My background and latest finding (POIS symptoms completely gone at this point!)

[eccentricbipois]

Posted this on r/POIS as well: https://www.reddit.com/r/POIS/comments/gw5rxt/story_treatment_my_background_and_latest_finding/

Hey everyone,

So just in the past week I've discovered something life-changing, something that I can undoubtedly say has eliminated the POIS symptoms to a point in which I forgot I had an orgasm on the previous day. I'm making this post in hopes that it can help others out there manage this truly awful illness.

First, a bit of background on myself -- I'm 35 years old, currently living in Texas. I've had POIS as long as I could remember, presumably since puberty. Whenever I orgasm'd, I'd get the classic symptoms POIS sufferers experience; Cognitive dysfunction, brain fog, fatigue, sensory and motor problems, intense discomfort and irritability, gastrointestinal issues, craving for relief etc. The symptoms would last 3-7 days.

This may sound bizarre but I thought what I was experiencing after orgasm was typical for most guys, just accepted it as part of life, something that just you just experience after orgasm... I was already apprehensive about talking about sexual function with other guy friends, and it kinda felt weird to bring something like this up to my doctor, and I hadn't for the longest time... I had so many distractions in life, focused on school and my career in my 20s, just kinda accepted it and was somehow able to manage it at the time by abstaining as much as I could.

This all changed when I had my first sexual partner at 26 years old, finally someone I could comfortably talk to about my experiences. When I explained to her what happens after orgasm, she assured me that what I'm experiencing is not normal. Upon an easy search, I found the Wikipedia page for Postorgasmic Illness Syndrome, and it described it perfectly. I realized then I had a rare illness that most people hadn't even heard of, but there are others that suffer in a similar fashion in their own unique ways. At this point whenever I'd suffer from this I'd go on the POIS forums, looking for answers, figure out what helps provide relief from the pain when the symptoms are at their worst. I'm 9 years in and still figuring it out.

I did finally see my primary care physician about this. He recommended seeing an allergy specialist, urologist, neurologist, and psychiatrist. The allergy specialist suggested Ibuprofen. The urologist and neurologist both gave me the same answer: "We have no idea." I've seen a few psychiatrists since then, they would prescribe me SSRIs and stimulant medications which have been helpful to be sure, but not enough to truly manage this and their primary purposes were to address other matters that I have.

• There were things I've tried and didn't really help me: Niacin, L-Tyrosine, Zinc, Acupuncture
• There were things I've tried and thought they helped a little but wasn't really sure: Vitamin B & D supplements, Turmeric Curcumin, OTC antihistamines Fexofenadine, Diphenhydramine, Loratadine
• Then there were things that helped to some degree: NSAIDs (Ibuprofen), Ginger supplements, Kombucha and foods heavy in pre/probiotics, Breathing Exercises, Full-Body Massages, Cold Showers, Cranial Electrotherapy Stimulation devices, Cardiovascular Exercise
• Then there were things that helped to a substantial degree: CBD/CBG tinctures and vapor, SSRI and stimulant medications (these were used to address anxiety and ADHD-related issues I also have but I have noticed they help manage POIS as well)

The only thing that was truly effective at improving the symptoms was sleeping it off, if I was able to... lots of tossing and turning in bed while I was in agony, suffering...

I lost my job in January due to performance related matters that I realize in retrospect were from supplements I was trying to help manage POIS, as well as transitioning to new medications and trying new dosages. At this point I took it upon myself to take a brief break from my career and try to address this problem head-on and accelerate my findings. On the POIS forums I found a list of doctors that were at least aware of this condition, the closest one to me being Dr. Hellstrom at Tulane University Medical School Dept of Urology. He suggested I try Fexofenadine and Adderall, to see which of these medications was at least providing some relief. The Adderall I'm still taking today since I find the stimulant medications help with the brain fog, among other issues I've had. The Fexofenadine was maybe mildly helpful at best, no real noticeable improvement.

Fast forward to the past month. I got frustrated with the psychiatrist I was seeing at the time, wasn't making much headway in figuring this out with them, so I decided to see a new psychatrist. I'm so glad I made this change. This new psychiatrist was sincerely fascinated and curious about this condition. Of course like most others he wasn't sure what was going on but he prescribed me two medications; First was Bupropion, something that he thought would possibly help if it was indeed a brain chemistry issue. The second medication is what has helped manage the symptoms completely at this point, to that I thank him so much for. He prescribed me the antihistamine Hydroxyzine Pamoate. Even he was skeptical that this would work, but just threw it out there for me to try.

