What's Postcoital Dysphoria And How Can You Combat It?

Although sex is often regarded as one of the best things in the world, it can be confusing. Not only is human sexuality complicated, but the act of sex in itself — whether it's intercourse or other types of sex acts — can bring out a lot of physical and psychological aspects. One such aspect that isn't talked about enough is postcoital dysphoria (PCD).

"Postcoital dysphoria is when a person experiences feelings of sadness, depression, anxiety or agitation after consensual sex — even if that sex was loving, satisfying, or enjoyable," sexpert Wendasha Jenkins Hall, Ph.D., tells Cosmopolitan. (Fun fact: it can happen after masturbation too.)

According to a 2015 study published in the National Library of Medicine, 46% of women have experienced PCD at least once, and a 2019 study in the same publication found that 41% of men had also had PCD episodes at least once in their lifetime. There's no one explanation for why someone might suffer from postcoital dysphoria, but a few reasons behind it have been linked to past trauma, hormones, issues in the relationship, an unhealthy relationship with sex as a whole, or mental issues like depression, stress, and anxiety.

But if you're suffering from or have suffered from PCD at some point in your life, know that you're not alone. Here are six ways to help combat it.

Usually, when people hear the term "aftercare" when it comes to sex, they immediately think of BDSM — which isn't entirely misguided. Sexual aftercare does have its roots in the BDSM community because whether you're a dom or a sub, the high that comes with such intense sex play can't be left open-ended. Instead, after that high, there should be cuddling, intimacy, and recapping of the experience that's just been had. But you don't have to be into BDSM to reap the benefits of aftercare — it's something everyone can benefit from physically and psychologically after sex.

"Part of the point of aftercare is to diminish any post-sexual shame, which can be heightened by sex followed by goodbye, leaving a partner to feel you [didn't care] for them but only [wanted] sexual gratification," psychiatrist Gail Saltz, M.D., tells Mind Body Green. "Women, in particular, have been socialized to feel that [sex for] sexual gratification only is a shameful act. It is, of course, not, but nonetheless, being cared for in some way afterward often mitigates those feelings of shame."

When the PCD starts to kick in, don't run for the door. Stay in bed, cuddle, talk, and if you need to cry or feel anxious or any of the other symptoms that come with PCD, then do that in the arms of your partner.

Suffering from PCD can be confusing. You've just had a great time with your partner, and you might have even had a mind-blowing orgasm, but now you just want to curl yourself into a ball, cry your eyes out, and you're pretty sure you're just 30 seconds away from a panic attack. Because these feelings can confuse us, it can seem like the best way to handle them is to push them down deep inside and leave them there. But don't. Not allowing yourself to feel your feelings eventually creates more problems.

"When we resist our emotional experiences, it often makes them worse — whatever you resist, persists," sociologist and clinical sexologist, Sarah Melancon, Ph.D., tells Men's Health. "Accepting how you feel in the moment, even if it makes no obvious sense, will help you move through your emotions more quickly and easily." Having feelings is part of the human condition; they exist for a reason. Don't try to ignore them.

When we're experiencing an emotional rollercoaster, like the kind postcoital dysphoria can bring on, it's important to ask yourself what you need to help you through these emotions, all while feeling them at the same time. Do you need a bubble bath with Bon Iver on the speakers? Do you need a distraction like watching a movie or playing a board game with your partner? Do you want to get delivery and eat pizza or Chinese food in bed? Ask yourself what's going to help you not just process these emotions but get you on the other side of them, then do it. 

There's nothing wrong with having needs that must be met after sex, either by your partner or yourself. What is wrong is not recognizing those needs and honoring them. It's on par with ignoring your emotions instead of sitting with them and allowing yourself to experience them fully.

Anytime we feel a negative emotion coming on, it's always a good idea to turn to mindfulness. If, after a fantastic sex sesh with your partner, you feel the postcoital dysphoria rising up in you, don't try to talk your way out of it. Instead, pause and take a deep breath. Then begin diaphragmatic breathing — which is five seconds exhale, then five seconds inhale — to find your way back to your center. 

"Our mind wanders all the time, either reviewing the past or planning for the future," Suzanne Westbrook, M.D., tells The Harvard Gazette. "Mindfulness teaches you the skill of paying attention to the present by noticing when your mind wanders off. Come back to your breath. It's a place where we can rest and settle our minds." Not only does mindfulness bring us back to our center when we experience PCD, but it also forces us to embrace the feelings and emotions that come with it. 

Whenever we find ourselves in a difficult emotional space, whether it's related to post-sex blues or not, journaling is a healthy way to figure out what's going on in our heads. Being able to attach words to the emotions can really have a positive impact on how we interpret our emotions.

"Journaling can help with processing through negative thoughts and feelings," therapist Bisma Anwar, LMHC, tells Talkspace. "It can be a way to let out strong and intense emotions that might be challenging to cope with ... Journaling is a healthy coping strategy that includes mindfulness of emotions and insight building which can happen when we start to write down our thoughts and feelings."

While rolling over post-sex to immediately chronicle your feelings may not be regarded as sexy, if you fear you won't be able to really convey your emotions thoroughly if you wait, then grab that journal and do it in the moment. A supportive partner won't mind if this is a technique that's necessary for you to process your postcoital dysphoria.

If you're struggling with any of the symptoms that come with postcoital dysphoria, it's definitely not an easy thing to hide from your partner. While your instinct may be to leave the room and be with your emotions alone — which is totally fine and normal — at some point, you're going to have to talk to your partner about it and how it's affecting you. "When partners work together to face PCD and address the issues with compassion, the relationship can actually become stronger and more loving," clinical psychologist and relationship expert Dr. Carla Marie Manly tells AskMen.

Although PCD isn't something that's permanent, if you find that you're experiencing it more often than you're not experiencing it, then talking with a sex therapist can help. Medications like antidepressants, for example, can really make a difference in some people's lives. If PCD is starting to dominate your sex life, don't hesitate to reach out to a professional. A good cry never hurt anyone, but if it happens every time you have sex, then it's time to do something about it.