Table 1.
Studies evaluating the purposed mechanism and treatment
| Study | Year | Design | Cases (n) | Purposed mechanism | Treatment |
|---|---|---|---|---|---|
| De Amicis et al.8 | 2020 | CR | 1 | Psychological disorder | Immunotherapy |
| Reisman15 | 2021 | CS | 14 | NAa | Treatment modalities |
| Highly selective alpha 1A blocker (silodosin) | |||||
| If unresponsive, ibuprofen | |||||
| If still unresponsive, prednisone | |||||
| Pierce et al.12 | 2020 | CR | 1 | Sympathetic dysregulation | Alpha-blockers (terazosin and alfuzosin) |
| Takeshima et al.6 | 2020 | CR | 1 | Hypogonadism | NSAIDs (celecoxib) followed by TRT |
| Bolanos and Morgentaler13 | 2020 | CR | 1 | Testosterone deficiency | Subcutaneous injections of hCG |
| Kim et al.18 | 2018 | CR | 1 | Allergic type I hypersensitivity reaction | Intralymphatic immunotherapyb |
| Depreux et al.19 | 2018 | CR | 1 | Involvement of neurobiochemical mediators | NA |
| Jiang et al.11 | 2015 | CR | 1 | Disorder of the endogenous µ-opioid receptor system | NA |
| Waldinger et al.2 | 2011 | CS | 45 | Combined types I and IV allergic reaction | NA |
| Waldinger et al.17 | 2011 | CR | 2 | Immunogenic/allergic etiology | Hyposensitization treatment |
| Waldinger and Schweitzer1 | 2002 | CR | 2 | NA | Benzodiazepines and SSRIsc |
aSilodosin, which can cause anejaculation, was an effective treatment in 57% of the POIS patients. bIntralymphatic immunotherapy plus prescription drugs, including NSAIDs, antihistamine, and mucolytic drugs. cCombined use of flutamide to diminish ejaculation frequency. CR: case report; CS: case series; hCG: human chorionic gonadotropin; NSAIDs: nonsteroidal anti-inflammatory drugs; NA: not applicable; SSRIs: selective serotonin reuptake inhibitor; TRT: testosterone replacement therapy; POIS: postorgasmic illness syndrome