POIS is an inflammatory condition that is set off by ejaculation. A wave of inflammation penetrates the entire body resulting in the following symptoms:
cognitive dysfunction, aphasia, severe muscle painthroughout the body, severe fatigue, weakness, and flu-like or allergy-like symptoms,[4] such as sneezing, itchy eyes, and nasal irritation.[5][2][6] Additional symptoms include headache, dizziness, lightheadedness, sensory and motor problems, intense discomfort, irritability, anxiety, gastrointestinal disturbances, craving for relief, susceptibility to nervous system stresses (e.g. common cold), depressed mood, and difficulty communicating, remembering words, reading and retaining information, concentrating, and socializing.[5][7] Affected individuals may also experience intense warmth or cold
Everyone on this forum has tried a number of various treatments to treat the symptoms of POIS. Each treatment has varying degrees of success and usually multiple treatments need to be employed in order to completely resolve the inflammation.
Each round of ejaculation will trigger off another round of inflammation. If ejaculation is avoided then no inflammation will occur.
This suggests that ejaculation is the trigger.
Ejaculation is controlled by the sympathetic nervous system.
The autonomic nervous system is a network of nerves that control the functioning of the body. It keeps us alive and allows the body to function ?automatically? without conscious thought.
It is made up of three arms.
The sympathetic, parasympathetic and enteric nervous systems.
The sympathetic and parasympathetic systems are like yin and yang. They complement each other. They are two opposites. If the sympathetic system is over active then the parasympathetic system is under active.
What makes the sympathetic system over active?
? sleep related disturbed breathing
? temporal mandibular joint disorder
? increased stress
? poor sleep quality
? mouth breathing
? lack of exercise
Obstructive sleep apnoea can increase the sympathetic system overactivity and can increase chronic inflammation.
Patients with obstructive sleep apnea often have a history of snoring, gasping respiration or
choking, and witnessed pauses in breathing (apneas) during sleep.
Common clinical symptoms of untreated obstructive sleep apnea include frequent nocturnal awakenings, non?restorative sleep, morning headaches, and excessive daytime sleepiness. Patients with OSA often describe difficulty with attention and concentration, mood disturbance, and difficulty controlling other medical comorbidities such as diabetes mellitus, hypertension, and obesity.
Untreated OSA can lead to many serious consequences. Excessive daytime sleepiness increases the risk of motor vehicle accidents and diminishes quality?of?life. Neurocognitive impairment leads to decreased scholastic and occupational performance. Chronic intermittent hypoxemia and heightened sympathetic neural activity, endothelial damage and heightened inflammation are related to metabolic dysfunction and end?organ sequelae. Untreated obstructive sleep apnea increases risk of insulin resistance, coronary artery disease, congestive heart failure, myocardial infarction, hypertension, stroke, cardiac arrhythmia, and sudden cardiac death.
SOURCE: American Association of Orthodontists - White Paper: Obstructive Sleep Apnea and Orthodontics
What are the implications of an over active sympathetic system?
? INCREASED CHRONIC INFLAMMATION
As the body goes into chronic inflammation, it produces cortisol, a natural steroid, whose effect is to reduce inflammation.
Cortisol is derived from cholesterol. So are the sex hormones (estrogens, progesterone, testosterone) and salt hormone (aldosterone).
If cortisol levels are chronically high, the cholesterol is constantly being depleted to make the cortisol. Thus less cholesterol is available to make the salt hormone or sex hormones. Hence we experience a lowered libido and hence why some people respond well to testosterone replacement.
We need to lower the cortisol levels. Thus tracking backwards, we need to reduce sympathetic over activity.
Sympathetic overactivity has been well documented to cause damage to various organs.
An overactive sympathetic nervous system has become an identified characteristic of several
cardiovascular diseases including, ischemic heart disease (Graham et al., 2004), chronic heart
failure (Leimbach et al., 1986), and hypertension (Grassi, 1998). However, elevated SNA is
not isolated to diseases of the cardiovascular system and has also been reported in a plethora
of other conditions including: kidney disease (Converse et al., 1992), type II diabetes mellitus
(Huggett et al., 2003), obesity (Grassi et al., 2007), metabolic syndrome (Grassi et al., 2005),
obstructive sleep apnea (Narkiewicz and Somers, 1997), pre-eclampsia (Greenwood et al.,
2003), depression (Barton et al., 2007), and ulcerative colitis (Furlan et al., 2006). Importantly,
sympathetic overactivity is associated with poor prognosis in patients with chronic heart failure
(Barretto et al., 2008; Cohn et al., 1984) and end-stage renal disease (Zoccali et al., 2002) as
well as in community dwelling elderly individuals (Reuben et al., 2000). For example, a recent
study of heart failure patients showed that increased muscle SNA was a significant independent
predictor of one-year cardiac mortality (Barretto et al., 2008) (Figure 2). The scale and potential
pathological significance of excessive sympathetic nerve activity becomes clear when one
considers the prevalence and mortality rates of conditions with which it is associated. These
diseases represent some of the major causes of death in industrialised nations (Lloyd-Jones et
al., 2008).
