Treatment protocol for POIS

[melt]

I am pharmacist and dentist.
I've had POIS since 2012, I'm not sure how it all started but my theory is that it could have been a combination of roaccutane treatment for acne, excessive orgasms (twice a day), and coffee.
These are just my theories and I haven't taken the time to delve further into it but your research has got me excited. Please feel free to pick apart and/ or prove these theories.
1.   Roaccutane is a modified Vitamin A analogue, so it basically replaced my natural vitamin A for this synthetic version which may have changed the way my body responds to stress and orgasms.
2.   Excessive orgasms sensitises the body to a 'threat' and makes it respond defensively to fight off this threat and started the change towards POIS
3.   Daily coffee consumption, coffee is a diuretic which would cause your body to flush out vital nutrients which when not replaced would place the body under significant stress, the body's response to stress would be pro inflammatory and catabolic in nature

Like everyone here, I didn't know what was happening with my body, eventually I saw a sexual health doctor who diagnosed me with POIS, I had some investigations done and all the blood work was normal. I saw an immunologist who said my symptoms were not consistent with a type 1 allergic response meaning I wasn't having anaphylaxis/ ALLERGY to my semen.
He thought that my symptoms were a manifestation of neurologic inflammation.
So the inflammation is triggered along nerve pathways.
Ejaculation and orgasm is controlled by the sympathetic nervous system (SNS)
The SNS practically connects to the entire body which explains why the POIS symptoms are far reaching and affects every single part of the body from your head to your toes.
So how to stop the inflammation?
1.   Remove the cause ? stop ejaculating, which is practically impossible
2.   Use anti-inflammatory methods ? which is what I do but I haven't been able to cure POIS yet.


My anti-inflammatory methods.
My POIS symptoms have become milder and I can recover up to 90% within 1 day if I complete all the steps.
1.   Chiropractic adjustment of back and neck
2.   Deep tissue massage full body
3.   Gym session whole body rehab with machines
4.   Epsom salt bath
5.   Lumosity brain training
6.   Take supplements and medicine
7.   Sinus rinse
8.   Peppermint tea, Pu Er Tea , Oolong Tea
9.   Pelvic floor strengthening
10.   Vocal workout
Chiropractic adjustment
-   The neck is the information highway that connects your brain to the rest of your body
-   POIS results in inflammation in the muscles around the neck
-   A stiff neck results in poor information transmission between the head and the body
-   Headaches, sore shoulders, brain fog, muscle pain and weakness, irritability and mood disturbances are related to the stiff neck
-   All muscles connect to bone and allow movement of the particular limb
-   Various neck muscles connect to the spine. Inflammation in the muscle results in tightness of the muscle and swelling which pulls the spine towards the contracted muscle and out of its proper alignment.
-   Releasing the muscle through soft tissue work (targeted massage) and spinal adjustments removes the tension in the neck and relieves the associated symptoms.
-   You should book a chiropractic adjustment for the same day you plan to ejaculate
-   Absolutely vital for recovery
Deep tissue full body massage
-   POIS is generalised inflammation of the muscles and other tissues
-   The muscles become swollen and painful
-   Swollen, painful muscles don't operate properly as non-inflammed muscles
-   Thus the muscles don't support the joints adequately and you get joint pain
-   You need to remove the inflammatory fluid from the muscles by massaging it out
-   A deep tissue massages targets the sore spots on the muscles and relieves the tension and pain.
-   It is a painful massage but you need to do it
Gym session
-   Since the muscles are out of whack, you need to rehab the muscles with a good gym session
-   Don't push too hard since the muscles don't function to their full capacity and you risk getting injured
-   I use the machines at the gym since they're easy and safe to use and isolate various muscle groups
-   Start with the biggest muscle group, the legs, then work your way to the core, arms, back
-   Jump on the bike, do cardio, get a good sweat out of the workout to also cleanse the muscles of inflammatory fluid
-   Do push ups, squats, make sure to sweat a lot
-   Go for a swim ? water provides a great environment for muscle rehab
-   Aim is to get each and every muscle moving in its normal range of motion so that it can support everyday tasks and movement
-   Do sets of 10 starting at a light weight and increase progressively
-   Wear compression gear to improve circulation and remove inflammatory fluid from the muscles faster
-   I wear Skins calf compression on both sides
-   I wear elastic knee supports on both sides and also elbow supports now that I have tennis elbow

