Have you ever had great sex and then felt down after? 

Sex isn’t always sunshine and rainbows like it is in erotic literature or movies. The post-sex blues, or postcoital dysphoria, happens when you feel sad, upset, or even panicked after being intimate with someone, even if you had a great time in the moment. 

If you find yourself asking, “Why do I feel sad after sex?” — this one's for you.

What is postcoital dysphoria?

Postcoital dysphoria in females, males, and people of all genders is when negative emotions, like feelings of sadness, anxiety, or irritability, come up after consensual sexual activity. 

Sometimes referred to as PCD, postcoital dysphoria is a real disorder that affects many. So many, in fact, that a study from The Journal of Sexual Medicine found that 46% of survey respondents, mostly young women, had experienced it at least once. Postcoital dysphoria is also called postcoital tristesse (PCT), and “tristesse” in French literally means “sadness.”

You may have postcoital dysphoria if you experience the following symptoms: 

• Sadness: After sex, you might feel a level of sadness that isn’t normal for you. It occurs even when nothing’s technically wrong, and there's no conflict or dissatisfaction surrounding the sexual activity.

• Anxiety: Anxiety from postcoital dysphoria is more than performance or relationship-related nerves. It's sudden, unpleasant, and feels out of place.

• Irritability: This isn't just feeling slightly annoyed. You might experience intense agitation for seemingly no reason. If you've ever snapped at a partner after sex, postcoital dysphoria could be why. 

• Feeling dissatisfied: Even if the sexual experience was consensual and both partners felt great, postcoital dysphoria can cause negative feelings like dissatisfaction on a regular basis.

• Crying: If you've ever cried happy tears after orgasm, this is the opposite. Crying after sex can be particularly puzzling, but it's a common symptom of dysphoria. 

• Shame: Sexual shame is a jarring experience, especially when it comes after pleasurable sex. If you have postcoital dysphoria, you may feel deep-seated, misplaced guilt, like you did something wrong even though it felt right in the moment. 

• Panic attacks: Postcoital dysphoria may manifest as a panic attack after a sexual encounter. This goes beyond typical anxiety, with symptoms of psychological distress like intense, sudden fear, shortness of breath, and an overwhelming feeling of impending doom. Having a panic attack after sex can be surprising, especially when it happens in an environment that usually feels safe. 

Why do I feel empty after sex?

Feeling empty, sad, or anxious around sex could happen for many reasons, like hormones or bigger emotional problems in your relationship. The point of postcoital dysphoria is that it happens even when the sex is consensual and enjoyable — so if you’re sad after an experience that doesn’t fit that bill, you might want to talk to someone. 

While there isn’t a ton of research out there on postcoital dysphoria, there are a handful of theories about why you feel down in the dumps after sex. From preexisting mental illness to hormones, here are a few different causes:

Hormonal changes

Hormonal shifts occur during and after orgasm. While many individuals experience post-sex bliss in reaction to the release of feel-good hormones like dopamine, others react differently to these changes, leading to sadness or anxiety when the hormones drop off. 

Sexual trauma

A history of sexual trauma or sexual abuse can significantly impact how you feel about intimacy, even if you’re now with a partner you’re comfortable with. Different sexual acts can remind you of previous negative experiences, contributing to postcoital dysphoria. This can happen at any point — not just after.

Relationship problems 

Tension or unresolved conflict in your relationship can make you feel sad or disconnected after sex. Even if the act itself was pleasurable in the moment, having sex when your relationship is rocky, isn't always healthy. Those underlying issues can cause emotional aftershocks, so address your problems before hitting the bedroom. 

Problems with sex

Other sex-related emotional issues, from shame to performance anxiety, can cause postcoital dysphoria. These might include:

• Feeling shame after sex: Societal norms, religious beliefs, and childhood upbringing cause some people to associate sex with feelings of guilt and shame. 

• Worry about sexual performance: An ingrained desire to satisfy a partner or even a negative experience causes performance anxiety, contributing to feelings of inadequacy post-intercourse.

• Having a negative self-image: Everyone feels insecure sometimes, and personal insecurities about sexuality, self-esteem, and body image can translate into postcoital dysphoria.

• Anxiety about a new partner: Feeling nervous about having sex with a new partner can trigger negative emotions after doing the deed.

Mental health challenges

People with preexisting mental health conditions like depression and anxiety might have lower libido or problems performing, which could contribute to postcoital dysphoria. If you're experiencing symptoms of these conditions after sex and in other parts of your life, discuss them with your healthcare provider. 

Lack of orgasm 

If you or your partner doesn't orgasm, you might connect it to self-doubt or low self-esteem — even though it has nothing to do with you and your value. Your partner not reaching orgasm doesn't reflect your sexual prowess or skills. Quite a few factors, including emotional and physical reasons, could play a role. 

How to treat postcoital dysphoria

Navigating postcoital dysphoria is tough, especially if it feels like you’re doing something wrong in the bedroom. It’s intimate, and that can make it hard to talk about.

But you deserve to feel great after sex, whether that’s with your partner, a one-night stand, or even on your own. The goal is to have fun — and if you aren’t feeling that way, that means it’s time to self-reflect and make a change.

There are a few different ways to get over, or lessen, the impacts of postcoital dysphoria, and understanding the cause is a step in the right direction. Then you can get to the root, address your feelings head-on, and improve your well-being 

Here are some recommendations for treating postcoital dysphoria:

• Journaling: Writing things down can help you identify patterns or triggers and offer valuable insights into the potential causes of postcoital dysphoria. Over time, you'll understand your emotions better, and you might even find the words to communicate your feelings to others.

• Communication: Open dialogue with your sexual partner is invaluable. Share your concerns to help them understand the situation, where you're coming from, and how to support you. Chances are, they might need some support, too. Create an aftercare practice that works for both of you.

• Education: Learning about the biological and psychological aspects of postcoital dysphoria can be therapeutic. Read up on what you're going through to demystify and destigmatize the ins and outs of sexual health. 

• Individual or couples therapy: There's no shame in seeking professional help, alone or with a partner. A therapist can offer a safe space for discussion as well as strategies to cope, heal past traumas, and address relationship issues that might be contributing to your dysphoria. 

• Sexual dysfunction treatment: It’s also okay to get a doctor or sex therapist involved. If your postcoital dysphoria is linked to sexual dissatisfaction or health issues, address the root cause and figure out a treatment plan. 

Build a healthy sex life with Quinn

Another way to work on developing a healthy relationship with sexual intercourse is through loving yourself and your body. If you need help with this, masturbation is a great place to start. 

Quinn is an audio erotica app created by women for the world, and it’ll help you rekindle your appreciation for your body and your sexual self. Narrated stories can help you find what feels right (and feel great after), and Quinn has a wide range of erotic content to get you started.

To access thousands of guided sessions and audio stories, download the Quinn app for iOS or Android.