Sexless Marriage

[peiguy]

I have had POIS symptoms [imagine the flu] pretty much ever since I can remember.  They are triggered by ejaculation. 

Saw a doctor about it when I was 15 after suffering for a couple years.  His recommendation was abstinence.  So I abstained from masturbation - he had prescribed some medication to make it easier - and I'd have a wet dream about once or twice a month.  No problem with wet dreams - I'd awake, fall back to sleep, in the morning feel fine.

In my dating life I was the guy who all the moms and dads wanted to date their daughter as I was a good boy and didn't do anything naughty.  Sure, I wanted to, but I didn't want to throw up after climaxing.

Things got serious when I met my wife.  She made it clear that she was not into sex and that I should probably look elsewhere.  I explained that I experienced great discomfort with climax and thus preferred to avoid it.  A year later when I proposed we agreed that it would be a sexless marriage - we would make an exception for procreation.

We married and a few years later decided to have kids.  By then my wife knew the details of what my great discomfort was.  She suggested that I try Gravol when we had procreative sex.  I did and it muted the nausea a lot.  Still felt fatigued and brain fogged, but it was at bedtime so could sleep it - and the Gravol - off.

After that, my wife suggested that I masturbate once a week at night before bed after taking Gravol.  We had a little bedroom in the basement and I would spend that night there.  She would administer the Gravol and I'd self pleasure, then fall asleep.

For those who suffer from POIS and find abstinence the best way to deal with it, my story is to remind you that it is possible to find a spouse who will want a sexless marriage.

Currently I'm on Rapaflo.  I can now self pleasure to a dry orgasm.  No POIS effects with a dry orgasm for me.

[Prospero]

Do you always experience a dry orgasm under Rapaflo/Silodosin? If not, do you have POIS when you ejaculate?

[peiguy]

8 mg Rapaflo prevents ejaculation for 3 days.  Due to other side effects, I take 4 mg Rapaflo daily.  As such, my orgasm is always dry unless I go off the Rapaflo for a few days.

If I don't take my Rapaflo, I can ejaculate and I have POIS symptoms [mine are nausea, sometimes to the point of vomiting, headache, fatigue, brain fog, flu symptoms]. 

If I don't take Rapaflo and want to self-pleasure to orgasm and ejaculation, I can avoid the nausea by taking Gravol first.  Due to the sedating qualities of Gravol and the "high" I only do this before bedtime.  I go to my little room and my wife administers the Gravol to me.

[Quantum]

8 mg Rapaflo prevents ejaculation for 3 days.  Due to other side effects, I take 4 mg Rapaflo daily.  As such, my orgasm is always dry unless I go off the Rapaflo for a few days.

If I don't take my Rapaflo, I can ejaculate and I have POIS symptoms [mine are nausea, sometimes to the point of vomiting, headache, fatigue, brain fog, flu symptoms]. 

If I don't take Rapaflo and want to self-pleasure to orgasm and ejaculation, I can avoid the nausea by taking Gravol first.  Due to the sedating qualities of Gravol and the "high" I only do this before bedtime.  I go to my little room and my wife administers the Gravol to me.

Hi Peiguy, and welcome to the forum.

What you describe as dry ejaculation is a known side effect of silodosin, called retrograde ejaculation.  The semen ends up in the bladder.   This side effect occurs with around 3% of men taking silodosin ( https://www.healthgrades.com/drugs/silodosin/side-effects ).  Great that it happens that you have this side effect and that it allows you to avoid your POIS.

However, other members must know that they may not have this particular side effect, and may ejaculate as usual even if they take silodosin/Rapaflo, or another drug of this same class ( Alpha-1 blockers).

Thanks for sharing your method, Peiguy !

[certainlypois2]

What did your doctor prescribe to help you abstain from masturbation. 

[Prospero]

What you describe as dry ejaculation is a known side effect of silodosin, called retrograde ejaculation.  The semen ends up in the bladder.   This side effect occurs with around 3% of men taking silodosin ( https://www.healthgrades.com/drugs/silodosin/side-effects ).  Great that it happens that you have this side effect and that it allows you to avoid your POIS.

However, other members must know that they may not have this particular side effect, and may ejaculate as usual even if they take silodosin/Rapaflo, or another drug of this same class ( Alpha-1 blockers).

Thanks for sharing your method, Peiguy !

Anejaculation in 3% of men taking it, maybe, but 57% of the participants in this POIS study: Clinical experience with post-orgasmic illness syndrome (POIS) patients-characteristics and possible treatment modality (see : https://poiscenter.com/forums/index.php?topic=3326.0).

[Quantum]

What you describe as dry ejaculation is a known side effect of silodosin, called retrograde ejaculation.  The semen ends up in the bladder.   This side effect occurs with around 3% of men taking silodosin ( https://www.healthgrades.com/drugs/silodosin/side-effects ).  Great that it happens that you have this side effect and that it allows you to avoid your POIS.

However, other members must know that they may not have this particular side effect, and may ejaculate as usual even if they take silodosin/Rapaflo, or another drug of this same class ( Alpha-1 blockers).

Thanks for sharing your method, Peiguy !

Anejaculation in 3% of men taking it, maybe, but 57% of the participants in this POIS study: Clinical experience with post-orgasmic illness syndrome (POIS) patients-characteristics and possible treatment modality (see : https://poiscenter.com/forums/index.php?topic=3326.0).

Interesting, Prospero.  I have 2 hypotheses about this large discrepancy.  Either anejaculation is easier to trigger in POIS sufferers, or maybe the "official" monography of Rapaflo is trying to minimize the existence of this side effect.

I have found a reference in the article you site that tend to show that the second hypthesis may be the right one.  See at https://www.jsm.jsexmed.org/article/S1743-6095(15)32160-3/fulltext .  In this study, 100% of the 15 subjects had anejaculation !

