[5][2][6] Additional symptoms include headache, dizziness, lightheadedness, extreme hunger, sensory and motor problems, intense discomfort, irritability, anxiety, gastrointestinal disturbances, craving for relief, susceptibility to nervous system stresses, depressed mood, and difficulty communicating, remembering words, reading and retaining information, concentrating, and socializing.
[4] An online anonymous self-report study found that 80% of respondents always experienced the symptom cluster involving fatigue, insomnia, irritation, and concentration difficulties.
[11] Dhat syndrome is thought to be a culture-bound psychiatric condition and is treated with cognitive behavioral therapy along with anti-anxiety and antidepressant drugs.
[14] Post-coital tristesse (PCT) is a feeling of melancholy and anxiety after sexual intercourse that lasts anywhere from five minutes to two hours.
[1][18][19] This was conditioned by another study stating "IgE-mediated semen allergy in men may not be the potential mechanism of POIS".
[6] Alternatively, POIS could be caused by an auto-immune reaction not to semen, but to a different substance released during ejaculation, such as cytokines.
[medical citation needed] The majority of POIS symptoms like fatigue, muscle pains, sweating, mood disturbances, irritability, and poor concentration are also caused by withdrawal from different drug classes[21] and natural reinforcers.
There is anecdotal evidence on porn addiction internet forums, that many men experience POIS like symptoms after ejaculation.
Intense emotional stimuli during sexual intercourse can lead to autonomic imbalance with parasympathetic over-reactivity, releasing mast cell mediators that can provoke postcoital asthma and / or rhinitis in these patients.
[4] An online survey study suggested that only a small number of self-reported POIS fulfill entirely the five criteria.
This study proposed to change the Criterion 3 with “In at least one ejaculatory setting (sex, masturbation, or nocturnal emission), symptoms occur after all or almost all ejaculations.”[8] There is no standard method of treating or managing POIS.
[citation needed] Affected individuals typically avoid sexual activity,[4] especially ejaculation,[1] or schedule it for times when they can rest and recover for several days afterwards.
[5] In case post-coital tristesse (PCT) is suspected, patients could be treated with selective serotonin reuptake inhibitors.
[11][24] In one patient, the POIS symptoms were so severe, that he decided to undergo removal of the testicles, prostate, and seminal vesicles in order to relieve them.
[27] Another patient, in whom POIS was suspected to be caused by cytokine release, was successfully treated with nonsteroidal anti-inflammatory drugs (NSAIDs) just prior to and for a day or two after ejaculation.