Hi, I wanted to share my success story regarding POIS.
Profile:I'm a 24-year-old male. I had POIS since the beginning of my teenage years. The symptoms are crippling social anxiety, loss of verbal fluidity (can't find words), impaired thinking (my thoughts fall like a pile of magazines), depression, lack of motivation, no vibrancy (music and colors feel dull). Symptoms usually begin 30 minutes after ejaculation and last around 7 days. I went through undergrad abstaining because otherwise, I had trouble following lectures (I graduated in physics). Other relevant information: I took Accutane as a teenager because of severe acne (it did nothing to help), lots of doxycycline and tetracycline. I have other autoimmune diseases such as allergies, psoriasis, and mysterious facial flushing after eating. Symptoms are less bad if I block semen by pressing on the perineum with my fingers, causing retrograde ejaculation (I know it?s not good).
Now:I am free from POIS. I can read technical content, laugh, go to the gym, and socialize without problems. Although, usually you will still feel a slight downshift in mood after orgasm and ejaculation, mostly because of the rise in prolactin and fall in dopamine. I also think there are some benefits to semen retention independent of POIS. I will always feel more energetic on long streaks of abstinence which I guess could make sense for evolutionary reasons.
Method:I don't have a specific protocol on what to take before and after orgasm. My main goals were to raise testosterone as much as possible, support methylation, reduce excitotoxicity, increase mitochondrial energy, improve cognitive functions, and be really healthy. I did that through a bunch of supplements (yeah, like a lot), diet, and lifestyle. It's hard to know for sure what moved the needle the most, but I don't feel like experimenting; I feel great right now. Nothing here is medical advice.
Supplements:Dopamine Support:
I take these on a regular basis, and tolerance has not been an issue. Still, take a break sometimes.
-Bromantane 50mg (The heaviest hitter in the list. It works by epigenetically upregulating the tyrosine hydroxylase enzyme -- the enzyme that converts tyrosine to L-dopa. Greatly improves motivation and physical endurance. A milligram scale is necessary because powder density is not always the same) From
https://www.limitlesslifenootropics.com/product/bromantane-powder-10g/-N-acetyl-L-Tyrosine 1.5g (Bromantane works best with an L-tyrosine supplement. This is an L-Tyrosine supplement with an acetyl group added for bioavailability. From
https://nootropicsdepot.com/)
-B6 50mg (A known cofactor in the synthesis of dopamine. Also inhibits prolactin.)
-Caffeine 400mg (The blockade of adenosine receptors has a known cascade effect on dopamine and is generally helpful for wakefulness.)
Testosterone:
Research does not support the fact that masturbation reduces testosterone. Yet, after masturbation, I used to feel "low T" or "Beta" for lack of better terms. I don't feel like this anymore. In case masturbation really affects testosterone in some ways, I took these supplements to cover as many angles as possible. All of the supplements come from
https://nootropicsdepot.com/ (except the fadogia from
https://barlowesherbalelixirs.com/fadogia-agrestis-extract). I take them in the morning.
-Tongkat Ali 100mg (Perhaps the most popular testosterone-boosting herb. Tongkat increases both free and total testosterone by blocking estrogen receptors in the hypothalamus, which in turn causes an increase in LH secretion.)
-Cistanche 200mg (Contains echinacoside, which increases testosterone and DHT by enhancing LH secretion and upregulating androgen synthesis in the testes via steroidogenic enzyme induction.)
-Shilajit 300mg (Its strong antioxidant effect and rich mineral content contribute to testosterone and fertility enhancement.)
-Fadogia agrestis 600mg (Contains saponins that increase LH, which in turn increases testosterone production in Leydig cells. Warning: Might be toxic.)
