Sex is an activity that the vast majority of people find pleasurable, being a desirable and satisfying experience under normal conditions. We usually enjoy the whole process and once the interaction is over and we have reached orgasm there is usually a feeling of relaxation and satisfaction.

However, in some people feelings of sadness and anguish appear after the orgasm, and what is known as postcoital dysphoria or post-coitum depression may appear. It is about this concept that we will talk throughout this article.

What is postcoital dysphoria?

It is called postcoital dysphoria or post-coital depression to the syndrome characterized by the presence of sensations and feelings of sadness, melancholy and discomfort after the time of orgasm. Anxiety, feelings of emptiness, restlessness, uneasiness and irritability may also occur. This is a situation that usually appears after having a sexual relationship , although it can also appear after masturbation.

Technically, it is considered a sexual dysfunction linked to the resolution phase, being a diagnostic label proposed for research in view of a possible incorporation in different diagnostic classifications. However, the diagnosis would only be possible if dysphoria appeared in most sexual relations (not being a disorder if its appearance was somewhat punctual and sporadic) and as long as it could not be explained by other disorders .

It is important to keep in mind that this feeling is not the result of an unsatisfactory sexual relationship, but can be entirely pleasant for both parties and desired by the person who feels this dysphoria. Post-coital depression (rather a sadness, not really a depression) usually appears either immediately or shortly after orgasm and usually disappears within minutes , although it can even go on for several days.

Who suffers from it?

This type of syndrome is not new, there being references to it since ancient times. Although traditionally it has been considered that postcoital dysphoria is something specific to women of a certain age, the truth is that it can appear in both sexes and at any age. It seems to be more frequent in women, although generally there have been few studies carried out with men in this sense.

Although it is generally an under-recognised syndrome, recent studies show that it is much more common than is generally thought, with the percentage of people affected varying according to the study. Furthermore, postcoital dysphoria may not always be present and it is normal for it to appear at specific moments sporadically, being a problem only when it occurs consistently over time. In some cases, it has been observed that practically half of the participants have acknowledged having suffered from it at some time in their lives.

Symptoms and repercussions

Post-coital dysphoria is, as we have said, something that is not well recognized socially, and it can have repercussions on the sexual life of those who suffer from it. Often its presence is experienced with discomfort and guilt by the person who experiences it, considering that he should feel satisfied and not understand his own reactions. A possible fear of the existence of partner conflicts may also develop, or even an avoidance of sexual contact may appear. Moreover, it is a situation that, as in other sexual dysfunctions, is often hidden and lived with shame.

The sexual partner may also feel uncompetent or unwanted in the face of their partner’s reactions, and real conflicts and other sexual dysfunctions may also appear such as aversion to sex.

Possible causes

Since ancient times, attempts have been made to explain the appearance of sexual dysphoria, both in terms of its specific appearance and its consistent appearance.

One of the theories in this respect refers to the fact that the causes of this alteration are mainly neurochemical: after the orgasm certain hormones are released which counteract those responsible for sexual pleasure, and sadness and low mood may appear as a result of this regulation. In this same sense, it has been observed that at a biological level the amygdala (which is linked to anxiety and fear among other emotions) decreases its activity during intercourse, and dysphoria may appear as a consequence of the reactivation of this part of the brain .

Another theory, which is also compatible with the previous one, indicates that the appearance of post-coital dysphoria may be linked to the influence of a restrictive and religious education, in which the idea of sex and sexual pleasure and enjoyment may have been internalized as something sinful or criminalized.

Another option is derived from the experience of traumatic situations such as child sexual abuse or rape, unconsciously associating the enjoyment of a normative and consensual relationship with the one lived during the abusive experience and appearing sadness, anguish and even disgust with the current enjoyment.

There are also theories that talk about sadness being due to the emotions of sadness and uneasiness being caused by the end of the act of union with the partner. There may also be the possibility that sadness is due to the presence of partner difficulties or the consideration that the relationship is based or sustained only on sex.

Treatment

At the level of the person and his/her partner, it is recommended that the orgasm is not the end of all interaction between the members of the couple, being able to enjoy activities such as caressing or hugging unless it generates discomfort or uneasiness to the person with dysphoria. This involves generating a bond after the sexual encounter . In any case, if it is something habitual, it may be useful to consult a psychologist or a sexologist.

Although not common, postcoital dysphoria may require psychological treatment. Firstly it is necessary to assess the possible existence of organic alterations . In the case of traumatic experiences, these could be worked on in consultation. Likewise, the presence of guilt or consideration regarding sex may need to be worked on. In the case that it is necessary or is due to a conflict in the couple, it may be useful to use couple therapy and sex therapy to help.

Bibliographic references:

  • Schweitzer, R.D., O’Brien, J., & Burri, A. (2015). Postcoital dysphoria: Prevalence and psychological correlates. Sex Med, 3: 229-237.
  • Burri, A.V. & Spector, T.D. (2011). An epidemiological survey of post-coital psychological symptoms in a UK population sample of female twins. Twin Res Hum Genet, 14: 240-248.