Feel sad, anxious or ‘homesick’ after sex? You might have post-coital dysphoria

<span>‘Why do I feel sad afterwards?’ one study participant asked.</span><span>Photograph: skynesher/Getty Images</span>
‘Why do I feel sad afterwards?’ one study participant asked.Photograph: skynesher/Getty Images

In 2009, a young woman went to the student clinic at Queensland University of Technology in Australia with a problem: after sex with her partner, she always felt sad. Sometimes it was a hollow feeling, like a “black hole opened up” inside her. Other times, it was more subtle, akin to “homesickness”. It never happened during or before sex, only after. She was confused because she loved her partner, and they were in a stable relationship. The sadness could last for over an hour.

“This was a very counterintuitive experience, because that’s not really what you expect,” said Robert Schweitzer, an adjunct professor in the Faculty of Health and the School of Psychology & Counseling at QUT. Schweitzer, who predominantly studied refugee mental health at the time, searched for mentions of post-sex negative emotions, and found very little research. But when he turned to Google, he found more than 50,000 websites that described post-coital blues or what’s now called post-coital dysphoria or PCD.

Schweitzer and his colleagues published their first study on PCD in 2011, finding that around 33% of women had experienced PCD at least once, and 10% had felt post-sex blues in the prior month. Since then, research on PCD has determined that people of all genders and sexualities, in different kinds of relationships, have had such feelings after sex and masturbation.

What does post-coital dysphoria feel like?

It may have taken academia some time to catch up, but the post-sex blues have been described in proverbs, philosophy and literature for thousands of years. One saying, apocryphally attributed to the Greco-Roman physician Galen, can be translated as “all animals are sad after sex”. Sad-boy philosopher Schopenhauer wrote that “directly after copulation the devil’s laughter is heard”, while the philosopher Spinoza remarked that “after the enjoyment of sensual pleasure is passed, the greatest sadness follows”.

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PCD is the experience of negative emotions, like anxiety, anguish, sadness or tearfulness, after having felt pleasure during sex with another person or through masturbation. It can be a combination of several negative emotions, or just one that is amplified, said Patrícia Pascoal, a clinical psychologist and sexologist at Lusofona University of Humanities and Technologies.

A large proportion of the research on PCD has been done on women, but in 2019, Schweitzer and his colleague looked at men. They found that 41% had experienced PCD, and 20% said they had in the last month. About 3% to 4% experienced PCD on a regular basis. In one case report from 2022, a 24-year-old man went to the hospital saying he was irritable and had crying fits after sex for six months. They happened consistently after orgasm, and lasted for 30 minutes to an hour and a half.

People can be confused about the disconnect between what they felt during sex, and what came later. “Sex is meant to be a really positive, connecting, intimate thing and my experience is different to this,” one study participant told Schweitzer. “Why do I feel sad afterwards?”

When does PCD happen?

To identify PCD, sex therapist and sexologist Jennifer Litner looks for signs of significant sadness, tearfulness, mood swings or frustration that take place only after sex. Researchers and clinicians only consider these feelings to be PCD when they occur in consensual sexual encounters. By contrast, negative emotions after sex that someone feels pressured into or doesn’t enjoy aren’t dysphoric – they are an appropriate response to a negative experience.

A recent survey study on PCD from Darcie Raftery, a Nottingham Trent University psychologist, asked people about their feelings after orgasm or sex, as well as questions about their mental health, attachment styles and attitudes toward masturbation. This was the first study to look specifically at whether casual sex and masturbation are more likely to bring about PCD. Men and women reported that they had experienced PCD while in a relationship, but for men the highest rates of PCD happened after masturbation, whether they were in a relationship or not, and for women the highest rates occurred after casual sex.

Still, it’s hard to generalize when PCD is likely to occur, because it’s rare that people seek out sex therapy for PCD, Litner said. Her clients generally seek treatment for sexual-function problems or intimacy concerns.

There could also be a difference between a one-time occurrence and frequent post-sex blues. Litner considers it PCD only when these kinds of emotions happen repeatedly and “for a duration of time, like an hour or so”. “There’s a pattern,” Litner said. “It’s not just a moment where they had a difficult interaction with their partner.”

What causes PCD?

There’s no single explanation for what leads to post-sex blues, said Schweitzer, mostly because the research has focused on discovering how prevalent it is.

One theory is that after orgasm, there’s a shift in mood from an extreme high back to baseline, which could lead to negative feelings. “If you have this big release, it feels really intense, and then it’s gone,” Litner said. This might be explained by certain hormonal changes, but this hasn’t been demonstrated conclusively in any studies. Litner said it’s important to also consider the possible involvement of other factors like attitudes toward sex, mental health conditions and body image.

Schweitzer has looked into the relationship between PCD and psychological influences, like a history of abuse or the level of intimacy in a relationship – but did not find a strong correlation. It’s not possible to explain PCD as a “merely hormonal” or purely “sexual phenomenon”, Pascoal said.

What should you do if you experience PCD?

Even though scientists aren’t sure exactly what causes it, there are still some ways to approach post-sex sadness.

PCD can lead people to avoid sex, or to avoid certain behaviors or attitudes during sex. Someone with PCD might prevent themselves from letting go and fully diving into a sexual experience, Pascoal said. This can lead to “spectatoring”, or self-monitoring, during sex and detaching from the pleasurable side of sex. It can lead to problems in a relationship, too, like miscommunication, or a loss of intimacy and connection.

“I don’t think it’s normal to feel this way after sex, especially with sex with someone you love,” one person told Schweitzer. Another said: “A few times I have left the room and [got] into the car and have physically left the house.”

Hiding these feelings from others can compound the distress. Litner recommends seeking help from a sex therapist and also focusing on aftercare, a term from the kink community that refers to what you do for yourself and your partner after sex.

If you experience a drop in mood after sex, Litner recommends activities that would “feel nourishing or supportive after this experience”. This can be a soothing ritual involving something you’ll enjoy, like “taking a shower, journaling, having a partner rub your back or having a glass of water or snack”, she said.

People respond to the post-sex period in different ways, says Schweitzer, and he doesn’t feel PCD needs to be pathologized. What’s most important is not eradicating the negative feelings, but being able to communicate them to your partner, rather than feeling a need to hide them.

“This is the bigger issue: the degree to which people feel embarrassed or ashamed to share with their partner,” Schweitzer said.