So I took the hydroxyzine, had an orgasm, went to sleep. The following day would normally be filled with irritability and agony under typical circumstances but instead I got a pretty feel-normal kind of day, to a point in which I had to double check my log to see if I did in fact have an orgasm the day before. Turns out I did. Absolutely incredible. Wow. I realized then, after 20+ years, I found something that finally truly helped provide relief from this suffering and have a better quality of life all around. Super thankful to have made this discovery, just wish I could've discovered this sooner. Better late than never, I suppose...

I'm not sure if hydroxyzine will help you but it certainly has helped me even when other antihistamines haven't really helped. Hoping this story helps someone out there who's in a similar experience w/ POIS as I am. I was on the verge of unironically entertaining the idea of castrating myself until I made this discovery. Stay strong, brothers! Keep searching until you find something that truly helps you. I'm hoping you find it soon.

I'm going to visit an allergy clinic next week to get their take on it as well. For now I'm taking it as needed, within 1 hour before having an orgasm ideally.

TL;DR Had POIS since puberty, tried many things, Hydroxyzine and Loratadine by far has helped eliminate POIS for me.

[drop247]

What dosage do you take?

[hapl]

How many times have you tried it, and any concerns about long term effects? I've had a few friends who find hydroxyzine is the ONLY antihistamine that works for them, but I've personally never tried it.

[eccentricbipois]

What dosage do you take?

Was prescribed 25 mg capsules

[drop247]

And you take just one I assume? How long before O do you take it?

[quikot]

Do you take one capsule everyday? Any side effects?

[Moses]

Hi Accentricbipois, I?m so happy you found something that works for you. About a year ago I decided to try stimulant meds to help my general slow brain processing. I started with vyvanse and it helped me a lot. And I also noticed that it cut my orgasms short (4 second orgasm instead of my normal 7 seconds), leaving me with a little bit of a burning sensation in my penis. But it also shortened my pois symptoms by one day. (1-2 days of pois instead of 2-3 days)
But 3 months ago I lost insurance for vyvanse so I switched to Adderall. My orgasms were now like 15 seconds and I started to have pois for 4-7 days. I?m happy Adderall didn?t have this bad effect for you. Anyway now I take gooseberries before orgasm and It prevents pois almost 100%.

[certainlypois2]

I believe someone else post about hydorxyzine on reddit. They claimed it is the strongest antihistamine.

[Muon]

Another POISER saved by medication for Mast Cell Activation Disease:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003574/table/T9/

More options here (it's trial and error):
https://poiscenter.com/forums/index.php?topic=3236.msg33462#msg33462

[hurray]

Posted this on r/POIS as well: https://www.reddit.com/r/POIS/comments/gw5rxt/story_treatment_my_background_and_latest_finding/

Hey everyone,

So just in the past week I've discovered something life-changing

So how many times have you successfully taken it? I'm assuming once or twice if you discovered it in the past week?

[eccentricbipois]

And you take just one I assume? How long before O do you take it?

Yeah, I find 30 min before orgasm is sufficient, the medication is supposed to kick in 30-60 min after taking it.

Do you take one capsule everyday? Any side effects?

I was taking it daily since that's what my psychiatrist recommended, however I find that to be overkill so I'm just taking it as needed. Side effects I experience with it are drowsiness from the sedation effects (pretty standard for 1st gen antihistamines) and dry mouth. Ideally I plan to have the orgasm at night before bedtime and just take the capsule before then.

Hi Accentricbipois, I?m so happy you found something that works for you. About a year ago I decided to try stimulant meds to help my general slow brain processing. I started with vyvanse and it helped me a lot. And I also noticed that it cut my orgasms short (4 second orgasm instead of my normal 7 seconds), leaving me with a little bit of a burning sensation in my penis. But it also shortened my pois symptoms by one day. (1-2 days of pois instead of 2-3 days)
But 3 months ago I lost insurance for vyvanse so I switched to Adderall. My orgasms were now like 15 seconds and I started to have pois for 4-7 days. I?m happy Adderall didn?t have this bad effect for you. Anyway now I take gooseberries before orgasm and It prevents pois almost 100%.

