After many years with POIS ( 37 years now), I have found things that helped me decrease the severity of my symptoms. Then, last November (2014) , I have found this forum. After many months of testing the new information I have found on this forum, I have refined and added to my prevention and control method, and have currently an 80% to 100% rate of success. So here is what I do, and it works for me safely.
Before describing the combination of supplements I take before release, which is a key in my higher rate of success, I cannot leave untold the following parts of my overall POIS control method, because, without these, I do not think the supplements alone would bring me as much relief as they currently do:
Healthy diet: about 15 years ago, I have started to eat a more healthy diet. It has been an ongoing process. Now, I may have an ultra-healthy diet. Not a cure in itself, but it sure has helped reduce the fatigue and the severity of the POIS symptoms I used to have. So, no refined sugars, no artificial flavor or color, no preservatives, no MSG, no aspartame, no suspect ingredients ( yes I read all the food labels), no fruit juices ( just whole fruits), no HFGS, no milk ( I can eat cheese, but milk causes tons of mucus production in my sinuses and in my bowels, I have replaced it by hemp, almond or rice drink in my morning organic cereals ),.. I have introduced organic food, healthy spices, healthy veggies, veal liver, dried fruits and nuts, organic wheatgrass juice, omega-3, sources of tryptophan, lots of source water, etc... I take probiotics with Lactobacillus and Bifidus strains. All that has taken care of any bowel inflammation problems I had, which, in my opinion, worsen POIS ( I already have written about this) Also, I have reduced quantities I eat by half, at least ( and did not have lost a pound). I am not a diet freak: I eat meat, fish, eggs, dark chocolate, I sometimes drink wine, and I do not eat tofu at all - it's tasteless! I eat at the restaurant with friends - it's just like, I won't order French fries and will choose something healthier on the menu.
Regular exercise: a good sweat two times a week ( my preferences are badminton and tennis in double - the social/team aspect is a real bonus for me). Exercise is good for the brain and for the body. On the second day of POIS, if I have residual symptoms, they will be gone after exercise. I never work out/exercise two days in a row, because I recover very slowly, and ejaculation plus two times of sport, within 2 days, is too much for me to take, and I may have 30 to 40% POIS symptoms relapse because I got too tired, and that's way too much for my new standards of emotional quality of life. If I get 20% symptoms the day following ejaculation,I avoid exercising that day and wait for another day. With 90% to 100% relief, no problem to exercise that day or the day after.
Abstaining from release as much as possible: my prevention method is based on one or two ejaculations a month and seems to also work at once a week ( I do not think it would work for me with multiple ejaculations in the same week). It would take me 5 to 8 weeks without ejaculation, approx., before I may have a NE, so with one or two releases a month, I usually do not have NE. That way, I can manage at what time I will have a release ( timing is important, as you all know!), and will be able to have taken my pre-pack before. Obviously, with my wife, my 2 kids, my business, my friends, I have much to enjoy in life, and I have not much time to devote to "POIS life suspensions", waiting to get my life back, so I have ejaculations the less often possible. Furthermore, I am now 50 y/o, and sex has not the same importance for me now. Of course, in a relationship for 28 years ( yes guys, it is possible, even with POIS), it is important to keep an active sexual life, and I have done so, through the years. I have managed to develop some useful strategies ( like not every relation has to end with me having a release, etc...), and found a long time ago that magnesium and green tea were helping me with POIS, so I have managed to survive.
Psychotherapy: anxiety from any sources adds up. My childhood has left me with a tendency for anxiety ( you can call it a general anxiety disorder), and I had to live with anxiety way before POIS. POIS will worsen my anxiety level a lot, whatever it is at the moment. After 8 years of psychotherapy, my regular anxiety level is now low. I'd rather raise from 1 to 3, than raise from 7 to 10, which was very detrimental to me and to those around me. The anxiety from POIS is not "all in my head" of course, but a part of it is/was. I have to be careful and keep my baseline anxiety as low as possible.
