Muscle contraction during ejaculation connected to POIS/poor circulation?

[Nightingale]

So I was thinking about POIS (like I usually am) in the shower the other day after having discussed the topic of poor circulation and its connection with POIS.  Niacin, our #1 best friend so far, causes the capillaries in our skin to dilate (vasodilation), increasing blood flow.  Fenugreek and Ginko biloba are both two other vasodilators that have helped.

I thought again about the ejaculatory process: we have covered many aspects of it, the semen, the hormones, but I made a connection that I hadn't put together before...  What happens immediately when I feel the POIS start?  A lot of things happen around the time of orgasm, but it my experience is that the moment my muscles contract to make that ejaculation, I begin POIS.  The sensation seems to start right there, where the ejaculatory muscles are near your prostate.

Ejaculation is a series of muscle contractions, forcing out the semen.  This issue of poor circulation is one of vasoconstriction, or contraction of the smooth muscles of your vessels.  Could there be an abnormal amount of contraction-inducing molecules or signals be affecting the rest of our bodies while successfully ejecting our semen out the urethra?

I will tell you, I have always noticed I have an extremely strong ejaculation, as have my partners.  The distance traveled by my semen is FAR further than what I have researched to be average (look here for a video of a "normal" ejaculation http://en.wikipedia.org/wiki/Ejaculation).  I think my ejaculatory muscles contract much harder than most men.

But in addition, my urine retention and bowel movement frequency show tightness/constriction.  I have always had an issue where I only urinate 2, mabye 3 times a day.  Some days only 1.  But when I urinate it would be for a long time, after looking up averages and getting jokes from my friends.  My longest urination I recorded was over a minute and a half of non-stop stream.  I also have bowel movements only once every 2 days, sometimes 3.  The muscles that control these things all are connected to the same nerve branch that controls ejaculation.

I felt I should share this, as I don't think it's something that's been discussed.

Studies I looked at:

Neurotransmission and the contraction and relaxation of penile erectile tissues.
http://www.ncbi.nlm.nih.gov/pubmed/9066089

Identification of a Potential Ejaculation Generator in the Spinal Cord
http://www.sciencemag.org/content/297/5586/1566.short

[fidalgo]

I have strong ejaculations too and I think this is connected with POIS. My problem with urine is the opposite if yours, I urinate a lot of times per day.

[kurtosis]

I have strong ejaculations too and I think this is connected with POIS. My problem with urine is the opposite if yours, I urinate a lot of times per day.

Me too. Some others have talked about experiencing POIS like symptoms at the gym. I wonder are they merely talking about fatigue or other cognitive aspects?
I've noticed that as my POIS worsened, my ability to exercise decreased.

[Starsky]

I have hypotension. But my ejaculations are strong too.

[Nightingale]

I have hypotension. But my ejaculations are strong too.

Maybe I should re-title the post to saying "poor circulation" rather than "hypertension""

I too have low blood pressure, but not diagnosed hypotension

[Nightingale]

I've noticed that as my POIS worsened, my ability to exercise decreased.

This is absolutely the case with me.  My hamstrings and calf muscles are always sore and weak post-orgasm, for at least 2 days.  I can't run nearly as well either.

I am looking into the nerve anatomy of these affected areas, to see if there is a relation between dysfunction between them.  Pinched nerves, nerve damage, neuroinflammation, damage to the spine...

[poisioq]

years ago I was diagnosed with myofascial muscles spasm.
I have low blood pressure too.
but i have the feeling i don't eyaculate with enough strenght and my urinations seems to be shorter than the average.
 if i eyaculate after yoga exercises (mainly after the ones that release the pelvic floor mucles) , i have better eyaculations and a bit lower pois symptoms.
but that could also be because yoga also helps in balancing adrenaline and other hormones levels in hour body

[Nightingale]

So far no one has a "normal" ejaculation, which lends credence to the theory there is something off neurologically that's managing our "plumbing"

[demografx]

Elegant condensation, Nightingale!

