Sadness After Sex: What Is Post-Coital Dysphoria?

Ph.D., CPsychol., AFBPsS, Health Professional
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We don’t have to look far to find all sorts of advice about sex. Bookshelves are filled with information about dating, relationships, having good sex, and having bad sex. But where’s the information about the things that occur immediately after sex? Have you ever been in a situation where the person with whom you’ve just shared the most intimate moments started to cry, or looked utterly miserable? Perhaps these things went through your head: Was it something you did or didn’t do? Were you really that bad between the sheets? Are they now so full of regret that it’s come to this? What’s much more likely is that you’ve witnessed something called post-coital dysphoria.

Post-coital dysphoria (PCD), otherwise known as post-coital tristesse or, more commonly, “post-sex blues,” is the experience of feeling upset immediately after sex. A 2015 study published in the Journal of Sexual Medicine indicates that PCD is a broad term that embraces a number of emotions, such as anxiety, agitation, tearfulness, melancholy, agitation, and aggression. The article points out that PCD is both under-recognized and under-researched, yet is quite common. Of the 230 females who took part in this study, 46 percent reported PCD symptoms at least once in their lifetime, and just over 5 percent reported symptoms within the previous four weeks.

Causes of post-coital dysphoria

The fact that PCD is so under-researched leaves us in a situation of speculation. It appears to occur in both men and women to some degree, and because there appear to be no long-lasting negative effects, the situation might be considered perfectly normal. As of early 2018, the International Society for Sexual Medicine provides a single page of information about PCD. They speculate that the bonding process during sex is so intense that breaking the bond triggers sadness. There is also some indication that childhood sexual abuse could play a part. This comment may refer to an earlier study that reported a correlation between PCD and childhood sexual abuse, based upon the self-reports of 222 female university students.

Could hormones cause sadness after sex?

I’m certainly no expert in the field of PCD, but when it comes down to it, I’m not sure who is. When I searched around for explanations, two things quickly became clear. The first is that PCD is so common that we shouldn’t be overly concerned about it. The second is that the likely cause may well be hormonal.

In terms of the hormonal aspect, I did struggle to find a solid reference to back such claims. It’s easy enough to find magazine articles that use a sex therapist or psychologist as their source, but that’s as far as I got. However, the hormone explanation suggests that during sex, there is a rush of hormones such as dopamine, oxytocin, and endorphins, followed by the release of other hormones, notably prolactin, low levels of which have been linked to male sexual problems. In PCD, so the argument goes, the same hormones that result in a feel-good factor most of the time can also generate more negative feelings.

Psychological explanations for post-coital dysphoria

It stands to reason that if mental health issues, such as stress, anxiety, and depression, are affecting everyday lives, these could easily affect sexual activity as well. But there is also the possibility that relationship problems exist, or perhaps something about sex itself is troubling. In these situations, it’s important to try to uncover the issues and bring them into the open with your partner. Talk about what you feel comfortable doing and what makes you uncomfortable. For many people, intimacy continues after orgasm; so, for example, if your partner jumps out of bed leaving you feeling a bit “used,” then say so. If the situation goes deeper, as in the case of some former sexual abuse, it may be wise to seek professional counselling.

Don’t normalize what’s uncomfortable

I mentioned earlier that one of the most common things I’d read about PCD suggested it was so normal that we shouldn’t be too concerned. I certainly don’t want to cause unnecessary upset, but I’m concerned that we know so little about the extent or breadth of PCD that statements like this may be viewed as dismissive.

Perhaps a little sadness or mild anxiety after sex is nothing to be worried about, but I would argue that something like aggression should not be viewed as normal or acceptable. My message, therefore, is simple: Don’t try to normalize what feels uncomfortable to you. Try to verbalize why you feel uncomfortable and if that doesn’t work, consider therapy.

See more helpful articles:

Do You Feel Depressed After Sex? You are Not Alone

What to Do After Sexual Assault: First Steps

Coping With Disinhibited and Inappropriate Sexual Behavior