Making sense of “postcoital dysphoria.”

By David W. Wahl Ph.D.

• Postcoital dysphoria (PCD) involves feelings of sadness, depression, or anxiety after sex that last anywhere from a few minutes to several hours.
• Nearly half of men and women report experiencing at least one instance of postcoital dysphoria.
• Guilt surrounding sex, body or performance issues, or past sexual trauma can all contribute to postcoital dysphoria.
• In many cases, talking with a partner can help soothe feelings of post-sex sadness. In cases of trauma, talking to a therapist may be helpful.

The sexual interlude comes to a close. The couple parts and lie side by side in the dark. One partner experiences a feeling of relaxation and happiness. The other, however, feels empty and sad—feelings that were not present before or during the sexual encounter.

Why do some people have feelings of sadness or anxiety after sex, and how common is this occurrence? It’s called postcoital dysphoria (PCD). It involves feelings of sadness, depression, or anxiety that occur after a sexual encounter. These feelings can last anywhere from a few minutes to several hours. It can occur on a single or a few occasions, or it can be embedded as a pattern in sexual experience.

Not only is this condition more common than you may think, but almost anyone is susceptible to PCD—regardless of sexual orientation or gender—although not everyone experiences PCD in the same way. In a pair of university studies in Australia, researchers sought to discover how often people experience PCD and the symptoms attributed to it, a subject the researchers deemed to be under-researched. In the first study (Schweitzer, O’Brien, and Burri, 2015) of female respondents (N=230), researchers reported that 46 percent of the study’s participants claimed to experience PCD at some point in their lives. This percentage was slightly less in the male study (Maczkowiack and Schweitzer, 2018), in which 41 percent of male participants (N=1208) reported having experienced PCD.

Why Does Postcoital Dysphoria Occur?

While PCD is understudied, as noted in both the aforementioned research projects, there is not a lack of potential underlying causes of this condition. Possible reasons for feelings of sadness following an intimate moment include:

A hormonal response. The body is saturated with a rush of hormones during arousal and orgasm, after which there is a dramatic drop in hormone levels. This drop can carry with it a negative emotional response.

Guilt about having sex. This is not to say that there was not consent. Some individuals have sex based on hormonal or emotional impulses and afterward, regret the decision they made, wishing they had waited to have sex in a different situation, location, or with a different partner. This reason is often echoed in my interviews with research participants on the subject of their loss of virginity.

Relationship feelings. Uncertainty about the state of the relationship comes into play with the negative feelings one may feel after having sex. This is particularly evidenced when an individual has sex believing it will save a relationship or they have sex believing it will better define the state of the relationship.

Body issues are voiced with regard to postcoital feelings of depression when an individual is particularly unhappy with their body. Not only is there concern emanating from how they view their own body, but there can also be anxiety in wondering what their partner thinks about their body. All this can feed into a negative postcoital response.

Sexual performance. Just as someone may have negative feelings after sex with relation to their body and concern for the thoughts their partner has about their body, they may also be concerned about their sexual performance. Not only may they question whether or not they performed adequately, the more pressing question may be what their partner thought of their performance. Without talking about it with their partner, this can be a considerable source of anxiety and depression for some people.

Lack of orgasm. PCD can also be a question of orgasm. Insecurity about one’s sexual performance is one thing, but the same depression and anxiety can set in if their partner didn’t orgasm. This isn’t necessarily a performance issue. When a partner does not orgasm, it may have nothing to do with their intimate other’s performance. There are many physiological, emotional, and social reasons why someone does not have an orgasm (I’ll save this for a future column). Nevertheless, the lack of orgasm in one person may lead to sadness and depression in the other when self-doubt sets in. Furthermore, the individual that did not have the orgasm, for whatever reason, may also experience PCD when the self-posed questions about their inability to orgasm emerge.

Sex as a triggering event. When an individual has experienced sexual trauma, whether that trauma has been addressed or not, sexual encounters can trigger a negative response for the individual. That trigger may not occur until after the sexual experience, although it can occur at any point in the process.

Sex as a band-aid. Having problems in the relationship? Sex may not be the answer. In many cases, sex is, at best, a temporary band-aid. While it may seem like the bonding experience the relationship needs, it can further complicate the situation and take an emotional toll. This is especially true if sex is being used to prevent a break-up or an attempt to re-spark a relationship with an ex.

Infrequent sex may be another reason. Perhaps the individual is sad because they know that particular sexual encounter may the last one for quite a while. This is a genuine concern and source of postcoital negative emotions for some in sexless relationships. A sexless relationship defined here as a sexually involved relationship where the frequency of sexual activity is less than ten times per year. The knowledge that the recently completed sexual encounter may be the last one for a long time causes some people to feel sad and more harshly evaluate the recent sexual venture.

Sexual socialization. Our sexual scripts are often shaped through the process of socialization. If an individual was socialized to feel shame about sex, those feelings may manifest in the reactions they have following an intimate encounter.

The intensity of orgasm. Finally, feelings of anxiety, depression, or sadness may be attributed to the intensity of the orgasm. Until the body relaxes and the mind clears a bit, a good orgasm does have the potential to be a cause of these postcoital negative states.

How to Manage Postcoital Dysphoria

What can one do if they experience these negative feelings after sex? In some cases, a focused self-reflection is all that is needed. Sometimes we can identify the origins of the issue by ourselves and act to reassure ourselves and bring calm.

For many of the causes listed, talking to your partner can be a relatively easy remedy. If the anxiety or sadness is based on sexual performance or lack of orgasm, talking about it is a good first step. People in the kink and BDSM community often provide what’s known as aftercare to help ensure the well-being of their partner. The same type of aftercare, wherein partners make sure the other is OK, can become part of any sexual routine, whether there is a noted need for it or not.

If, however, negative postcoital feelings are a result of the triggering of past traumatic events, professional help is recommended. Seek out a qualified healthcare professional and get the attention you need.

Sex can be a wonderful and rewarding experience, but PCD can negatively impact the sexual episode. Acknowledging the feelings, in yourself or your partner, recognizing the origins of the feelings, and taking proper care to attend to them, can only serve to enhance sexual well-being.

Originally published at Psychology today