SOURCE: Central Sympathetic Overactivity: Maladies and Mechanisms
James P. Fisher1, Colin N. Young2, and Paul J. Fadel2,3
1 School of Sport and Exercise Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT,
England 2 Department of Medical Pharmacology & Physiology, University of Missouri, Columbia, MO,
65212, USA 3 Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
Could POIS be the symptom of sympathetic overactivity?
If we correct sympathetic overactivity will that reduce or eliminate POIS?
How do we reduce sympathetic over activity? Do we need to increase parasympathetic activity? How can we increase parasympathetic activity?
How long will it take before we notice a change, an improvement?
I've had POIS for 7 years.
When initially diagnosed, life was tough and confusing.
My symptoms included almost everything on the list.
? Brain fog, aphasia, poor concentration, poor memory, or learning ability,
? Chronic fatigue
? Difficulty breathing, blocked sinus, blocked nasal airway, phlegm in chest
? Constantly getting sick with the flu almost every week. I'll recover and then get sick again very shortly after
? Muscle aches and pains, joint pains, knee pain and weakness, joint instability, neck stiffness and neck pain
? Premature ejaculation
? Fear of ejaculation and POIS symptoms
? Anxiety and depression about the shitty prison sentence I had received.
The worst thing about POIS was getting sick and the brain fog. I just couldn't function.
I've come a long way since my initial diagnosis. I don't get sick after ejaculation. Brain fog is much milder and I can function at work.
I can say I've conquered most of the symptoms and by saying that I mean I've reduced it to close to zero or to a point where their impact is minimal. I still get muscle spasms, joint pain, neck tightness and mild brain fog after POIS but the amount of inflammation is much less and manageable.
If we use the flooded house analogy, previously POIS symptoms would be like a monsoon that flooded the house to knee level. Now it's is more of a light rain with a leaky roof where the floors get wet and can be easily cleaned up with a mop and floor towels.
My treatment involves pumping out as much inflammatory fluid as possible as soon as possible to get the best result. By removing inflammation asap, you minimise the damage that inflammation causes. The less damage to healthy tissue, the faster your body can recover.
This of course took a lot of time and Trial and error.
I suspect that POIS is an exaggerated normal reaction.
What is the normal ejaculation response? What does a normal orgasm feel like? A normal orgasm would most likely be a wave of relaxation. It feels good. But we get a wave of punishment. It's still a wave. Perhaps the only thing that changed is instead of a small wave lapping at your feet, we are overcome by a tidal wave or even a tsunami that just overwhelms us.
So how do we get back to a small wave of relaxation?
Can we turn off or reduce or calm this sympathetic over drive?
I?m sure everyone has done almost every test possible but if you haven?t checked these things it may be worthwhile to take a look.
1. See an Ear Nose and Throat (ENT) surgeon. Check out your airways for any blockages in the nose or throat and clear the blockages so that you can breathe clearly through your nose. Mouth breathing is unnatural. Nose breathing also helps to regulate the sympathetic system through the generation of nitric oxide. Nasal breathing also aids with getting a good refreshing night of sleep. If you have been a chronic mouth breather, it takes training to learn to nasal breathe again. Look into Buteyko Breathing. Have a look at "Close Your Mouth: Buteyko Clinic Handbook for Perfect Health" Book by Patrick G. McKeown
2. Get a sleep test done. Check for obstructive sleep apnoea. If you stop breathing whilst sleeping your body doesn?t recharge correctly. You can also stop breathing in your sleep if you have gastroesophageal reflux disease (GORD) or constipation. Insufficient good sleep results in increased chronic inflammation. Have a read of the book by Matthew Walker called ?Why We Sleep?. I know someone with POIS reported feeling better with a good nights sleep!
3. Get a dental cone beam computed tomography CBCT. The ENT will need this to check your airways, sinus for any polyps, inflammation, enlarged adenoids, tonsils, turbinates. The ENT will also scope to see where the obstruction is. The CBCT is required to check the temporomandibular joint TMJ as well. It needs to be taken in 3 views. The TMJ needs to be in an open, clench and rest position. If the TMJ is in an incorrect position it may cause irritation of the auriculotemporal nerve in the posterior disc space. This nerve is a sympathetic nerve and constant irritation through clenching, grinding your teeth, eating every day of every week of every year may possibly throw out the sympathetic system. It may cause sympathetic dystrophy or sympathetic over activity. Sympathetic overactivity is also associated with increased chronic inflammation. Sympathetic dystrophy may be the cause of POIS as ejaculation is controlled by the sympathetic nervous system.