Daily yoga and meditation: also help to keep my baseline anxiety level as low as possible. Again, my main POIS symptoms, apart from fatigue and hypotension, are mostly emotional: anxiety, irritability, mood swings, dysphoria, social phobia, lack of motivation, low self-esteem, and the like. Daily yoga and meditation have been of great help in staying centered and calm. ( P.S. 2016-01: after reading about the Polyvagal Theory, about Heart Rate Variability ( HRV ), and also about the Cholinergic Anti-inflammatory Pathway, it has become clear to me that yoga and meditation are also a good way to reduce inflammation because they raise the vagal nerve activity, which in turn reduces the inflammation reactions in the body through the Cholinergic Anti-inflammatory Pathway, involving the spleen and the immune cells in it - see
http://poiscenter.com/forums/index.php?topic=2200.msg17995#msg17995 for details. Other ways to raise Heart Rate Variability, like spending time with loved ones, are also as good! )
Now, here is the composition of what I call my "pre-ejaculation pack", or pre-pack, which are the supplements I take before release in order to prevent my POIS symptoms. This is my current version, and every element is there for a reason ( written in brackets ). You will notice I like low and safe doses of several things, instead of high doses of just a few things, so what I take are safe doses:
1 x Quercetin 500mg / Bromelain 750GDU (TDO inhibitor, antioxidant, anti-allergy, mast cells stabilizer )
1x Peppered curcumin (Curcuma longa 400 mg + piperin 5mg) (IDO inhibitor, anti-inflammatory, antioxidant, mast cells stabilizer, anxiolytic )
1 x 5-HTP 50mg ( serotonin precursor )
1 x Green tea extract 200mg ( antioxidant, raises blood pressure, potentiation of 5-HTP in the brain by inhibiting its peripheral metabolism by Dopadecarboxylase, NMDAR blocker, mast cells stabilizer [EGCG] )
1 x Magnesium 100mg / tablet (NMDAR blocker, potassium regulator)
2 x Flaxseed oil, 1000mg/caps ( NMDAR blocker, antioxidant )
1 x Omega-3 triple concentration, 600 mg EPA/ 300 mg DHA ( emotional support/anxiolytic, anti-inflammatory effect )
1 x Lycopene 10mg (antioxidant having an affinity for the prostate )
1 x L-Theanine 250mg (NMDAR blocker, and supposed mast cells stabilizer )
1 x potassium citrate ( electrolytic rebalancing)
( IMPORTANT WARNING: I personally have a tendency to low potassium , = hypokalemia. This is a personal condition, so, do not take potassium supplements without the advice of your health professional, if you take too much of it for your own needs, it can be dangerous, and can even cause fatal cardiac arrhythmia )If I have time to, I swallow the 11 pieces of my pack with "rosemary water", that is, a glass of water with one drop of rosemary essential oil in it ( rosmarinic acid act as an IDO inhibitor, and also has GABA-enhancing properties through GABA transaminase inhibition, and rosemary also contains luteolin, a mast cells stabilizer ).
For my pre-pack to be effective, I have to take it at least 15 minutes before release, and best if 30 to 60 minutes before. But not always possible, in a relationship... when things happen spontaneously, I take my pre-pack just at the beginning, and since I have become, with time, better than a Taoist monk at delaying a release, it is no big deal for me to make it last 15 to 20 minutes, so the active ingredients have time to make it to my bloodstream and everywhere in my body. Obviously, since there are many different supplements in my pre-pack and ti is rather long to prepare, I always have one pack prepared in advance at my bedside, along with some water. If I am not disciplined and take it after release, even if only 2 to 10 minutes after, the prevention and control is far less effective ( better than nothing, but not impressive and very disappointing when I have known better relief).
Now, a short explanation about why I have chosen these particular supplements.
Of course, it is tailored to my own symptoms. For example, I have low blood pressure as one of my main symptoms, so green tea extract helps with that.
Blocking the NMDA receptors is good to lower anxiety level and for other psychological symptoms, so I have put a few in there ( Mg have been in fact the first effective tool I have found against my POIS , 15 to 20 years ago). NMDA receptor blockers in general seem to be good for me. As a side note, taurine is, among other things, an NMDA receptors blocker, and I read some members had good results with it ( I think about B_jim, in particular). It has a good effect for me too, as taurine helps with anxiety, but I have it in powder, so I did not include it in my pre-pack for practical reasons. I don't know if the effectiveness of taurine, magnesium, L-theanine, zinc, or the lignan in flaxseed oil, is related to their NMDA receptor blocking properties, but they are all beneficial for my POIS. Anyway, NMDAR blockers are known for their neuroprotective properties against excitotoxicity, and I believe there is excitotoxicity involved in POIS pathophysiology ( in particular, I think, from quinolinic acid, as I have mentioned before). I have read that some POIS sufferers had good results with tramadol, a potent NMDAR blocker, but I didn't try it, I have chosen not to treat myself with prescription drugs, since I can have good results with natural products and OTC products.
GABA agonists are good for anxiety, so molecules enhancing GABA activity like rosmarinic acid, which can be found in rosemary and other spices and herbs like lemon balm, marjoram, basil, oregano, are good for me.
IDO and TDO inhibitors are good to protect the brain from the change in tryptophan metabolic pathways that I think may be involved in POIS. It works best for me if I use at least one IDO inhibitor with one TDO inhibitor, to block both metabolic ways by which kynurenine is produced ( this may be not the exact scientific reason why TDO inhibitors and IDO inhibitors work for my POIS, but what is sure is that they do help. However, the kynurenine pathways implication has been scientifically proven in other illnesses, like depression, Huntington disease, and in some auto-immune diseases, so this is not folklore )
Serotonin is good for calm, well-being, socialization, and it also helps raise blood pressure. So 5-HTP, a direct serotonin precursor, is good for me, in a low dose.
