I think "excessive masturbation syndrome", which I would consider a subset of "sexual exhaustion syndrome", is a condition where there are predisposing underlying problems.
The addition of sexual activity past a certain amount stresses then collapses compensatory mechanisms that had previously allowed one to function well.
If these underlying problems did not exist, then sexual exhaustion syndrome would not occur.
Common underlying problems include thyroid problems, immune system inflammatory activity, hypothalamic-pituitary-adrenal dysregulation, chronic infections, nutritional deficiencies, insulin resistance and diabetes, nervous system dysfunction, environmental stress, hypogonadism, etc.
Sexual function involves information processing activity involving the brain's libido circuits and the primary seeking circuit. There are many intercellular signals involved including dopamine, norepinephrine and oxytocin, testosterone, estradiol, etc. These promote interpersonal connectiveness, sex drive, sexual pleasure and excitement. Dopamine signaling helps trigger the primary seeking circuit to determine the form of sexual behavior that satisfies the libido circuitry. Norepinephrine signaling occurs within the sympathetic nervous system as a component of the libido circuitry. It helps promote excitement during sex. And a pulse of norepinephrine triggers the orgasm.
One problem with the circuitry is the use of norepinephrine as a signal. Norepinephrine has multiple systemic actions aside from sexual function. It is the primary signal for stress (thus sex itself can be considered a stressful, though enjoyable activity). Norepinephrine also triggers energy on demand. It increases thermogenesis. It can lead to changes in thyroid function - up or down. It can lead to insulin resistance, increasing the need for insulin production. It can change renal function, leading to the loss of zinc, iodine and other minerals. It can activate immune system pro-inflammatory signaling. Etc.
If there are underlying problems which already increase stress or demand for norepinephrine signaling, then the sum of these and additional sexual activity can increase norepinephrine signaling excessively leading to the problems one can experience with sexual exhaustion. Some of the changes can lead to positive feedback signaling loops which are self-perpetuating - resulting in a prolonged illness, if triggered. Some of the positive feedback loops prolong sympathetic nervous system, i.e. norepinephrine, signaling. Some changes can result in nutrient deficiencies which cause prolonged dysfunction if not addressed.
In briefly reviewing the symptoms listed on the internet for over-masturbation or sexual exhaustion syndrome, I found the following:
anxiety
depression
insomnia
lack of energy
impaired memory
mood swings
loss of libido
erectile dysfunction
headaches
body pain
blurred vision
flushed face
constipation
frequent urination
dizziness
palpitations
hair loss
Note that these symptoms indicate a systemic problem. Generally, the systems involved include the nervous system, endocrine system, immune system, metabolism and nutrition.
Some simple associations between function and a few of the signals or nutrients that are most often affected are as follows:
Anxiety: norepinephrine, serotonin, cortisol, CRH, thyroid, dopamine, testosterone, progesterone, etc.
Depression: dopamine, inflammatory cytokines, iron, Vitamin A, B-vitamins, vitamin D, testosterone, etc.
Insomnia: norepinephrine, thyroid, cortisol, iron, etc.
Lack of energy: thyroid, inflammatory cytokines, norepinephrine, cortisol, insulin, iron, vitamin A, B-vitamins, salt-intake, etc.
Impaired memory: dopamine, norepinephrine, thyroid, inflammatory cytokines, B-vitamins, Vitamin A, etc.
Mood swings: norepinephrine, inflammatory cytokines, cortisol, testosterone, estradiol, thyroid, iron, Vitamin A, B-vitamins, protein intake, etc.
Loss of libido: norepinephrine, inflammatory cytokines, testosterone, estrogens, thyroid, cortisol, iron, zinc,
Erectile dysfunction: norepinephrine, inflammatory cytokines, testosterone, estrogens, thyroid, cortisol, nitric oxide, protein intake, etc.
Headaches: inflammatory cytokines, norepinephrine, cortisol, etc.
Body pain: inflammatory cytokines, norepinephrine, cortisol, thyroid, iron, aldosterone, etc.
Blurred vision: norepinephrine, thyroid, inflammatory cytokines, iron, etc.
Flushed face: norepinephrine, thyroid, inflammatory cytokines, iron, etc.
Constipation: thyroid, norepinephrine, etc.
Frequent urination: norepinephrine, thyroid, inflammatory cytokines, iron, etc.
Dizziness: norepinephrine, inflammatory cytokines, aldosterone, cortisol, nitric oxide, salt-intake, etc.
Palpitations: norepinephrine, inflammatory cytokines, cortisol, etc.
Hair loss: norepinephrine, thyroid, inflammatory cytokines, testosterone, estradiol, DHT, DHEA, zinc, biotin, etc.
Treatment of sexual exhaustion syndrome would involve assessing and addressing the psychosocial factors, nervous system factors, endocrine system factors, immune system factors, metabolic and nutritional factors that are involved to cause dysfunction once sexual activity is added to the system. Often there are multiple underlying problems. Generally, mental dysfunction (e.g. sexual dysfunction) indicates the presence of multiple underlying problems, often involving multiple body systems. __________________
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Romeo B. Mariano, MD, physician, psychiatrist