Epsom salt bath/ swim in the ocean
-   Via the process of osmosis, inflammatory fluid can be drawn out of the muscles towards the outside of the body as you sit in a salt bath
-   I use about 1kg of Epsom salt in a 150 L bath tub using warm water and submerging myself for about 30mins
-   It can make you quite dehydrated so make sure to drink plenty of water and replace electrolytes
-   Drink hydralyte or Gatorade/powerade  make sure to rinse out with water since these drinks are acidic and will cause acid erosion of the teeth over time. Can also use a fluoride mouth wash after drinking your electrolytes
-   You need to drink electrolytes because the electrolytes in your blood have moved into your muscles so it is low in the blood and needs to be replaced
-   If you don't replace electrolytes, then you don't get maximal extraction of the inflammatory fluid in the muscles
-   The body self regulates and will try to retain fluid when the body is dehydrated so you need to treat the dehydration with electrolytes
-   Go soak in the ocean achieves a similar result and is probably better since you can move freely whilst floating in the water

Lumosity brain training
-   Brain fog is inflammation in the brain
-   Principle is to use exercise once again to clear the inflammatory fluid
-   Push ups in plank position is great for pushing fresh blood into the head and clearing away toxins and metabolites to speed up recovery
-   Lumosity brain training is fantastic in that it provides categorised games that target a different attribute. The games focus on speed, memory, attention, flexibility, problem solving
-   This game is worth subscribing for the lifetime which ends up being cheaper in the long run
-   Once you've mastered the games, it can get a bit boring so you can find other brain training games to give your brain a workout and clear the brain fog
-   The games are quick and easy to play taking about a minute per game
-   Reading gets the brain ticking as well
-   Information processing, problem solving, anything that gets the brain thinking will help

