Dean* was 13 years old the first time he ever masturbated. Immediately after his first orgasm, he found that his energy plummeted and his brain felt slow. “Within like five seconds, I would go from top of the world to just terrible,” Dean, now 24, told Men’s Health.
Stringing together sentences and saying them out loud strained him. It felt as though he were trying to lift an impossibly heavy weight. “If you could imagine just like a structure crumbling, like when they do demolition, that’s kind of how it felt in my brain,” he says.
At first, Dean thought his post-orgasm response was normal. “I wondered if this happened to everyone and everyone was just really good at hiding it,” he added. But as he got older, his post-climax moods worsened, and the effects would last for days afterward. He still had an adolescent’s hyperactive libido, but whether or not to indulge it proved an overwhelming dilemma.
Because his masturbation habits weren’t high on the list of things he wanted to discuss with his parents, Dean turned to Google instead. He obsessively keyed in on many search terms: “emotionless after orgasm,” “emotionless after ejaculation,” “blank after orgasm.” Eventually, he landed on an informal forum for men suffering from an extremely rare disorder: post-orgasmic illness syndrome (POIS).
According to Dutch neuroscientist Marcel W. Waldinger, who identified POIS and published a case report on the condition in 2002, POIS is defined by flu-like symptoms directly after ejaculation, including runny nose, congestion, itchy eyes, sore muscles and throat, headache, exhaustion, feverishness, cognitive impairment, and difficulty speaking. (It’s not the same as post-coital tristesse or dysphoria, a condition that results in intense feelings of depression after orgasm; while post-coital tristesse seems to affect men and women alike, POIS predominantly affects men.)
According to a newly published review of available research, around 50 cases of POIS have since surfaced in medical literature. Hoang Minh Tue Nguyen, the paper’s lead author, says that other known indicators of POIS include irritability, inability to focus, patchy memory, and depression.
In an email to Men’s Health, Nguyen said a person who exhibits one or more of those effects at least 90% of the time is considered a likely candidate for POIS, particularly if their symptoms last for two days to one week and disappear spontaneously thereafter. Nguyen, who has never met or treated Dean, said that his symptoms seemed to meet the criteria, though he added the caveat that “the length of his symptoms sound longer than the criterion reported (most last for 2-7 days).”
Researchers don’t know what causes POIS, but there are a few possible explanations. One hypothesis points to a chemical imbalances in the brain, while another suggests a semen allergy or an autoimmune disease. “Currently there is no known treatment for POIS, partly due to the rarity of the disease,” says Nguyen. For this reason, those who have it are left to manage the effects on their own.
POIS also often goes undiagnosed, in large part due to the stigma surrounding masturbation. When he was 14, Dean tried to bring it up with his doctor, but he found it “too embarrassing and too awkward” to bring up what he suspected was the cause of his symptoms. That doctor diagnosed him with clinical depression, and Dean says he does indeed experience depression and occasional suicidal thoughts. But it’s unclear whether his mental state caused his post-orgasm side effects, or vice versa.
What is clear, however, is that POIS can easily derail someone’s life. Not only does it potentially interfere with patients’ daily schedules, but it also makes relationships hard to sustain, creating deep internal conflict surrounding sex and intimacy.
“I would be hanging out with a girl, [and] it would be a really weird dilemma,” Dean says. “Obviously, you’re young, you’re a teenager, you’re trying to get sex or whatever, but at the same time, in the back of my head, I’m like, ‘I know if this does happen, it’s going to be terrible. And she’s going to be right there.’”
These days, Dean takes antidepressants, which he says keeps the acute effects of his symptoms in check; he can now reach orgasm without feeling like he “got hit with a truck the next morning.” And indeed, there is some evidence that certain classes of antidepressants—for example, selective serotonin reuptake inhibitors (SSRIs) like Prozac—might work for certain patients.
Nguyen says that antihistamines, benzodiazepines (also known as benzos), and “hyposensitization therapy with autologous semen” (i.e., the patient being injected with his own semen, thus supporting the hypothesis that POIS is caused by a semen allergy) have also shown promise as potential treatments.
But if doctors don’t know what causes a disorder, they have few tools to treat it. That’s why Dean hopes “just getting [information] out there a little bit more might help someone put a name to this crazy thing.”
*Last names have been withheld to protect source’s privacy.