Silodosin-induced anejaculation a potential treatment for postorgasmic illness syndrome

Silodosin, which helps patients achieve anejaculation, may be an effective treatment for postorgasmic illness syndrome (POIS), a recent study has found. Nevertheless, POIS remains an understudied condition with debilitating consequences on patients and their partners, underscoring the need for further investigations.

Researchers conducted a retrospective, observational study of 14 patients seeking treatment for POIS. The study objective was to characterize POIS and identify potential treatments, for which silodosin, an alpha1A-blocker, was tested.

Twelve patients (86 percent) had POIS complaints after any type of sexual contact. Most frequently, complaints included extreme fatigue, nose congestion, pressure of a heavy head, and muscle tension (>30 percent for all). All participants reported experiencing more than one of the aforementioned symptoms.

POIS was accompanied by sexual problems, too, including lifelong premature ejaculation (n=2) and reduced libido (n=3); there were no reports of erectile dysfunction. Seventy percent of patients said that POIS also affected their partners’ sexuality, while 90 percent reported a loss of intimacy.

Laboratory tests were largely normal in all patients, with none of the urine and blood examinations revealing notable abnormalities.

In terms of treatment, all 14 participants were given first-line, on-demand silodosin at 8-mg doses. Eight patients (57.1 percent) achieved orgasm without ejaculation and reported no postorgasmic complaints. The seven unresponsive patients received ibuprofen 400 mg, leading to improvements in two patients.

The five remaining patients unresponsive to silodosin and ibuprofen were given prednisone as third-line treatment. Four showed symptom improvements. The remaining patient was given supportive therapy.

“For the first time, anejaculation was described as a possible symptomatic treatment aiming at the possible source of the postorgasmic symptoms. These findings need verification in large multicentre clinical trials, allowing much more progress in the diagnosis and management of POIS,” the researchers said.