Postcoital Dysphoria: How to Cope With the "Post-Sex Blues"

Sex can be a fulfilling, pleasurable experience for many people. But sometimes, even when you’ve enjoyed sex, you may have negative feelings in the immediate aftermath.

People who experience emotions like sadness, anxiety, or irritability after consensual sexual intercourse, activity, or orgasm may be experiencing a condition called postcoital dysphoria.

Postcoital dysphoria is sometimes referred to as post-sex blues or postcoital tristesse. This is not to be confused with the colloquial term "post-nut clarity," which refers to a feeling of clear-headedness after reaching orgasm (particularly in men).

What Is Postcoital Dysphoria?

“Postcoital dysphoria is when an individual feels strong negative feelings after consensual sexual activity, which may include irritability, anxiety, agitation, sadness, depression, and crying spells lasting minutes to hours,” explains Sarah Melancon, PhD, clinical sexologist, and lead researcher and medical review board member for Women’s Health Interactive.

According to Dr. Melancon, postcoital dysphoria isn’t new. “This phenomenon has been observed throughout history, including by Greek writer Galen and philosopher Baruch Spinoza,” she says.

The Sexual Response Cycle

In order to understand postcoital dysphoria, it can be helpful to consider the sexual response cycle, a framework credited to William Masters and Virginia Johnson.

The sexual response cycle is thought to have four main parts:

1. Excitation
2. Plateau
3. Orgasm
4. Resolution

“Postcoital dysphoria is an atypical response in the resolution phase, where the physiology returns to baseline after orgasm,” Dr. Melancon.

Unfortunately, research on postcoital dysphoria is sparse, and experts aren’t exactly sure what causes it. Its causes are likely a combination of psychological, hormonal, and environmental triggers.

Symptoms of Postcoital Dysphoria

A wide range of feelings is possible among people who experience postcoital dysphoria. The main characteristic is that the feelings you experience are negative, and they happen in the immediate aftermath of a consensual, otherwise positive sexual experience.

Postcoital Dysphoria in Women

Multiple studies have found that postcoital dysphoria is more common in women than men. For example, the results of an online survey published in Sexual Medicine found that almost half of all women (46%) had experienced postcoital dysphoria in their lifetime, and 5% had experienced it in the past month.

Postcoital Dysphoria in Men

Postcoital dysphoria is often referred to as “post-nut clarity” in men. Although postcoital dysphoria is less common in men, it’s experienced more than you might realize.

A 2019 study published in the Journal of Sex & Marital Therapy found that 41% of males had experienced postcoital dysphoria in their lifetimes, and 3% to 4% experienced it on a regular basis.

Reasons for Postcoital Dysphoria

Experts are still investigating the precise causes of postcoital dysphoria, and data is limited at this time. It’s also important to understand that the reason why someone experiences it doesn’t have to be clear for it to be a real and impactful experience.

While the exact causes of postcoital dysphoria aren’t known, researchers have pinpointed several factors that may make a person more likely to experience the condition:

• History of physical abuse
• History of emotional abuse
• Relationship dissatisfaction

“Sex is intimate and can bring up a lot of feelings,” says Dr. Melancon. “In addition, the various hormones released during sexual activity and orgasm may bring our emotions to the surface more strongly, particularly with a history of abuse or with current relationship problems.”

Aivigail Lev, PsyD, psychotherapist, and founder and director at Bay Area CBT Center, says that many factors can contribute to postcoital dysphoria. In her experience, people who’ve endured sexual trauma, have insecure attachment styles or have a personality disorder, are more likely to experience it.

How to Cope with Postcoital Dysphoria

If you are experiencing postcoital dysphoria, you should know that you aren’t alone. Moreover, there are things you can do to cope with your feelings and help decrease their frequency and intensity.

Our experts shared their top tips for coping with postcoital dysphoria:

Accept Your Emotions

First, it’s important to try to fully accept your feelings, as difficult as they may be. “Practice ‘being’ with your feelings,” Dr. Melancon suggests. “Emotions, no matter how painful, are temporary so learning to ride the wave without judgment or resistance can help the feelings move through.”

Explore Your Feelings

“To cope with postcoital dysphoria, it is important to understand its origins and assess why it is happening,” Dr. Lev recommends. It can be helpful to ask yourself certain questions, she says, such as:

• Does postcoital dysphoria happen in certain situations?
• Does it occur with specific kinds of sexual partners?
• Did you feel any ambivalence about the sexual interaction before it happened?
• How long after the sexual interaction did the dysphoria manifest?

Journaling

Keeping a journal can help you track your experiences and understand any patterns that are present, Dr. Melancon says.

Practice Mindfulness

Practicing mindfulness and meditation can help you more fully process your emotions in the moments you are experiencing them. “Noticing what emotions you feel and where you notice sensations in your body can reduce the intensity of your emotions and help them to release in time,” Dr. Melancon describes.

Post-Sex Self-Care

Coming up with some ideas for post-sex self-care can help ease some of the intensity of your feelings, Dr. Melancon says.

You can even get your partner involved if that feels right. Some ideas for this type of self-care include taking a warm bath after sex, wrapping a blanket tightly around your body (like a human burrito), listening to music, using essential oils, or getting a massage, Dr. Melancon suggests.

Getting Professional Help

It’s normal to experience postcoital dysphoria from time to time, and many people have experienced it at one point or another in their lifetime. It’s when you experience it frequently that it may be time to get some help. “It's time to see a therapist when the symptoms significantly impair one's sex life and overall quality of life,” Dr. Lev described.

Therapy

Dr. Lev says that the type of therapy you need may depend on how your postcoital dysphoria is experienced. “If postcoital dysphoria is a common occurrence related to personal stigma about sex, psychoeducation can be beneficial,” she says. If body image issues may be contributing, it can be helpful to find a therapist who focuses on this, she says. “In cases related to insecure attachment styles, working on creating more secure attachment behaviors in relationships would be a focus,” says Dr. Lev.

If you are dealing with past traumas that may be contributing to your experience of postcoital dysphoria, finding a therapist who specializes in trauma is essential. “In situations where trauma is involved, addressing the trauma through techniques like prolonged exposure therapy would be prioritized,” Dr. Lev described. “Ultimately, the approach depends on the specific causes of postcoital dysphoria.”