable to pursue sexual and romantic relationships. But thankfully, the doctors managed to treat his problem using a simple over-the-counter antihistamine.
The condition is known as postorgasmic illness syndrome, or POIS. Sufferers (almost always men) experience symptoms similar to hay fever or a flu following ejaculation, such as fatigue, itchy eyes, stuffy or runny nose, and even memory problems. These symptoms appear after every or nearly every orgasm, usually within seconds but sometimes up to hours later, and they can last anywhere from two to seven days.
There are many different illnesses that can affect a person’s sexual function, but POIS is especially rare. The National Institutes of Health estimates that fewer than 1,000 people in the U.S. currently have it. And according to the authors of this latest case study, set to be published in the November issue of Urology Case Reports, there are fewer than 60 reported cases of POIS in the medical literature.
The report describes an otherwise healthy 27-year-old man who first began to experience his symptoms at the age of 18. In addition to his flu-like illness, he would often break out into hives along his forearms after orgasms. He had seen several medical providers over the years, including an otolaryngologist, an infectious disease specialist, and multiple allergists, but nothing they offered seemed to help. By the time he saw these doctors, he had long been actively abstaining from any kind of sexual activity and romantic relationships.
Because of its rarity, there’s very little known about exactly why POIS happens. But it’s suspected to be a type of hypersensitivity reaction to something within a person’s ejaculate. Most people with POIS, for instance, have tested positive on skin prick tests using their semen as the allergen. One plausible theory is that sperm cells might trigger this immune response, since they contain only half of the genetic material found in most other cells. But even sterile individuals have developed POIS, suggesting that the true culprit is usually some other ingredient in semen.
In this particular case, the man recalled that his first episode occurred after he had recovered from a case of acute epididymitis, or inflammation around a specific area of the scrotum. Epididymitis is often caused by a urinary tract infection or sexually transmitted bacterial infection. It’s possible, the doctors speculate, that this infection set off a chain reaction that caused his immune system to become sensitized to his semen from then on.
There’s no official treatment for POIS, but the doctors decided to test out an antihistamine, which can tamp down the symptoms of other types of allergy. Their initial treatment didn’t seem to work, but they then switched to an over-the-counter version of fexofenadine, taken daily (the drug has long since become generic but is sold under the popular brand name Allegra). Additionally, they advised the man to gradually ramp up his frequency of orgasms. The fexofenadine worked like a charm, leading to a self-reported 90% decrease in symptoms and allowing the man to finally resume sexual activity.
The doctors suspect that the other antihistamine may have failed to help because its peak effects only last for a few hours, while fexofenadine is both long-lasting and non-sedative. But although this drug is safe, cheap, and easy to take, the doctors do recommend that more research be done to confirm that it can be a reliable option for those with POIS.
“Our experience demonstrates the feasibility of treating a complex disease with a simple medication and hopefully will be replicated in future patients,” they wrote.