Supplements
These supplements are mostly anti-oxidants and may be in higher demand when the body is stressed during POIS. I prefer to take the maximal dose according to the packaging. If unsure check with your health care professional.
-   Vitamin C 1000mg daily
o    Vitamin C is a cofactor in collagen synthesis, collagen is found in connective tissue and essentially all over the body
o   Inflammation of the muscles causes damage to the muscles and hence you need to repair it. Vitamin c helps with the repair process
-   Magnesium 150mg daily
o   Magnesium is required for muscle contraction, low magnesium leads to muscle spasms
-   Mega B complex daily
o   B vitamins help regulate stress and improve energy production in the body, so it helps to counter the stress of POIS on the body
-   coQ10 600mg once or twice daily
o   CoQ10 is a cofactor in ATP synthesis which is an energy molecule. It helps with energy production in the body and is supposedly depleted with age
-   N-acetyl cysteine (NAC) 600mg daily
o   NAC is an antioxidant which supports liver function, the liver metabolises toxins and removes it from the body
-   Probiotics30 billion CFU
o   Required for gut health. Gut inflammation arises from POIS and hence the intestinal barrier to infection is weakened and you find yourself getting sick easily. Good and bad bugs reside in the gut. The gut acts as a barrier keeping these bugs out but when it is weakened with inflammation, some bad bugs get in and make you sick.
o   Probiotics increase the number of good bacteria
-   Curcumin 500mg
o   Anti-inflammatory take before1 hr ejactulation
-   Vitamin D3 5000iu 1 capsule weekly
o   A lot of people are low in Vitamin D from lack of sun exposure
Medicine
Pseudoephedrine 30mg  helps clear the sinus and brain fog
Phenergan 25mg  antihistamine counters the inflammation and reduces the swelling in the muscles ? take 1 at night
Sertraline 100mg SSRI great for clearing the brain fog, great for premature ejaculation, take 50mg in the morning and 50mg half an hr before sex. Get a prescription from your doctor
Bisolvon 100mg  - for phlegm in the chest which is basically inflammation in the chest lining like in asthma
Ventolin 100ug to open the lungs and improve clearance of the phlegm and make it easier to breathe ? take 2-3 puffs as needed
Telfast 180mg  antihistamine for swelling and sinuses, take 1 in the morning
Nurofen 200mg  anti-inflammatory NSAID  take 1-2 30mins before sex and afterwards as needed
Sinus rinse
-   Get a flo sinus rinse, fill with water, add 1-2 sachets of the salt into warm water and use after POIS to counter the sinus inflammation
-   This is a must. It is a bit daunting to do initially, stand over a sink, breath in and squeeze it into your nostril as you breath out and cough at the same time
-   Takes some coordination  but the water should go in from your nose and out the back of your mouth
-   Blow your nose,
-   Bend over tilt your head to the side so one eye is on top of the other and blow your nose then turn to the other side and blow your nose
Peppermint tea
-   Is effective in irritable bowel syndrome which is inflamed bowels!
-   Great for settling the bowels and reducing inflammation in the bowels and hence prevent break down of the gut lining and reducing the risk of infection and getting sick with the flu
-   Make the tea 2 tea bags in a small volume of water and take it like a shot
Pu er tea
-   Great for digestion problems, it seems to get the bowels moving
Oolong tea
-   Anti-stress tea  very calming

Pelvic floor strengthening
-   I believe that weak pelvic floor is a driver for premature ejaculation and I suspect that spasms in the pelvic floor are a trigger for POIS
-   Strengthening the pelvic floor will reduce premature ejaculation and it seems to lessen the POIS response
-   Squeeze the muscle that hold in the piss, count to 100 and squeeze for each number, or count to 100 and squeeze from 1-100, repeat 5 times
Vocal workout
-   I find I get a bit of a stutter once POIS hits
-   This would be inflammation of the tongue and facial muscles
-   Exercising the voice will get these muscles moving
-   Count out loud 1-100 and squeeze the pelvic floor at the same time
-   Count the alphabet
-   Count the alphabet but call out the sounds ba ca da fa ga etc
o   Then be ce de fe
o   Then bi ci di fi
o   Then bo co do fo
o   Then bu cu du fu
-   Repeat 5 times
-   I usually do this in the car while driving to work so I don't look ridiculous
you can also sing a song out loud and memorise the lyrics which works the facial muscles as well as test your memory

Try it! It definitely works and is based on sound scientific principles.
If you do all this on the day of POIS you can recover quite quickly but I still find there is like a residual 10% of POIS that takes more time to shift
it will take more than one day to implement this. Maybe even a year to reap the full results. if you maintain a month or more of abstinence the improvements occur quicker.
each round of POIS stacks up and pulls you back into the rabbit hole. its like a game of snake and ladders, most of the time its snakes!
Essentially this will help your body heal and get better for the next POIS attack
Unfortunately i doubt there is a cure for POIS
I dont even remember what a normal orgasm feels like but i imagine it's a wave of relaxation that takes over the body.
POIS is, in my opinion, an exaggeration of the normal body response to orgasm. it is a wave of relaxation that has gone to far and become a wave of inflammation.
if you look at rheumatoid arthritis, it is inflammation of the joints. there isnt any cure for it. these patients are on antiinflammatory medications their whole life and suffer joint deformities.
i reckon if you can get yourself back to just a wave of relaxation it would be as close as you could get to a cure

another theory, ive noticed that the female period has some similar symptoms like  bloating, muscle and joint pain, inability to concentrate. maybe what ever is happening in the female period could be driving POIS?