Thanks! Glad the gooseberries help! I heaven't heard of that particular regimen. Yeah the Adderall seems to work pretty well to counter the side effects I get from the SSRIs and just improve daytime wakefulness and sleep quality. I am curious to try vyvanse but I'm not on insurance as well, so cost will be a factor of course.

I believe someone else post about hydorxyzine on reddit. They claimed it is the strongest antihistamine.

Yeah my psychiatrist said it's like "Super Benadryl" But unlike Benadryl or the other OTC antihistamines, hydroxyzine actually works for me. I honestly haven't heard of it until the psychiatrist brought it up.

So how many times have you successfully taken it? I'm assuming once or twice if you discovered it in the past week?

Right it's pretty new for me but I've done it 3 times so far and all 3 times I've had success by taking it 30-60 min before having an orgasm before sleep. I do wake up a bit groggy in the morning from the sedation but that wares off pretty quickly and I feel completely fine by late morning. Will follow up with this thread in a few months time to see how it continues to pan out then.

[Nas]

Hey eccentricbipois,
I tried Hydroxizine 25mg an hour before orgasm, didn't help at all, but it surely knocked me out to sleep right after.
My question is, do you take Hydroxizine only before sleep? and do your symptoms disappear instantly or only after you wake up the next day?   

[Quantum]

Hi eccentricbipois,
I have added you as reference members in the POIS Types Chart, at https://poiscenter.com/forums/index.php?topic=2338.msg19448#msg19448 .  You are listed in the type # 8, "POIS Type responding to antihistamines".
I have specified that you use 25mg of hydroxyzine, 30 mins to 1 hour before orgasm, at bedtime.

[hurray]

I tried Atarax (Hydroxyzine) about 10 years ago, but I didn't notice any relief for my POIS symptoms. As Nas says, it works well if you want to get to sleep.

[eccentricbipois]

Hey eccentricbipois,
I tried Hydroxizine 25mg an hour before orgasm, didn't help at all, but it surely knocked me out to sleep right after.
My question is, do you take Hydroxizine only before sleep? and do your symptoms disappear instantly or only after you wake up the next day?

Bummer, sorry it didn't help ya 
I take hydroxyzine before I orgasm, regardless of time of day, but I try to only have orgasm in the evening/nighttime so I don't end up throwing off my sleep schedule.
It's hard to say whether symptoms disappear instantly since I usually fall asleep after orgasm either way. What's noticeably different is that I don't feel like I'm in pain/agony throughout the day the following day.

[eccentricbipois]

Hi eccentricbipois,
I have added you as reference members in the POIS Types Chart, at https://poiscenter.com/forums/index.php?topic=2338.msg19448#msg19448 .  You are listed in the type # 8, "POIS Type responding to antihistamines".
I have specified that you use 25mg of hydroxyzine, 30 mins to 1 hour before orgasm, at bedtime.

Thanks! There may be some changes and additions as I'm still very new to taking hydroxyzine (have only done this for about 2 months or so but have multiple successes). As I'm learning now, 25mg used to be enough for the first few times but unfortunately it feels like it's not quite enough to take care of the symptoms entirely anymore . I've tried taking 50mg hydroxyzine pamoate and while it does remove the symptoms completely again, my new problem is fighting off the sedation and drowsiness that lingers all day on that dosage, on top of the 12+ hours of sleep needed! (I don't get that nearly as much with 25mg).

After talking to an allergy specialist they suggested trying Cetirizine HCl since it has a similar pharmacology to hydroxyzine (didn't confirm the accuracy of this). Upon experience with cetirizine while it does help alleviate the POIS symptoms as well it introduces some side effects that make things worse for me (mostly all-day headaches, shortness of breath). They gave me samples of Levocetirizine Dihydrochloride (Xyzal) as well which I will try instead next time.

I'll certainly update if I find a good 2nd generation antihistamine to compliment the hydroxyzine pamoate to completely rid of the POIS symptoms and am open to recommendations. While a lot of progress has been made, there's still just a little more ways to go...

[eccentricbipois]

I tried Atarax (Hydroxyzine) about 10 years ago, but I didn't notice any relief for my POIS symptoms. As Nas says, it works well if you want to get to sleep.

