Sex

Have You Ever Felt Sad After Sex?

Post-coital dysphoria and the good-enough sex model.

Posted Aug 10, 2020

The standard model of the human sexual response cycle proposes four phases. The first three phases—excitement, plateau, and orgasm—are generally well understood by researchers. However, the resolution phase has been less studied, and what we know about it is generally based on anecdotal reports.

The resolution phase is often experienced as emotionally positive, with feelings ranging from elation to contentment in the wake of a satisfying sexual episode. It’s also the time when lovers bond, as they cuddle, kiss, and engage in pillow talk, basking in the afterglow of sex. However, not all consensual sex leads to a satisfying resolution.

Even when sex is wanted and experienced as pleasurable by both partners, the resolution phase may lead not to euphoria or relaxation but rather to feelings of irritability, sadness, and even an overwhelming desire to cry. This condition is known as post-coital dysphoria, or PCD for short. While the incidence of PCD in women has been explored in previous studies, Australian psychologists Joel Maczkowiack and Robert Schweitzer have extended this research to men in a recent study published in the Journal of Sex and Marital Therapy.

Previous research has shown that post-coital dysphoria is a fairly common experience among women. Several studies have shown that nearly half of all women have experienced PCD at least once in their life, 5-10 percent have experienced it within the last month, and a small number of women—about 2 percent of these interviewed—reported PCD on a regular basis. In other words, even when sex is consensual and otherwise experienced as pleasurable, it’s not unusual for women to experience sadness after orgasm.

Maczkowiack and Schweitzer suspected, from anecdotal reports, that post-coital dysphoria might occur at a similar frequency in men, and testing this idea was the first goal of their study. Furthermore, the researchers also wanted to explore a number of possible correlates of PCD to get some idea of what circumstances might lead to it.

For this study, the researchers recruited over 1200 participants to respond to a set of surveys online. All participants were male and sexually active. These men ranged in age from 18 to 81, with an average age of 37; they represented the full range of male adulthood. They also came from 78 different countries, and a large majority of them reported being in a sexually satisfying relationship.

The participants were first asked about their experiences with post-coital dysphoria. After that, they responded to a number of questions intended to assess factors that the researchers believed may be associated with PCD. These factors include:

  • Psychological distress. Participants were asked if they’d experienced psychological distress over the last month. This included feelings of either anxiety or depression. They were also assessed for a history of anxiety, depression, or bipolar disorder.
  • Past abuse. Plenty of research has documented the fact that emotional, physical, or sexual abuse in childhood can lead to sexual dysfunction in adulthood for both men and women. The participants were asked if they’d experienced abuse either before or after the age of 16, which marked a rough division between childhood and adulthood.
  • Other sexual dysfunction. The researchers speculated that post-coital dysphoria may be associated with other common male sexual dysfunctions. Thus, participants were surveyed on their experience with hypoactive sexual desire (low libido), erectile dysfunction, delayed ejaculation, and premature ejaculation.

The prevalence of these disorders among the participants was within the normal range.

The men in this study also reported experiences of post-coital dysphoria that were similar to those reported by women in previous studies. Namely, 41 percent of the men reported having experienced PCD at least once in their lifetime, and 20 percent of them said they had done so in the last month. In other words, PCD is a common experience for both men and women.

The participants in this study were also given the opportunity to describe their experience of post-coital dysphoria. Common descriptions included a strong sense of self-loathing, a feeling of shame, as well as depressive episodes. Some men also reported crying spells, which they often tried to hide from their partners to avoid worrying them.

All three factors that the researchers tested—psychological distress, childhood sexual abuse, and sexual dysfunction—correlated with the experience of post-coital dysphoria. However, the correlations with the second and third factors were small. In other words, childhood abuse and previous sexual dysfunction may have an impact on PCD, but it also often occurs even without these prior experiences.

In these data, at least, only current psychological distress was strongly predictive of post-coital dysphoria. In other words, the men in this study most often experienced PCD when they were also feeling a lot of stress, anxiety, or depression in their life more generally. The researchers point out that this is an important finding for therapists working with clients who suffer from PCD, as it suggests that a resolution of more general psychological issues may help alleviate PCD as well.

In conclusion, the researchers argue that it’s better to think of post-coital dysphoria as part of the normal range of sexual experience rather than as a disorder. Although sex is often touted as the ultimate pleasurable experience, reality belies this notion.

In line with the “good-enough sex model,” the researchers note that expectations of perfect sexual performance are unreasonable. Rather, we should accept that some sexual episodes will be more fulfilling than others. And so long as post-coital dysphoria is infrequent and occurs without significant distress, it should be seen as part of the normal range of human sexual experience, rather than as a disorder.

Facebook image: Fabiana Ponzi/Shutterstock

References

Maczkowiack, J. & Schweitzer, R. (2019). Postcoital dysphoria: Prevalence and correlates among males. Journal of Sex and Marital Therapy, 45, 128-140.