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What to Know About Postcoital Dysphoria

Medically Reviewed by Dan Brennan, MD on June 11, 2021

When you get a sad or irritable feeling after consensual sex, you may have postcoital dysphoria (PCD). This is commonly referred to as “post-sex blues.” This happens when you feel a range of negative feelings after wanted sexual activity. You can feel a range of emotions including sadness, irritability, agitation, anxiety, and depression after sex with a partner. 

What Is Postcoital Dysphoria?

PCD refers to negative feelings after sex. This is different from female sexual dysfunctions (FSDs) which refer to feelings and functions before or during sexual activities. When you have PCD you may feel melancholy or depressed after sex. You may also get aggressive or feel agitated, even if the sex was wanted by you and your partner.

Postcoital dysphoria occurs more in women than men. Most studies have focused on the condition in females. Symptoms of PCD can happen after completed consensual sex. It can happen even after physical pleasure and orgasm.

Symptoms of PCD in women include: 

  • Tearfulness
  • Sadness
  • Anxiety and depression
  • Irritability
  • Feeling unsatisfied 

Although there’s not a lot of research, recent studies show that PCD is a common experience for men too. In one study, 41% of men reportedly experienced PCD at least once in their life. Of men in the study, 3% had PCD regularly.

Regardless of the cause, postcoital depression is a term only used to describe negative feelings after consensual, enjoyable sex. It doesn’t refer to assault or forced sexual activity.

Causes of Postcoital Dysphoria

There’s not a lot of research that specifies an underlying cause of PCD. However, scientists believe multiple factors lead to these feelings. 

Abuse. Having a history of childhood sexual abuse might make you more at risk for PCD. Sexual abuse from a young age or in your adult years can cause symptoms of PCD. Physical and emotional abuse may also put you at risk for postcoital dysphoria later in life. 

Anxiety. These childhood traumas might also cause anxiety and depression. These mental health conditions can be linked to feelings of sadness or cause behavioral problems. 

Resentment. If you have a history of abuse, you may be more resentful about sex or sexual experiences. You may feel like you don’t have complete control over these encounters which can cause anxiety. You could also feel like you need to assert your wants and needs, which can make you irritable. 

Postnatal depression. Hormonal fluctuations can cause postnatal depression. Postnatal depression, also known as postpartum depression, is depression that happens shortly after you give birth.

Women with postnatal depression are also more likely to experience PCD. The way your estrogen fluctuates your body is more sensitive to estrogen, and that makes you more at risk for postnatal depression. Depression can make you feel sad even after enjoyable sex. 

Intimacy and Postcoital Dysphoria

Intimacy and close relationships are not a factor in PCD. Studies have found no correlation between the two. Two components of intimacy play a part in how you function sexually. 

Role of attachment. In this case, how attached you become in your relationship can affect your level of intimacy. You may become more intimate and this can cause you to become more attached. 

Differentiation of self. The ability to healthily manage intimacy in your relationships and not intertwine your identity to your intimate relationships can play a role in how you feel after sex. Being able to remove your emotions from your rational mind also affects how you choose to have intimacy in your life. 

Despite the misconception, postcoital dysphoria is not caused by a lack of intimacy or determined how close your relationship is. You may be in a healthy, intimate relationship but still feel sad, or anxious, and depressed after sex. 

Mental Health Effects on Postcoital Dysphoria

If you experience anxiety, depression, childhood and adult trauma, or postnatal depression, you have a higher chance of having PCD. These conditions can turn your good sexual experience into feelings of doubt, shame, or sadness afterward. 

You should talk to your doctor about these feelings. You can also see a psychotherapist to treat the underlying cause of PCD. With cognitive behavioral therapy, they can help you overcome these feelings and traumas.

Sex can put you in a vulnerable position. When you have underlying anxieties or concerns, these feelings may be more likely to surface after sex. A therapist can help you work through these feelings. 

It's okay to talk to your partner about these feelings. If you're in a safe, intimate relationship you should feel comfortable bringing up your feelings. Having an open conversation might also help you work through these feelings of sadness after sex. 

WebMD Medical Reference

Sources

SOURCES:

Journal of Depression and Anxiety: “Overlap of Postnatal Depression and Postcoital Dysphoria in Women-Implications for Common Underlying Mechanisms.”

Journal of Sex and Marital Therapy: “Postcoital Dysphoria: Prevalence and Correlates Among Men.”

Mayo Clinic: "Postpartum depression."

Psychology Today: “Post-Sex Blues: Both Men and Women Say They Have It.”

Sexual Medicine: “Postcoital Dysphoria: Prevalence and Psychological Correlates.”

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