[kurtosis]

So far no one has a "normal" ejaculation, which lends credence to the theory there is something off neurologically that's managing our "plumbing"

I've brought this up (no pun intended) with my current girlfriend and with 2 past ones, 1 of which I'd discussed POIS with. Superficially they didn't notice anything was wrong when I ejaculated. It's not like I phoned them up to ask about it. It just happened naturally during the relationship and I explained it away as me wondering about a postcoital migraine.  There's never been a "that's odd" moment from a girl so I guess I thought that whatever problems I had were only obvious to me and I appeared normal otherwise. However I have noticed that sometimes an erection feels like there's pressure building up in my brain and eyes. Does anyone else get this?
It's a POIS thing. I noticed nothing like this in the first O's I got when I was a teenager.

[haidcat]

 I will say that my prostate muscles are very spasmy and contract sometimes on their own.... There is definitely something wrong with that whole area, because I am 24 years old and my urologist told me I have the prostate of a 60 year old.

Regardless, there seems to be a common trend here of hypotension, and its pretty clear that if you are already slightly hypotensive, then having sex/masturbating will definitely make you extremely tired, light headed, etc.

But for me, I can definitely say that after orgasm and when im in POIS it feels as if all my muscles in my body are in a constant tense mode, and i can feel that circulation throughout my arms, legs, and neck is poor.. Its as if the blood has to pump much harder to get to where it needs to go.

[demografx]

Please click H E R E now to donate  to The POIS Medical Research Fund

[Nightingale]

An update:

I've mentioned elsewhere that my doctor told me I have Raynaud's disease, a condition where my hands/extremities have poor circulation.  This became very obvious when I tried to come off of lithium, which I have been taking for mental health reasons.  Raynaud's is often caused by too much norepinephrine, and lithium chances the levels/absorbtion in your body.  After returning to my regular dose of lithium, I still had issues, so I got my doc to prescribe me a medication to help.  I have been curious about the ties POIS has to norepinephrine, so I think there is something connected here.

I found the drug guanfacine (Tenex, Intuniv)  It lowers the amount of norepinephrine in your body by acting on a site in your brain.  It is similar to an alpha-blocker. Tenex is branded as a drug to combat hypertension, and Intuniv is branded interestingly enough as an ADHD medication.  I was prescribed Intuniv 1mg to start.  The first time taking it I felt a strong effect, not good or bad, but different.  After 1 week I had to stop if for side effects.  Here is what I found:

• I felt much more at ease/relaxed - guanfacine has been found to help people with PTSD who have nightmares sleep better.  I have been having very scary sleep interruptions since I messed with my lithium dose, but guanfacine nearly eliminated it 100%
• My hands were still blotchy.  I don't think I was on it long enough for it to work, but I was no longer having any pain in my arms/hands/feet
• My cognitive function became worse.  This had the opposite effect of what I would want from an ADHD medication.  This is not surprising, since I have tried almost every other ADHD medication and had no effect.  But this may have to do with drug interations with my lithium and my antipsychotic.  I have many psychotropic drugs working on me, maybe someone would find benefit.
• I lost 3 pounds within 5 days.  !  This is a good thing in my opinion, as my other meds have been causing me to retain weight for years
• Lastly, I had a MUCH improved sleep schedule.  My antipsychotic, Seroquel, makes me very sleepy and I have a hangover effect every morning.  Guanfacine made it so I woke up early and felt ready for the day

Unfortunately, the mental slowness was too much.  I had such a hard time talking with people, making sentence that made sense.  I was getting depressed, so I stopped.  I will see my doc this week and switch to an alpha-blocker instead, probably Minipress.

Hope this helps you guys,and hope you're having a good September!

