During orgasm there is a sudden rise in norepinephrine (noradrenaline) and epinephrine (adrenaline). This norepinephrine (and epinephrine) can cause vasodilation via the beta2-adrenergic receptor of the arteries in the brain and through out the body. Vasodilation creates a ballooning stress on the arteries that is normal under certain temporary conditions such as orgasm or exercise where increased blood flow is needed in certain areas of the body. However, any arteries that have been injured by latent infection of CMV (or HHV-6) will be triggered by this stretching stress to reactivate the virus (RefSE2) causing an immune response. Norepinephrine levels may fall shortly after orgasm. However, because of the immune response to reactivated CMV, histamine and nitric oxide levels rise causing a secondary vasodilation (stretching) of the arteries.
Could it be that the injured arteries are located in the reproductive tract, and that it is the stretching stress during ejaculation which triggers the immune response?
I am asking this also because of the following observations:
- I feel that my POIS symptoms are positively correlated to the strength of pulsing of the penis during ejaculation. Maybe stronger pulsing corresponds to more stress on the arteries?
- I once had blood in my urine (after an intense run) at a time where I did not yet have POIS (at the age of 12, I think, whereas POIS emerged around the age of 18). Could this blood in the urine be related to a fracture of arteries, predisposing me for developing immune reactions in response to stress on the arteries during ejaculation?
(Maybe my questions are completely off - my understanding of biology is not very developed.)
Hi BluesBrother,
Thank you for your question and sharing your experience with stressed arteries. Your question is both relevant and informative. First I'll give some background before trying to relate the
herpes-vascular-stretching paper to your experience. Sometimes I'm too technical I've been told so please ask questions if something isn't clear or if I have made a mistake.
Cells use the inflammatory pathway (Arachidonic acid/COX-2/PGE
2/JNK) to sense stress.
Herpes also uses this same pathway to reactivate (
Post). I used the term "stress-trigger" as a short-hand to describe anything that upregulates COX-2/PGE
2. I am oversimplifying this a little since there are other prostaglandins (i.e. PGF
2alpha) that can also trigger herpes reactivation. Below is a list of known herpes stress-triggers (upregulate COX-2 and JNK):
So the stretching stress on vascular tissue is one of the known stress-triggers that reactivates CMV and HHV-6. Since not everyone with POIS smokes (nicotine) or is constantly exposed to UV light, vascular stretching seems like a more probable candidate for herpes reactivation leading to POIS. As far as I can tell,
Egordon was the first person on POIScenter to propose that POIS is linked to a known orgasm-induced vascular disease (
post). The second person to suggest POIS is linked to a known rgasm-induced vascular disease was
existentialdrifter (
post). (
I apologize to anyone if I have miscredited these two vascular diseases.) Egordon suggested a
post-coital headache (PCH) mechanism, and Existentialdrifter suggested POIS may be related to
Reversible cerebral vasoconstriction syndrome (RCVS). Both of these diseases are very similar to Post-Orgasmic Illness Syndrome. However, I think that the missing link between PCH/RCVS hypotheses and POIS is how to trigger the immune response. To address your questions/comments specifically:
- I feel that my POIS symptoms are positively correlated to the strength of pulsing of the penis during ejaculation. Maybe stronger pulsing corresponds to more stress on the arteries?
I agree with this statement. Also note that the strength of ejaculation is correlated with our heart rate and systemic blood pressure. In healthy people,
"Orgasm increased blood pressure, heart rate, plasma catecholamines and prolactin." -Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence (Ref) During orgasm, adrenaline (epinephrine) and noradrenaline (norepinephrine) rises, which increases our heart rate and untimately our blood pressure everywhere in the body (reproductive organs, brain, etc...). So orgasm, like exercise, places a lot of physical stress on the vasculature.
- I once had blood in my urine (after an intense run) at a time where I did not yet have POIS (at the age of 12, I think, whereas POIS emerged around the age of 18). Could this blood in the urine be related to a fracture of arteries, predisposing me for developing immune reactions in response to stress on the arteries during ejaculation?
When there is damage to an artery, platelets form a clotting shield over the damaged section until growth hormones (angiogenic growth factors) and stem cells repair the vascular tissue. This happens whenever we cut our self and start to bleed, and this is normal.
Figure from: Human Physiology, Hematology (
link)
So I don't think damaged arteries alone predispose us to an immune response (
chemotaxis, inflammation, allergy) to stress. There are many cases where people have orgasm-induced headaches caused by aneurysms (persistent vascular damage) without a systemic immune response (
Ref1,
Ref2). Increased blood vessel permeability also does not induce immune response since ruptured aneurysms do not induce chemotaxis in general.
I think that in POIS, an infection (i.e. from a virus or bacteria) is what predisposes us to a stress induce immune response (
youtubevideo), and that infection would have to be associated with the location of the vascular/arterial injury. This happens a lot with heart surgery. The amount of immune response that a patient has after surgery depends on how sterile/clean the doctor's equipement was and the air quality (bacteria content). The location of the infection is key to the symptoms, and different locations of infection will produce different diseases (
Ref). So if an infection caused your urinary bleeding at age 12, then there could be reason to associate it with POIS.
Some POISsers report that their symptoms are located in their reproductive system with inflammation on their genitals. It could be that they have an infection in the genital area that is reactivated by these vascular stretching stresses during orgasm. I have never experience POIS symptoms or inflammation my in genitals, and I do not experience pain anywhere near my reproductive organs. So I do not think I personally have a POIS inducing infection in the reproductive system.
I had two brain MRIs which showed no damage to any brain tissue. However, I had a
brain angiogram which may have showed a bulging blood vessel (a possible aneurysm see
11. Brain scan:). My POIS symptoms start in the area of the brain where the neurologist located this damage. So it is possible that my CMV or HHV-6 infections are at least partly in the brain vasculature and that orgasm activates one of the above herpes stress-triggers (i.e. PGE
2, ROS, vascular-stretching, etc...). This is one hypothesis that maybe worth testing.
I hope something here was useful and not patronizing. If anyone has questions, comments or corrections please let me know. I do make mistakes sometimes. Thanks again BluesBrother for sharing!