Antrax is Hydroxyzine Hydrochloride which I never tried since I'm taking Hydroxyzine Pamoate (Vistaril), FWIW

[eccentricbipois]

An update: I've been trying different OTC antihistamines and have found loratadine to be the most helpful. I took 10mg loratadine along with 25mg of the hydroxyzine pamoate an hour before orgasm and I'm back to having the symptoms completely gone again. I realize this is preliminary so will follow up in a couple months time to see how this regimen works out long term.

EDIT: I realize the difference this time with loratadine and other antihistamines is that they work better if taken some time before O, rather than after.

[eccentricbipois]

Hey all, it's been a while but I thought I'd give an update since the discovery that hydroxyzine has provided consistent POIS relief for me. Some time after sharing this I actually found that loratadine alone was completely sufficient in preventing POIS and I no longer take the hydroxyzine which besides requiring a prescription in order to obtain also gave me hours of drowsiness as a side effect whereas with loratadine it's available OTC and the side effects are relatively negligible.

At first I tried taking loratadine daily but I found the medication to be problematic for mental clarity when being taken on a everyday basis when used as directed and so I switched back to taking it only as needed, ideally aiming for 15-30 minutes before a planned orgasm, otherwise immediately after if I have an unplanned one (nocturnal emissions).

At first I tried the normal tablets but because of my slow metabolism and the difficult to predict variability on absorption based on variables such as stomach content status I've found much better consistent success with the quick-dissolve/disintegrating tablets taken via sublingual administration (in the US where I live it's the Claritin RediTabs). While the recommended dose is 10mg but I personally found this dosage to be insufficient to address POIS so I increased it to 15mg and that did the trick. I take a 10mg and 5mg disintegrating tablet, placing both under the tongue at the same time.

By sticking to this and trying to keep time between orgasms to be a minimum of 3-4 days I've effectively eliminated my once awful POIS symptoms and have had incredible relief ever since.

Another big thing that I think has greatly helped me manage POIS is sticking to a HFLC/ketogenic diet as much as possible. I was consuming a higher carbohydrate diet at one point and the carb crashes and withdrawals I felt would exacerbate the symptoms.

I hope someone out there has found this helpful. This took many years to figure out and I owe some credit to this community as well as my previous psychiatrist that inadvertently helped me discover that my symptoms could be managed using an antihistamine. I'm sincerely wishing the best for everyone here on their quest to rid of this awful unfortunate illness. Stay strong!

[Quantum]

Hey all, it's been a while but I thought I'd give an update since the discovery that hydroxyzine has provided consistent POIS relief for me. Some time after sharing this I actually found that loratadine alone was completely sufficient in preventing POIS and I no longer take the hydroxyzine which besides requiring a prescription in order to obtain also gave me hours of drowsiness as a side effect whereas with loratadine it's available OTC and the side effects are relatively negligible.

At first I tried taking loratadine daily but I found the medication to be problematic for mental clarity when being taken on a everyday basis when used as directed and so I switched back to taking it only as needed, ideally aiming for 15-30 minutes before a planned orgasm, otherwise immediately after if I have an unplanned one (nocturnal emissions).

At first I tried the normal tablets but because of my slow metabolism and the difficult to predict variability on absorption based on variables such as stomach content status I've found much better consistent success with the quick-dissolve/disintegrating tablets taken via sublingual administration (in the US where I live it's the Claritin RediTabs). While the recommended dose is 10mg but I personally found this dosage to be insufficient to address POIS so I increased it to 15mg and that did the trick. I take a 10mg and 5mg disintegrating tablet, placing both under the tongue at the same time.

By sticking to this and trying to keep time between orgasms to be a minimum of 3-4 days I've effectively eliminated my once awful POIS symptoms and have had incredible relief ever since.

Another big thing that I think has greatly helped me manage POIS is sticking to a HFLC/ketogenic diet as much as possible. I was consuming a higher carbohydrate diet at one point and the carb crashes and withdrawals I felt would exacerbate the symptoms.

I hope someone out there has found this helpful. This took many years to figure out and I owe some credit to this community as well as my previous psychiatrist that inadvertently helped me discover that my symptoms could be managed using an antihistamine. I'm sincerely wishing the best for everyone here on their quest to rid of this awful unfortunate illness. Stay strong!

Thanks for this update!   Nice to have found an antihistamine with fewer side effects that also works as good to get you relief from POIS.