But most interesting, this latter study, done on a voluntary basis by 15 male urologists, states that silodosin does NOT cause retrograde ejaculation, because they say they did not find any semen in their urine, afterward.  So they conclude that the mechanism of action of silodosin is "a loss of seminal emission".

Unfortunately, in the first POIS study you refer to, the author does not say if all men had anejaculation but only 57% had relief of their POIS symptoms, or, if 57% had anejaculation, and all of those who had it were relieved.  It would be interesting to ask the authors!

[Prospero]

Many thanks for your very relevant comments, Quantum. It would be good to know this information, indeed.

Mushnikk, on the Poiscenter topic quoted earlier, does not seem to have experienced anejaculation with Silodosin, only "reduced semen volume", with "a remission of symptoms (fatigue, brain fog)".
As for me, I believe that I can testify that I didn't have the usual Pois (especially the overwhelming fatigue) after a deliberately aborted orgasm (without medication), though I don't know if it was a case of anejaculation or retrograde ejaculation. It may have occurred more than once, when I didn't know "POIS" yet, so I don't remember.

[Progecitor]

Some info I have found that may be of some interest:
Among the oldest attempts are the a1 adrenoceptor antagonists that have been used to treat benign prostate hyperplasia for decades and are known to cause ejaculatory disorders as an extremely frequent side effect. The retrograde ejaculation that alpha antagonists, including the most recent ones such as silodosin cause in a significant fraction of patients, explains only a part of the azoospermia that seems to be mostly attributable to a loss of seminal emission. A prospective double-blind randomized placebo-controlled crossover study conducted in India by another group tested 8 mg silodosin as an on-demand male contraceptive, reporting reversible azoospermia, no unintended pregnancies, and no dropouts due to drug-related adverse events. In the present application the French inventors claim that continuous daily administration is also a safe and effective option if an extended release formulation with a 12 mg dose is used that causes no substantial orthostatic hypotension.
https://www.liebertpub.com/doi/pdfplus/10.1089/adt.2019.969

I haven't tried silodosin, but one of the last psychiatric medication I took was clomipramine [Anafranil Sr 75 mg retard pills]. Clomipramine is also an a1 adrenoceptor antagonist, so it may be somewhat similar in action. As I wrote earlier clomipramine made it really difficult to achieve an O, but when it happened I still had a full extent POIS episode. This happened 7 years ago, so I can't go into details, but it was also the reason why I abandoned this treatment. If I remember well it also caused orthostatic hypotension.
https://en.wikipedia.org/wiki/Silodosin
https://en.wikipedia.org/wiki/Clomipramine

[Quantum]

Very interesting, Progecitor

[demografx]

What you describe as dry ejaculation is a known side effect of silodosin, called retrograde ejaculation.  The semen ends up in the bladder.   This side effect occurs with around 3% of men taking silodosin ( https://www.healthgrades.com/drugs/silodosin/side-effects ).  Great that it happens that you have this side effect and that
it allows you to avoid your POIS.

bold emphasis mine -Demo

I’ve been discussing this with a POISer friend and I’m starting to wonder if dry ejaculation might be a “cure” for POIS!

My thinking includes the anajeculatory side effect of some drugs, as described above… as well as the radical surgical procedures by Forum Member Animus. In the latter case, Animus attributes his POIS-free state to dry ejaculation.

I realize, of course, that this conclusion would require extensive research, which is not yet on the drawing board!

[peiguy]

In follow up - my family doctor had referred me to an urologist a few months ago.  The urologist told me that Rapaflo commonly causes anejaculation, not retrograde ejaculation.  He said it is very rare for a man to ejaculate when taking Rapaflo unless they have been off it at least 3 days 8 mg does or 2 days 4 mg dose.

I talked to him about POIS - he feels that it may be triggered by hormonal factors and to avoid ejaculation as much as possible.  He wants me to stop the Gravol idea and simply avoid masturbation.

I followed through with his advice but had issues, so I talked to my family doctor - she put me on Paxil on a PRN basis - essentially, if I feel like I must masturbate, take a Paxil.  This has been working quite well.

[Quantum]

In follow up - my family doctor had referred me to an urologist a few months ago.  The urologist told me that Rapaflo commonly causes anejaculation, not retrograde ejaculation.  He said it is very rare for a man to ejaculate when taking Rapaflo unless they have been off it at least 3 days 8 mg does or 2 days 4 mg dose.

I talked to him about POIS - he feels that it may be triggered by hormonal factors and to avoid ejaculation as much as possible.  He wants me to stop the Gravol idea and simply avoid masturbation.

I followed through with his advice but had issues, so I talked to my family doctor - she put me on Paxil on a PRN basis - essentially, if I feel like I must masturbate, take a Paxil.  This has been working quite well.

Do you still take Rapaflo, or only Paxil on a PRN basis, now ?

[peiguy]

I am back on Rapaflo now and taking Finasteride too.  My doc has taken me off the Paxil.

The Finasteride has done a really nice job of reducing my libido, so its quite easy to refrain from masturbation.  And, the Rapaflo prevents ejaculation.

My family doctor did caution me about Finasteride - she said I should cease taking it if I noticed any depression.  To date, that has not been a problem - indeed I am more cheerful and more interested in non-sexual things in my life.

My family doc also told me that usually there are no mental issues with Finasteride with older guys, especially if they are celibate and content that way.  She says for younger, or sexually active guys it can be problematic.

Rapaflo by itself has no such issues.  It simply makes the muscles down there to relaxed to allow an ejaculation to happen.  It also tends to mute the orgasm, making it similar to a ruined orgasm - e.g. things feel great building up and up to ... sudden loss of desire.  Its weird.