[Quantum]

I am pharmacist and dentist.
I've had POIS since 2012, I'm not sure how it all started but my theory is that it could have been a combination of roaccutane treatment for acne, excessive orgasms (twice a day), and coffee.
These are just my theories and I haven't taken the time to delve further into it but your research has got me excited. Please feel free to pick apart and/ or prove these theories.

Hi melt, and welcome to the forum!

(I have originally posted this answer to you in Nanna's thread, and post it again here, in your new thread.)

Thanks for having taken the time to share your theory about POIS, and your POIS control method.

You have developed a very extensive method, fighting POIS on many different fronts, and it pays off for you, as you get a 90% of relief form your POIS symptoms.

I deduct from your method that your main symptoms are muscles pain and stiffness, sinus congestion, and some brain fog.  I say "some" brain fog, because since you have managed to get two university diploma, your cognitive abilities are not that affected by POIS ( you may be aware that there are POIS sufferers who are drop out of College because of POIS, being unable to pass their exams, even if they were brilliant students in elementary school).    You do not seem to have much emotional symptoms, like irritability, social withdrawal, impulsivity, mood swings, and the like... Am I wrong in thinking that?

Many parts of your method/program have been used and discuss here, some less ( like chiropractic adjustment ).   

Take the time to read the wealth of information that is available on the forum, and I hope you will take an active part in our ongoing collective effort to solve the POIS puzzle.

Last but not least, you mention that a sex doctor has diagnosed your POIS.  That is a rarity, since their is only a handful of doctors in the world who have heard of POIS, let alone knowing the criteria for diagnostic.   I have currently put up a list of "POIS Doctors", meaning that they know about POIS and are seeing POIS patients ( and won't refer the patient to the psychiatric department...), and for now, there are only 3 doctors on the list.  They do not have a cure to offer, but at least, you can skip the part where you have to educate the physician about POIS and convince him that it really exist...  So, If you agree too, I would like to know the name of this doctor, so it can be added to this list ( see at  http://poiscenter.com/forums/index.php?topic=2575.msg22338#msg22338 ).

[uhtred sonof]

You might be interested in the hackstasis forums. A forum for post-finasteride syndrome suffers, many of whom believe it to be on the same spectrum of illness as POIS. One user in particular is popular for his theories on how this all comes about:

https://hackstasis.com/threads/gbols-pfs-theory-quotes.21/

ctrl+F accutane, post #18 explains how it ties into all of this. Let us know what you think after tying together your knowledge with their research.

[melt]

POIS  kinda kicked in towards the end of my pharmacy degree which affected my ability to complete the honours component. I dropped my honours component of pharmacy and finished it with the non-honours cohort

Dentistry was a challenge initially because I was getting diagnosed around the start of it.
The brain fog and getting sick with the flu all the time was big pain in the butt but after realizing what was going on, I was able to minimise the symptoms.

There was a period of depression feeling like being stuck in a bottomless pit but overcoming the brain fog helped me to forget about this wretched condition.

My head still isnt as clear as I would like it to be, but it's clear enough to function

If POIS is inflammation driven then the treatment would require removing that inflammation and it's not an easy task
The problem is sticking to the plan, and like i said it would probably take you a good year to come out better on the other side

The other problem with POIS is that because you expect it to happen each time, you psychologically drive it and make it happen. it creates a self fullfilling prophecy. Yes it is hard to say to yourself it's not going to happen this time but your mind set will also affect how severe it will be.

My solution isnt an instant fix and I doubt there is a silver bullet that you're looking for.

[melt]

An Analogy for POIS.

Suppose you have a house with a kitchen, living room, bathroom and 4 bedrooms.
Let's say these rooms are equivalent to a part of the body, for instance the brain could be the living room, the kitchen the stomach and the bedrooms the arms and legs.

