I'd highly encourage everyone here to look into the acetylcholinesterase (AChE) deficiency component of POIS as orgasm can create a sort of cholinergic crises for some/many of us. This is why some antihistamines (that are anticholinergic- like first generations (benadryl/chlorpheniramine, etc) are helpful. Cholinesterase testing is cheap and can be ordered through sites like ultalabtests.com A deficiency in AChE can result in excessive sweating, excessive urination, fatigue, irritability, soft bowel movements, etc. We have to be careful with foods/proteins that are high in choline as low AChE means acetylcholine isn't broken down at normal levels.
In my case, POIS became much worse after H Pylori, streptococcus/enterococcus levels became very high in my gut- found out the GI Map stool testing. I encourage everyone to do this. Could be a game changer for some... has been for me. Learning more about AChE has been huge too. Nootropics like Piracetam, Centrophenoxine and Alpha Lipoic acid help lower or utilize acetylcholine and lower it's burden. Hot showers/baths/sweating is important for detox.