Antioxidants are useful in blocking the formation of pro-inflammatory cytokines( like IL-6, TNF-alpha, etc...) , from the hypersensitivity/allergy reactions I think are part of POIS pathophysiology ( see
http://poiscenter.com/forums/index.php?topic=1988.msg15559#msg15559 for more details about this) . So, my hypothesis is using a combination of various antioxidants blocks many different paths of production of those cytokines and reduces the "cytokine storm" of the hypersensitivity reactions following release. Antioxidants all have some anti-inflammatory properties. By blocking different parts of the auto-immune reaction, and blocking different inflammatory cytokines, they have specific effects. Some are known, like the known positive effects of lycopene on prostate inflammation, or the known anti-allergic properties of quercetin and bromelain. In my own experience, anti-oxidants have a positive effect on my energy level, and on my overall health.
My POIS severity is not always the same, and I do not know why. Sometimes, when POIS is harsher, my pre-pack is not enough to get 100% prevention and relief ( that is why I say that I have from 80% to 100% relief with my method). If there are some POIS symptoms even if I have taken my pre-pack , I will take some other supplements every 3 to 4 hours as needed. I monitor my blood pressure, and I also have ways to estimate my level of fatigue and level of anxiety and irritability, so I can very accurately determine how relieved I am.
For low blood pressure: Currently, I have no more low blood pressure problems if I take my pre-pack correctly. However, If I notice after release that my BP is becoming borderline low ( which is for me, something like 107/68), I take some rosemary or some green tea extract, or sometimes another 25mg of 5-HTP with some green tea extract. Also, as needed throughout the day, I take water with salt added to it ( salt causes fluid retention, which makes blood pressure raise - that's why salt must be avoided by those who have hypertension). Salted water is cheap and very effective to raise blood pressure. For tolerance, you have to see what one's is able to take. I can take 1/4 teaspoon in a glass of water with no problem. It takes about 20 to 30 mins to show results on the blood monitor. Once my diastolic ( the second, smaller figure) raises at 70 or higher, I feel ok.
Having no more hypotension and extreme fatigue is in itself a great, great success for me in POIS control, and can be accounted as a 50% relief at least. Hypotension has been causing me a loooooot of fatigue, lightheadedness, intolerance to exercise, cold sweat, depressive feelings, a sense of powerlessness, trouble going through my day at work, and so on.
For residual fatigue : even if I have no hypotension ( low blood pressure), I can sometimes feel a certain level of fatigue, even if I have taken my pre-pack. I then take one or two of the following, at a moderate dose, which are essentially antioxidants and or IDO or TDO inhibitors: ginkgo biloba, vitamin C, grape seed extract, milk thistle, Vitalux\AREDS blend of antioxidants (cheap and easily found in pharmacies as they are used as eye vitamins, against age-related macular degeneration - ARMD ), lycopene, green tea extract, Moducare, peppered turmeric, or other good antioxidants blend, like SuperVision, from Webber Naturals.
For residual anxiety, irritability, and other emotional symptoms: I will add some omega-3, some flaxseed oil, some l-theanine, some other magnesium, or other NMDAR antagonists, like taurine and zinc. If it is near bedtime, I can use Relora or Passionflower, but not during the day, they cause me too much drowsiness.
My POIS used to last 2 to 3 days. Now, with my current method of prevention and control, I sometimes have no POIS at all. Sometimes I have to take some supplements 1 or 2 hours after release. and sometimes I may have to take a few supplements again up to 8 to 12 hours after release, when the effect of my pre-pack seems to fade away a bit, But rarely now do I need to take some supplements the day after.
I know that what works for me won't necessarily work for another one. But I hope the success I have with these supplements and this overall method will help inspire and motivate others to build a similar overall approach for themselves. Take note that it took me quite some time, I didn't get to 80% -100% success quickly. Some of the elements of my pre-pack are known beneficial to me for over 10 to 15 years, like magnesium, green tea extract, and rosemary essential oil. Some others are more recent, and some came only since I have found this forum. The idea is that I have found some core components that I know for sure are beneficial for me, then I have kept them at the same low to moderate dosage, and slowly have added other supplements one by one, not changing everything each time, or I will have never succeeded in knowing what works or not for me. I have a file of every pre-pack versions I have used in the last year, what time before release I have taken it, and what results I got ( Blood pressure monitoring, symptoms after 1 hour, after 2 hours, after 4 hours, and so on) so it has helped me keep a rational and scientific approach in developing my pre-pack.
Considering the nature of this post, I have to add this disclaimer: you are 100% responsible for what you do with anything I post on this forum and of any consequence it could have for you. Forum rule: ""Do not use POISCenter as a substitute for, or to give, medical advice" Read the remaining part at
http://poiscenter.com/forums/index.php?topic=1.msg10259#msg10259Thank you
Quantum