-Tribulus terrestris 500mg (Thanks to its protodioscin and β-carboline content, it boosts dihydrotestosterone (DHT) and upregulates androgen receptors. Androgen receptor sensitivity is important. A rat study found that sexual satiety might downregulate androgen receptors in regions of the brain)
--Microzinc 20mg
I'm aware it's a lot, and perhaps not all necessary, but it has worked really well for me. If this approach hadn't worked, I might have considered going directly to testosterone cypionate and HCG. I don't have bloodwork to prove that it had an impact on testosterone levels. I mostly rely on subjective feelings. Efforts feel good; I am motivated and do not shy away from confrontation. Also, I have regular morning erections and a high libido.
Excitotoxicity
NMDA antagonists are known to protect from excitotoxicity by preventing excess calcium inside the cells. For a while, I used dextromethorphan (DXM) but did not like it. Here's what I use now:
-Agmatine sulfate 5g (Agmatine sulfate is a weak NMDA antagonist and also has a powerful antidepressant effect.)
-Magnesium hydrochloride (Also a weak NMDA antagonist with a host of other benefits.)
Mitochondrial Energy
-Coenzyme Q10 200mg (CoQ10 is essential for mitochondrial function, especially in the cardiovascular system. It functions as an electron carrier, thus enhancing ATP energy production. Although ubiquinol might be better, it is a great combo with shilajit. Shilajit contains mitochondrial stimulants called dibenzo-alpha-pyrones (DBPs). These molecules work in tandem with CoQ10 to enhance ATP energy output.)
-Creatine 5g (Creatine works primarily by increasing the key energy molecule: ATP.)
-Red/Infrared/Sunlight
Methylation Support
Supporting methylation is an idea from this post
https://poiscenter.com/forums/index.php?topic=2502.msg21497#msg21497. I don't really follow his supplement stack, but it might be useful for those suspecting a methylation issue. To support methylation, I take occasional SAM-e, B6, B12, and creatine.
My facial flushing disappeared after healing my gut with glutamine and sodium butyrate. I also stopped processed foods. I can still eat some gluten and dairy.
DietI think having a varied diet is important. Protein sources with different amino acid profiles, fruits and vegetables with different nutrients, etc. I also believe that the average diet is overly varied on the margin. It becomes difficult to identify problematic foods without some regularity in eating patterns. Personally, fat is an important player. I eat a lot of saturated fat and very little seed oil. I do 16/8 intermittent fasting. Beware, it can become easy to become nutrient deficient if you do intermittent fasting for a long period of time. I am aiming for 3000 kcal per day.
Protein
-Beef
-Chicken
-Salmon
-Eggs (I do not tolerate more than one or two per day.)
-Occasional whey protein
Fats
-Coconut oil
-Olive oil
-Grass-fed butter
Carbs
-Frozen fruits (They have less need for preservatives since the cold is the preserving agent. Mostly strawberries, blueberries, and mangoes.)
-Some vegetables (Carrots and broccoli)
-White rice
I try to have most of my calories come from proteins and fats.
ExerciseThere is some good correlation between energy, grip strength, and cardiovascular health, so be sure to exercise.
-Weight lifting x5 per week
-5k running x3 per week
Look at other health markers such as morning erections, time and type of bowel movements, skin tone, breath, tongue lining, skin dryness, type and rate of thought, muscle aches and pains, headaches, heart rate, HRV, muscle fullness, dizziness when standing, grip strength, waist size, empathy, laughter, time of arousal from sleep, capillary refill, nail health, floaters, visual quality, time needed to get into the zone, time needed to get to sleep, the number of pull-ups in a row, sprint speed, single-leg balance...
We can call this a "holistic approach" but it doesn't mean that there isn't a single root cause for POIS, whether it is autoimmune, lack of testosterone, or something else (it might be different for each case). But we don't really know the root cause in many cases, so my goal was to cover as many angles as possible while improving my quality of life. So yes, it is possible to engage in sexual activity regularly while feeling as good as you do after many weeks of abstinence. Dealing with this illness is challenging, and I sincerely hope the medical community will find a treatment soon. Thank you for reading this, and I wish you luck on your personal journey.