[kurtosis]

Hey nightingale,
That's really interesting. Does your doctor plan to see if they can isolate the effects of guanfacine rather than testing it with so many other psychoactive drugs?
It seems it's quite difficult to see whether cognitive functions are being worsened by interactions or the drug itself.

For example, when I look up the effects of your anti-psychotic drug (Seroquel) I see that it's listed as a dopamine antagonist (See http://en.wikipedia.org/wiki/Dopamine_antagonist). Did your doctor prescribe this on the basis of a test finding too much dopamine? Seroquel is also an antagonist for auto-receptors of Norepinephrine. What this means is that it blocks the receptors which reduce norepinephrine (NE) levels. guanfacine effectively reduces NE levels so you're taking 2 things with some effects that cancel each other out. Guanfacine's NE reducing effects will make you more relaxed but it's difficult to say what it's effects on your dopamine levels would be if you weren't taking Seroquel.

I might get into trouble for saying this but here goes. There's some medical research that suggests a connection between schizophrenia and lowered dopamine levels in some parts of the brain while others suggest bipolar may be the result of elevated catecholamines (both Dopa and NE). Some drugs were originally prescribed for both schizophrenia and bipolar but may actually cause more harm than good in some circumstances.

I'm not a doctor, this is not medical advice etc. However, statistics is something I do know (hence the name) and statistical interactions are something I study.

However, I was prescribed a similar drug (antagonist of dopamine and norepinephrine) and while I felt more relaxed, my cognition was severely impaired, I ended up like a zombie for 2 weeks. I damn near lost my job as I could not do anything during that time and I fired the shrink who prescribed it when they refused to do test on catecholamine levels saying I needed to keep taking it for a few more weeks. I guess the shrink felt vindicated but at least I kept my job

Either way, this is something to discuss with your doctors. You're taking so much stuff with complicated interactions and they might need to go back to first principles. None of these drugs can be discontinued or have their doses modified without medical supervision. Please remember that.

[kurtosis]

Also, Nightingale, can you let us know if the alpha blocker works on raynaud's?
I'd have to take about 360 mg of ginkgo / day to warm up my extremities. I like in a cold country so having very cold hands and feet is annoying, if not quite on the same level as other POIS symptoms

[Snowblind]

Very interesting. I Have always had very strong orgasms, i also have looked up the average range and i have way longer than that. I think your definitly on to somethning here. I accually thaught about this yesterday when i had an O. About 40 minutes befor the O i took 500mg of Niacin. The thing i thaught was strange was that my ejaculation wasnt as strong as it usually is/have been. I didnt feel the cramp feeling when i ejaculated. I do not have any significant POIS sympthoms today and i wonder if it might be connected to the not so crampy, strong ejaculation?

I can also get some pois-like symptoms after a hard training at the gym. Maby i should take a niacin befor i go to the gym to?

[Nightingale]

Hey nightingale,
That's really interesting. Does your doctor plan to see if they can isolate the effects of guanfacine rather than testing it with so many other psychoactive drugs?
It seems it's quite difficult to see whether cognitive functions are being worsened by interactions or the drug itself.

No plans for that.  No one wants to mess with my drugs (I really hesitate) because I've had so many hospitalizations for depression/suicidality, and I've been more stable the last 1.5 years than I have in the 4 years before it.

For example, when I look up the effects of your anti-psychotic drug (Seroquel) I see that it's listed as a dopamine antagonist (See http://en.wikipedia.org/wiki/Dopamine_antagonist). Did your doctor prescribe this on the basis of a test finding too much dopamine? Seroquel is also an antagonist for auto-receptors of Norepinephrine. What this means is that it blocks the receptors which reduce norepinephrine (NE) levels. guanfacine effectively reduces NE levels so you're taking 2 things with some effects that cancel each other out. Guanfacine's NE reducing effects will make you more relaxed but it's difficult to say what it's effects on your dopamine levels would be if you weren't taking Seroquel.

