Is the patient from the Pierce et al. (2020) study on this forum to comment?

[BluesBrother]

The following article describes the case of a 28-year old man who has been tried on alpha-blockers:

Hudson Pierce, Jonathan Fainberg, Christopher Gaffney, Ahmad Aboukhashaba, Aleem Khan & James Kashanian (2020) Postorgasmic illness syndrome: potential new treatment options for a rare disorder, Scandinavian Journal of Urology, 54:1, 86-88, DOI: 10.1080/21681805.2019.1704861

https://www.tandfonline.com/doi/full/10.1080/21681805.2019.1704861

Here is the main statement from the study:

"[...] he was started on a trial of terazosin, followed by several months of alfuzosin. He reported significant improvement of all symptoms on both alpha-blockers. Following ejaculation, bowel movements normalized within two days, with no cramping and only one loose stool. He denied needing prolonged sleep and reported elimination of muscle soreness. His eye dryness and redness improved significantly. The only symptom he reported unaffected by alpha-blockers was his dry mouth and halitosis. Despite these beneficial effects, he decided to discontinue alpha-blockers due to dizziness and significant erectile dysfunction which he attributed to the medications."

Unfortunately, the study does not describe how exactly (doses, timing) the drugs were taken. Is the patient from this study maybe on the forum and can comment?

Based on the study, I have been prescribed Alfuzosin and have been given directions to take it an hour before ejaculation. For me, this has not helped improve my symptoms. The effects I noticed were some tiredness and I felt my heartbeat more (not beating faster, just more noticeable). If anything, the POIS symptoms on the next day were slightly worse than without the drug.

I understand that in the study, the patient took the Alfuzosin daily over a prologued period and not just before ejaculation. It would be great if we could learn more about the details.

[demografx]

Thanks, BB. Sent to POIS Research Team

[Muon]

You could try to get in touch with the author for correspondence (envelope symbol).

So what's up with his low total T and free T? Has anyone checked literature for a potential relationship between sex hormones and IBS?

[nanna1]

  Alfuzosin peaks at 8 hours. For any of the drugs/supplements that I used to try, I would wait for the peak concentration in the blood before having the orgasm. This is how I would target the trigger.

Source: https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/021287s011lbl.pdf
or
https://www.sciencedirect.com/science/article/pii/S009042950101322X
To find this information, do an image search on the internet/Google for "(drug name) pharmacokinetics".

  Since the elimination-time is very long (> 24 hours), taking that drug daily will lead to higher peaks and more potency each day. The blood concentration of Alfuzosin does not go down to zero at 24 hours. So daily use will likely lead to overdose.

[BluesBrother]

Thanks a lot nanna1 for looking up the blood concentration over time for Alfuzosin. I will try to time the drug intake accordingly. Thanks also for the general advice of doing an image search for pharmacokinetics for a respective drug.

Muon, thanks also for your suggestion to contact the author of the study. I might also do that.

[Muon]

Muon, thanks also for your suggestion to contact the author of the study. I might also do that.

Send me a PM if you manage to get info from the author. I will attach a note to the paper in the article thread once info given.