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J Sex Med. 2009 Aug;6(8):2271-7. doi: 10.1111/j.1743-6109.2009.01328.x. Epub 2009 Jun 2.

Weak with sex: sexual intercourse as a trigger for cataplexy.

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  • 1Department of Neurology, University Hospital Zurich, Zurich, Switzerland.

Abstract

INTRODUCTION:

Sudden, often positive emotions are typical triggers for cataplexy in patients with narcolepsy-cataplexy (NC). Cataplexy during sexual intercourse and orgasm (orgasmolepsy) has been previously reported, but its frequency and characteristics are poorly known.

AIM:

To assess frequency and features of loss of muscle tone during sexual intercourse in a series of patients with NC, other sleep-wake disorders, and healthy controls.

METHODS:

Review of sleep questionnaires (including the Stanford Cataplexy Questionnaire) of 75 subjects (29 with NC, 26 with other sleep-wake disorders, and 20 healthy controls), followed by an interview with specific focus on muscle loss during sexual activity in suspicious cases.

MAIN OUTCOME MEASURES:

Cataplexy during sexual intercourse and orgasm (orgasmolepsy).

RESULTS:

Orgasmolepsy was reported by three NC patients (two female, one male), one male patient with behaviorally induced insufficient sleep syndrome (BIISS) and cataplexy-like symptoms, and none of the healthy controls. In the two female NC patients, orgasmolepsy occurred by each sexual intercourse, and the male patient reported orgasmolepsy only when in a relationship involving emotional commitment and trust. In the patient with BIISS and orgasmolepsy, cataplexy-like symptoms involved unilaterally upper or lower limbs in association with negative emotions or sports activities.

CONCLUSIONS:

Cataplexy during sexual intercourse is a distinct feature of NC, which can, however, be reported rarely also by patients with other sleep-wake disorders. Insufficient arousal may favor the occurrence of cataplexy and cataplexy-like symptoms, including orgasmolepsy. Hypocretin deficiency and reward dysregulation in narcolepsy may further facilitate this phenomenon and contribute to its repetitive occurrence.

PMID:
19493288
[PubMed - indexed for MEDLINE]
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