I might get into trouble for saying this but here goes. There's some medical research that suggests a connection between schizophrenia and lowered dopamine levels in some parts of the brain while others suggest bipolar may be the result of elevated catecholamines (both Dopa and NE). Some drugs were originally prescribed for both schizophrenia and bipolar but may actually cause more harm than good in some circumstances.

I believe I'm overmedicated.  The trouble is which one(s) (Seroquel or Lithium?), and how much.  I was put on Seroquel after having a psychotic episode, most likely triggered by taking modafinil (Provigil) and by being on Cymbalta (SSNRI).  So many other antipsychotics gave me bad side effects, I can actually tolerate Seroquel.  At one point I was on only Cymbalta and Seroquel (didn't think Cymbalta was harming me at the time), and I tried coming off both meds.  Within weeks I was back in the hospital with psychosis.  Risking psychosis by changing or removing Seroquel is something I need to weigh with a very good doc.

I'm not a doctor, this is not medical advice etc. However, statistics is something I do know (hence the name) and statistical interactions are something I study.

However, I was prescribed a similar drug (antagonist of dopamine and norepinephrine) and while I felt more relaxed, my cognition was severely impaired, I ended up like a zombie for 2 weeks. I damn near lost my job as I could not do anything during that time and I fired the shrink who prescribed it when they refused to do test on catecholamine levels saying I needed to keep taking it for a few more weeks. I guess the shrink felt vindicated but at least I kept my job

Either way, this is something to discuss with your doctors. You're taking so much stuff with complicated interactions and they might need to go back to first principles. None of these drugs can be discontinued or have their doses modified without medical supervision. Please remember that.

I have plans to meet with the best doctor I can get to this Tuesday.  I'm traveling to Washington DC to have a consult with him regarding all this.  Im glad you've said what you have, I feel like there are some inroads there to my issues that I can bring up.  He is the retired director of inpatient service at the NIH and a very accomplished psychiatrist.  I absolutely understand this is a risk of my own undertaking, but I am really grateful for your observations.

I will talk with my primary care doc about the alpha blocker tomorrow.  Ill also ask him about tests for catecholamine levels, didn't think that was something available to your average doc.

[kurtosis]

I will talk with my primary care doc about the alpha blocker tomorrow.  Ill also ask him about tests for catecholamine levels, didn't think that was something available to your average doc.

Given the amount of meds you're taking, somebody needs to do tests for your levels of neurotransmitters. You're probably going to have to be a bit forceful with your doctors to get them to run tests.

I wish you luck my friend.

[Nightingale]

So I've started a new drug (Minipress), an alpha blocker for the reason of treating my Raynaud's and to reduce the effects of norepinephrine on my system

Results: Again, like Tenex/Intunive, I felt more relaxed and slept better but again, I suffered a loss in mental function.  Specifically my memory and attention.  I stopped it after 3 days once I realized my hypothesis that an alpha-blocker would not cause the same attention issues that a centrally acting alpha agonist would, for me.

I'm on my way to Washington DC to meet with a very good psychiatrist, I will be discussing my symptoms and results after taking these meds.

[Nightingale]

Just got back from DC after meeting with that doc.  Went extremely well.  I knew he was intelligent, but I wasn't totally sure if he'd entertain the idea of a mysterious sexual illness.  Was totally interested, and was happy to hear about our research as well as our theories.  He was particularly interested in going with the insufficient dopamine theory and prescribed me Mirapex, a dopamine agonist (read: increases dopamine) that is often prescribed to sufferers of Parkinson's and Restless Leg Syndrome.

I'm trying to write an objective note here, but I'm super freakin excited to try this.  This doc has also agreed to treat me over Skype!  Will save me the 4 hours to get to DC.  I feel like I have an ally in him, it's really validating!

He told me to have an O tonight and try taking the starting dose immediately after.  That was 20 minutes ago.  I will keep updating this as the week progresses and I take more of Mirapex.