Thoughts/help With Possible POIS (dopamine/testosterone/prolactin/etc.)?

VelvetNerves

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Feb 24, 2018
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After 14 years of sexual activity with no problems, and 4 years into a stress/insomnia crisis (but in an improving period), I've started having fairly severe problems after sexual activity.

For about 12 hours after I have physical discomfort (pressure in head/temple, a little achy, dry eyes), cognition issues (basically brain fog and lack of motivation), mood issues (a little anxious/depressed/fearful/hopeless), and exacerbation of sleep issues (sleep onset issues, which I had worked past).

Ibuprofen (NSAID, also anti-glutamate) helps with a bit of the physical discomfort.

Naltrexone (kappa-antagonist, pro-dopamine) helps a lot with the cognition issues, however naltrexone is very short lived and the additional mu/delta antagonism causes anxiety/discomfort if you try to dose higher to get more relief.

Naltrexone + progesterone (hormone/steroid, Sigma-1 antagonism, pro-GABA) helps mostly with the mood issues.

Progesterone + melatonin helps somewhat with the sleep issues, making sleep onset maybe possible, but also making my sleep quality/percent NREM (I've worked on my sleep issues for years; I still have very light/dreamy sleep) worse.

Thoughts? What is this POIS thing? Prolonged testosterone receptor downregulation, higher prolactin levels, and/or lower dopamine levels or higher re-uptake, etc? Anyone cured this thing? It's been about a year now.
 
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