4. Some dentists who may be able to help you:
a. Dr Kenneth Lee
b. Dr Mannish Shah
c. Dr Derek Mahony
d. Dr John Mew
e. Dr Mike Mew
5. I am getting my temporomandibular joint disorder (TMD ) treated by Dr Ken Lee and would highly recommend him.
6. I have been using a GELB splint during the day and an Upper Farrar at night which is 24/7 wearing of the splint to support my TMJ in a more anatomical position, to relieve the pressure on the auriculotemporal nerve and reduce that irritation to the sympathetic nervous system. I feel much better with the TMD treatment and it has only been 6 weeks since I started treatment (May 16th 2019)
7. Normally I space out POIS challenges every 2-3 weeks just so my body has time to recover. With the splint I have been able to reduce this to 1 challenge every week. The inflammation is reducing and has been the lowest that it has ever been. There still is a very mild amount of inflammation which results in very mild symptoms. Treatment of POIS is still required but the recovery is much faster. So far the results are very promising.
8. I am also trying to improve my sleep quality and quantity. I used to sleep only 6.5 hours but I have been trying to get 8 hours of sleep. I have mild obstructive sleep apnoea with and AHI of 12. I am chronically tired throughout the day and don?t get refreshing sleep. I have been using nasal steroids flixonase 400ug/0.4ml to keep the nose clear and restore nasal breathing. My sleep has improved since the splint therapy started.
9. I am trying to increase parasympathetic activity, increase cold tolerance. I saw that someone has tried vagal nerve stimulation with some good results
10. I recently learnt how to do acupuncture on the head and neck under the guidance of Dr Ken Lee and have found that there are certain acupuncture points which claim to calm the sympathetic nervous system. Acupuncture helps to reduce myofascial trigger points which are sore spots/ knots in the muscle. By inserting a needle into the sore part of the muscle and leaving it there for 20mins, the muscle relaxes and the pain associated with it reduces. As the muscle relaxes, it regains its function and is able to contract more normally to push away the inflammation in the area.
11. According to Professor John Mew, an orthodontist from London, the majority of people in industrialised civilisation have had excessive vertical growth of the face. Most people have long faces and there aren?t many people with ideal proportionate forward growing faces. A long vertical face results in narrowing of the airway, it narrows the jaws and leads to crowding of the teeth, it leads to narrowing of the nasal passages which makes nasal breathing difficult, it leads to incorrect formation of the temporomandibular joint (TMJ) and can lead to TMD. A narrow airway can predispose to sleep apnoea. If this is in fact true then it would imply that TMD is very common in the population but of course it is a spectrum of disease so some people present with no symptoms, some with mild symptoms, others present with moderate or severe symptoms.
12. I am now 5 months into my TMD treatment and can say it is the best thing I have done for treating POIS. Prior to the TMD treatment I ran out of ideas as to how to treat POIS and was simply managing the symptoms as best I could. With the TMD treatment, the inflammation associated with POIS has dropped significantly. I haven?t made any other change to my POIS treatment protocol. All I have been doing is simply wearing the GELB and Farrar splint. I used to feel like a prisoner trapped in my body and I am sure most of you do feel the same way. I can say, I feel more like I am on parole and hopefully soon I may be a free man.
13. Based on my research I feel that TMD and sleep related disordered breathing may be the true cause of POIS and it should be treated by someone qualified. Unfortunately this treatment I am receiving is a bit of a niche treatment and not every dentist is trained in this therapy. Please be careful when looking for a dentist to provide this treatment as they may offer you other types of dental splints which may not be appropriate. Best to speak to Dr Ken Lee if you want the same treatment as mine.
14. I feel that this THEORY is the most unifying theory to explain POIS with a biological cause. It is a form of neurological inflammation that travels along the nerve pathways of the sympathetic system since ejaculation (the trigger) is controlled by the sympathetic nervous system. The sympathetic nervous system can become overactive and damaging to the body through chronic inflammation as a result of sleep related disordered breathing and TMD. There may be a high prevalence of undiagnosed TMD and sleep apnoea in the general population due to a poor screening and understanding of the conditions. There may also be a high occurrence of TMD in the population due to the incorrect facial growth.
15. This theory has proved true for me. I hope that it proves true for you. I cannot prove this theory with just one case study. I need everyone to try this treatment and see if you can yield the same or similar results. Good luck.