If we have a clean dry house, it is a comfortable place to live in. We can go about our daily lives without any problems.
Imagine if there is torrential rain, the house becomes flooded, the roof is leaking, the taps burst and spills water all over the house.
The house is now flooded. You can still walk around the house but everything is wet. You can still use each room but it just isn't the same as when the rooms were dry and comfortable.

POIS is inflammation driven and is the same as having bodily fluid flood these different "rooms" i.e. different parts of your body.
So the symptoms of POIS are the direct result of inflammatory fluid penetrating these rooms.
So if we clean up and remove this fluid, if we remove the water, remove the flooding then the symptoms will improve.

To stop the flooding of the house, we have to wait for the rain to stop, make barricades to block the water entering the room, fix up the leaking roof, get a plumber to fix burst pipes.

Then we have to clean the water out of the house and get everything dry again so that we can use it and enjoy the house as it was before the flooding. We would have to clean up and repair the water damage to the walls and furniture.
These processes will take time and won't be done instantly.
To fix the house it requires multiple different approaches to get the house up and running again

Similarly, POIS requires removing the inflammation from all the rooms, it requires stopping the inflammation from occuring, it requires repairing the damage caused by the inflammation, it requires time and perseverance.

Another analogy would be an obese person versus a fit person.
POIS causes a lot of damage to the body that you could liken it to being an unfit obese person.
If you want to transition from an obese person to a fit person it takes a structured program and commitment to lose the weight and slowly improve the fitness. It requires making changes to the diet and ingrained habits and to develop healthier routines. it will take time.

The journey from POIS to recovery takes a lot of time and effort and costs a bit of money to get the right relief.

[Quantum]

Hi melt,

it is based on an idea similar to your house analogy that I have developed my own method for controlling my POIS symptoms.  Like your method, it is a multi-faceted approach ( see http://poiscenter.com/forums/index.php?topic=2090.msg16604#msg16604  ).   My pre-pack itself is composed of multiple elements, so that it helps protect the different "rooms of the house".

[melt]

HI Quantum,

Looks pretty good. I'll have to try some of your elements at some stage and see how much more improvement I can get.

[Quantum]

HI Quantum,

Looks pretty good. I'll have to try some of your elements at some stage and see how much more improvement I can get.

Hi melt,

I have just realized that I gave you the wrong link, my personal method for controlling my POIS symptoms is at http://poiscenter.com/forums/index.php?topic=2090.msg16604#msg16604 .  I have edited my previous post.

The link I gave you was for my POIS Types Chart ( http://poiscenter.com/forums/index.php?topic=2338.msg19448#msg19448  ) , which is a list of methods from members of this forum, that have been proven efficient on the long term ( at least more than 2 months), and for at least a 70% relief from POIS symptoms.

Sorry for the mix up.

 

[melt]

Another thing you could try if you find yourself getting sick a lot is Chinese Herbal Medicine

You need to find a Chinese doctor. They read your pulse and some how they can tell what's troubling you from counting your heart beats.

They then prescribe you a bunch of medicinal herbs, you take it home, boil it for an hour or so and drink the liquid. It's quite bitter though so best to take it like a shot.

It is a concoction of medicinal herbs that I find helps speed up the recovery from the cold and flu symptoms, even the gas and bloating and stomach issues that occur.

I can't tell you what they actually put in it but worth a try.

Another thing that may help with the cold and flu symptoms is the Chinese skin scrapping technique called GUA SHA.
This technique requires rubbing of an ointment on the skin like Vicks Vapour rub. Then a coin is used to scrape the skin in an outward direction all over the back. Kinda like carving out a Christmas tree. The skin is scraped until it turns red. It is a little painful to endure. If you can tough it out, you feel quite relieved and the symptoms of the cold and flu seem reduced.

Sure there probably isn't much scientific evidence to support alternative treatments but if it didn't work it would've died off a long time ago