Re-examining Neurally Mediated Hypotension

[haidcat]

None of this applies if you either do not get heart palpitations during or after orgasm or do not get low blood pressure/feel lightheaded with orgasm or afterwards

Hey guys, I recently got diagnosed with neurally mediated hypotension by my cardiologist, and I know I have brought up the whole POTS/Neurally mediated hypotension theory up before, but I wanted to add more information about what I have learned and why this might relate to POIS.

Basically, POTS and Neurally mediated hypotension both fall under a condition known as orthostatic intolerance, I encourage all of you to look up these terms.

What basically goes on with these issues is that the body is either low in blood volume or it is bad at constricting vessels enough to allow for enoughblood to reach the brain.

 With POTS, the body compensates with this low amount of blood going to the brain by causing a rather rapid heart beat through adrenaline and NE, with neurally mediated hypotension the body doesnt engage in this rapid heart rate to cause more blood blow to the brain. So with NMH(neurally mediated hypotension) the person will have low blood pressure during episodes. While with POTS, the person will have normal blood pressure but way too much stress hormones causing an uncomfortable rapid heart rate.

BOth POTS and NMH have what are called "episodes" in which this low blood flow to the brain/ rapid heart rate occurs. These epidoes happen usually during: 1. prolonged standing. 2. physical exercise 3. warm showers, warm weather. 4. After eating 5.stresful events. Essentially they happen when blood gets shunted somewhere in the body away from the brain.

I have a strong suspicion that a lot of us on here have this condition without even knowing it, I apparently have it and did not know this until very recently.

As to how this relates to orgasm/sexual stimulation. Where does blood go during stimulation? Away from the heart for sure :p. And what happens during orgasm? A massive release of noradrenaline. The key here is that one single episode of either low blood flow to the brain OR a rapid heart beat for sustained amount of time, can cause a myriad of symptoms including muscle pain, fatigue, sensitivity to light/noise, irritability, etc, for more than a day.

We may be getting these episodes from orgasm, from just having an erection, and from smaller things throughout the day like heavy meals, hot showers, too much standing etc. This would explain why several of us get POIS not just from orgasm but from stimulation also.

I encourage people who are not helped by niacin to look into Neurally mediated hypotension/POTS and the treatments for them. it just might help.

[haidcat]

A couple of more things to add:
From leading researcher on this condition:

Symptoms of OI:

The blood pressure and heart rate changes in NMH and POTS are accompanied by orthostatic symptoms such as lightheadedness, dizziness, nausea, fatigue, tremors, breathing or swallowing difficulties, headache, visual disturbances, sweating and pallor. Many patients develop swollen, bluish legs, providing evidence of blood pooling in the lower part of the body. These symptoms can become worse or be provoked more quickly in warm temperatures or hot indoor environments like saunas. (This last part is what many people who commented on the cooling cap story reported.)

And its also interesting that this same doctor mentions that with many patients, if they have allergies that these allergies MUST be treated for the POTS/NMH to get better, along with the other treatments that are required. So BOTH antihistamines/antiinflammatories  AND the other treatments(raise blood volume/prevent blood pooling in the limbs), are needed to fully treat this condition when allergies are present.
The Doctor mentioned the typical allergies and food allergies, but considering that POIS could very well be an allergy problem, what could be going on is some of us have this POTS/NMH and an allergic reaction from orgasm.

What has helped me quite a bit with POIS symptoms:
1. Dont take hot showers at all
2. Never eat large meals, which shunt blood to the digestive system
3. Never stand too long
4. Drink enough fluids to make sure that my blood pressure never gets too low(this includes taking salt and potassium with water sometimes, the salt increases water in blood vessels, and the potassium prevents too much urination of water)
5. Beta blockers- these prevent the rapid heart rate issue, that I get with orgasm
6. There are medications for this condition, but I have not tried them yet, it would be interesting to see if anyone else on here has either POTS or NMH.

What I have not figured out and am trying to figure out is how to stop the damn allergic aspects of this problem, the constant mucus drainage in my throat, sinus congestion, mucus in eyes, etc. I am currently taking zyrtec and will take it for a while to see if it helps with the allergic aspects of this terrible thing.

[Egordon]

I think this is a really exciting prognosis for us, as I've long suspected that this disorder was related to blood flow to the brain -- it goes some way towards explaining our huge need for water while under pois, and the fatigue/confusion I experience when I'm under and I exercise.

A problem for me, though, would be getting diagnosed. While I'm exercise intolerant when I'm under, normally I can exercise/stand with no problem (in fact, exercise typically makes me feel better -- which could provide support to the hypotensive hypothesis). And I don't get elevated heart rate after o, I don't think...

In any case, how are you being treated? Did they put you on a beta blocker? How have you responded? And how were you diagnosed? Were you under POIS when they did the test or do you have your symptoms perpetually?

[haidcat]

What is interesting is that people with neurally mediated hypotension, can excercise, actually, they can handle exercise better than just standing still, because the leg movements pump blood back up  to their brains. Also, if you have NMH you will not necessarily get a pounding heart rate after an O. What will happen though, and this is something you can test, is you will get an abnormally low blood pressure after certain things, such as hot showers, standing for greater than 30 minutes without much movement, eating too much, have an erection for too long, etc.

I have been put on beta blockers and while they definitely help, they are not enough, I am seeing my cardiologist in a couple of weeks and they said they might put me on the SSRI called Paxil, which has been shown to increase blood pressure, and therefore allow more blood flow to the brain.

Also, I was under POIS, I am always under POIS, lol. MY pois lasts around 3 weeks, and honestly at my age, I am way too damn horny to resist that long.

[Egordon]

Interesting! This jibes with what i've experienced. But how were you diagnosed? Do you normally have high blood pressure or only when you're under POIS?

As for your perpetual POIS, have you ever tried non-steroidal anti-inflammatories? I use Celebrex and it eliminates all the inflammation -- you should definitely talk to your doctor about it. But i'm interested in your diagnosis as I still don't always feel absolutely sharp.