16. It is great that so many people have tried so many different treatments. I think the solution is going to be multifactorial. Everyone has a different piece of the puzzle and we need to put them all together to solve this.
Dr Kenneth Lee B.D.S (Syd Uni), M.Sc. (oral implantology), FICD
Dr. Kenneth Lee is a full time practising dentist in Sydney Australia. He is the principal of Today's Dental. Dr. Lee graduated from Sydney University in 1988. He has a particular interest in orthodontics, head & neck pain, dental implants and smile makeovers. He is the Director of International Academy of Advanced Dentistry, and is one of the first to integrate Invisalign? into general practice.
Dr Lee is a committed and enthusiastic educator who shares his vast knowledge gathered over the years from all over the world
Dr Lee not only provides implant and Orthodontic dentistry for the public, he also teaches
other dentists advanced dental techniques through IAADent.
Dr Lee is the dentist other dentists come to for their treatments !
? B.D.S. (Syd. Uni.)
? Grad. Dip of Health Sci.(Uni. West. Syd.)
? Fellow of International College of Dentists (FICD)
? Fellow of Pierre Fauchard Academy
? Master of Oral Implantology (Goethe University Frankfurt)
? Diplomate and Master Senior Instructor of the International Board of Orthodontics (IBO)
? Fellow of the International Academy of Dental Facial Esthetics (FIADFE)
? President of International Association for Orthodontics 2015-2016 (USA)
? Chair of Education Committee, International Association for Orthodontics (USA)
? Fellow and Diplomate of World Association of Ultrasonic Piezoelectric Surgery
? International Board Member for WAUPS
? Principal Lecturer International Academy of Advanced Dentistry (IAADent)
? Fellow and Diplomate of International Congress of Oral Implantology (USA)
? Fellow of American Association for Functional Orthodontics
? Certified Senior Instructor of International Association of Orthodontics(USA)
? Diplomate of Asian Oral Implant Academy
? Member of Australian Society of Implant Dentistry;
? Member of Australian Association of Orofacial Orthopedics
? Member of Australian Dental Association State Federal Branch
On a personal note, Dr Lee is an avid cook who enjoys sharing his creations with his family and friends.
Dr Derek Mahony is a world renowned Registered Specialist Orthodontist and expert in Dentofacial Orthopaedics who has trained thousands of dentists.
BDS (Syd), MScOrth (Lon), DOrthRCS (Edin), MDOrthRCPS (Glas), MOrthRCS (Eng), FRCD (Can), MOrth RCS (Edin), FICD, IBO, FACD, FICCDE, FIADFE, FPFA, Grad Dip Dental Sleep Medicine (WA), Grad Dip Dent (Ortho)
Diplomate of the International Board of Orthodontics
Derek Mahony is a Sydney based Orthodontist who has spoken to thousands of practitioners about the benefits of interceptive orthodontic treatment. Early in his career Dr. Mahony learned from leading clinicians the dramatic effect functional appliance therapy can afford patients in orthodontic treatment. He has been combining the fixed and functional appliance approach ever since. His lectures are based on the positive impact such a combined treatment approach has had on his orthodontic results and the benefits this philosophy provides in reducing extractions of teeth.
After completing his Dental Degree at the University of Sydney Dr. Mahony proceeded to the United Kingdom where he completed his Masters Degree in Orthodontics at the Eastman Dental Hospital, Institute of Dental Surgery, London.
Further studies led to the successful completion of a Diploma in Orthodontics at the Royal College of Surgeons, Edinburgh. Dr. Mahony has also passed the Royal College of Dentists in Canada post graduate examination in the field of Orthodontics.
Dr. Mahony has passed examinations leading to a postgraduate qualification in Dentofacial Orthopedics from the Royal College of Physicians and Surgeons in Glasgow. He has also attained his Membership in Orthodontics qualification from the Royal College of Surgeons, England.
Dr. Mahony currently has over 3000 orthodontic patients in active treatment and has been a key note speaker at the International Orthodontic Summit meetings, the International Association of Orthodontics meetings, and the American Association of Functional Orthodontics meetings.
Dr. Mahony approaches his orthodontic diagnosis from a "facial profile" point of view. He sets his treatment goals to create not just straight teeth, but beautiful faces and healthy temporomandibular joints.
Dr. Mahony is a contributing editor to the Journal of Clinical Pediatric Dentistry, International Orthodontic Journal and Spanish Journal of Dentofacial Orthopedics.
Some useful websites for further information
https://www.todaysdental.net.au/why_choose_ushttps://johnmeworthotropics.co.uk/https://www.fullfaceorthodontics.com.au/
