Psychiatrist Explains, “Why Do I Feel Sad After Sex?”

Have you experienced sadness or depression after sex? If so, you’re not alone. Postcoital dysphoria (PCD), also known as postcoital tristesse (PCT), is a common condition where you feel anxious, depressed, or even irritable after sex or masturbation. It can be helpful to understand the causes of post-sex blues, how to discuss these issues with your partner(s), and when to seek support.

What Is Postcoital Dysphoria?

Postcoital dysphoria is a condition where you feel sad, anxious, panicked, or irritable after sex. Although it’s not frequently discussed, postcoital dysphoria is relatively common. One study found that 46% of women experience postcoital dysphoria at least once, although this number could even be higher.

Men experience postcoital dysphoria, too. Another study found that 41% of men have experienced PCD in their lifetime, and approximately 20% experienced PCD in the previous four weeks.

Postcoital dysphoria can be diagnosed by a physician or therapist. However, it’s not necessary to get a diagnosis before you reach out for help. The diagnostic criteria for PCD are as follows:

  • The individual experiences persistent mood disturbances following sexual activity
  • The mood disturbances are not due to any other mental disorder or medical condition
  • The mood disturbances cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
  • There is an absence of any satisfying sexual encounters after the onset of the disturbance

In addition to meeting the diagnostic criteria for PCD, individuals may also experience postcoital symptoms such as depression, crying, anxiety, irritation or aggression, regret or guilt, shame, numbness or emptiness, and in some cases, panic attacks.

What Causes Sadness After Sex?

More research is needed on the causes of postcoital dysphoria. However, researchers have identified a few possible psychological correlates that could contribute to the feeling of depression after sex including hormones, past sexual trauma, relationship difficulties, difficulties with sex, and underlying conditions like depression, anxiety, or stress.

Past Sexual Trauma

One potential cause of PCD is a history of past sexual trauma. Individuals who experienced sexual trauma or childhood abuse may be more likely to develop PCD later in life due to feelings of guilt or discomfort associated with sex. Sex is a hugely intimate act, and those who have experienced sexual abuse or a traumatic event during sex may be more likely to notice negative feelings after sex.

Biological Factors

Biological factors may also contribute to PCD. Orgasms release a surge of dopamine and other hormones in the brain. In particular, the release of oxytocin and prolactin may lead to feelings of discomfort or sadness if their calming effects are reduced too quickly from peak levels.

Environmental Factors

If an individual is not receiving adequate support or understanding from their partner(s), they could be more likely to feel ashamed or guilty about engaging in sexual activities which could contribute to the onset of negative emotions associated with postcoital dysphoria.

Ultimately, there are several possible reasons why many people experience postcoital dysphoria, or the “post-sex blues at some point in their lives. However, if it’s causing you distress, you might benefit from speaking with a therapist, doctor, or qualified healthcare professional.

How to Treat or Manage Postcoital Dysphoria

Postcoital dysphoria is common, and it’s not always cause for concern. However, if you find your PCD symptoms distressing or if they happen frequently, some strategies can help.

If you find yourself experiencing negative emotions following a sexual encounter, try journaling, relaxation techniques, taking a warm bath or shower, mindful breathing exercises, or doing something distracting like watching a movie or communicating with your partner(s).

For some, speaking with a therapist in individual or couples therapy can be helpful. To manage persistent postcoital dysphoria, you may need to experiment with a few different strategies, post-sex rituals, or treatment options before you find a method that works for you.

When To Seek Support From An Individual, Couples, or Sex Therapist

In the long term, therapy can be helpful with PCD, while self-help strategies are great to practice in the moment. There are many types of professional support available that can help those struggling with PCD. These include therapy sessions with a clinical psychologist or psychiatrist, group counseling sessions led by a trained mental health professional, or online resources such as self-help groups or chat rooms.

It’s always important to prioritize other wellness strategies including exercise, meditation, journaling, eating a balanced diet rich in nutrient-dense foods, and practicing healthy coping techniques with stressors in your life.

Postcoital Dysphoria: What’s Next?

Feeling sad, anxious, or agitated after sex is surprisingly common. However, if it’s a frequent issue for you, you may want to seek treatment.

The exact cause of PCD is unknown, but it may be linked to biological, environmental, or psychological factors, from sexual trauma to general stress and anxiety. Additionally, individuals with existing psychiatric disorders are more prone to experiencing PCD. Treatment for PCD may include therapy, self-care strategies such as stress management activities or mindfulness techniques, and social support groups. Seeing a psychiatrist for medications may be helpful, as well.

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