Having sex sets off a bunch of different chemical changes, sensations and reactions in the body. Sometimes this leaves us feeling uplifted and amazing. It’s also fairly common to feel sad, agitated, angry or otherwise upset. This phenomenon is called postcoital dysphoria, also known as postcoital tristesse (PCT). There isn’t a single cause behind it. It may be a hormonal reaction or latent stress and anxiety coming to the surface because you’re in a vulnerable state. In some cases, it may be due to negative feelings about yourself, your partner or sex. It can also be a result of relationship difficulties or past trauma.

A 2024 study found that the likelihood of having postcoital dysphoria somewhat depends on the situation: 35.3% of males and 31.2% of women said they experience postcoital dysphoria. For both genders, it was least likely to happen in the context of a relationship. Men experienced it most when they were masturbating (72.5%), followed by casual sex (49%). For women, the opposite was true — they experienced postcoital dysphoria most after casual sex (77.1%) followed by masturbation (51.4%).

There’s no way to prevent postcoital dysphoria from happening, but there are ways to manage these feelings when they come up. Taking care of yourself and building a supportive relationship with your partner are important ways to create a sense of safety. In this blog post, we’ll talk about potential causes of postcoital dysphoria and how to handle it.

Why do I feel sad after sex?

To feel pleasure during sex, we need to get a bit vulnerable, which requires quite a bit of trust in our partners. The state of our nervous system changes, and we get a rush of hormones that create strong physical and emotional sensations. We stop focusing so much on what’s happening around us and notice what we’re feeling in our bodies. 

It almost goes without saying that most of us don’t tune into the physical experience of our emotions very often in our day-to-day lives. Once the exciting part of sex is over, you may be left to deal with some “unfinished business” that you’ve been avoiding. If you’re comfortable with your partner and what you’re doing together, your nervous system may feel very relaxed and sensuous. If not, you might go into a defensive “fight-or-flight” mode or numb out and shut down. Coming back to a regulated state after moving into any of these adaptive extremes can bring on a rush of emotions.

What causes postcoital dysphoria?

There are many potential life situations and body sensations that can create the feelings associated with postcoital dysphoria. You may not be able to predict exactly when it will happen or determine one specific cause. Recognizing what you’re feeling and reflecting on what’s happening in your life are the first steps toward managing these emotions.

The following are some common causes of postcoital dysphoria:

• General anxiety, stress, or depression — Emotional distress is something we feel physically. If you’ve got a situation that’s weighing you down or if your system is under a lot of pressure, those things can come to the surface after sex. 
• Hormones — During and after sex, different hormones are released to create feelings of arousal, desire, pleasure, closeness, attachment, euphoria and more. As these chemicals fluctuate, they may trigger different thoughts and emotional reactions. 
• Past trauma — If you’ve been raped, assaulted or sexually coerced in the past, these feelings can come back, even with partners you trust. If it feels safe to do so, let your partner know what’s happening so they can support you. You should also consider talking with a psychotherapist or seeking treatment. 
• Body image issues — Any negative thoughts and feelings you have about your body may emerge during and after sex. Working on self-worth, self-love and a body-positive mindset can help you manage these thoughts.
• Judgments or difficulties with sex — If there are any judgments or doubts in your mind about sex, they’re likely to bug you afterward. Spend some time reflecting on your attitudes about sex and how you might address them. 
• Relationship difficulties — Negative feelings after sex may not have anything to do with your partner or your relationship, but it’s a possibility that you shouldn’t ignore. Is there anything you need to talk to them about?
• Abuse — If you’re any less than enthusiastic about having sex with your partner, they should respect your wishes. Setting boundaries in close relationships isn’t always easy, but if someone is taking advantage of you, it’s not your fault. Talk with someone you trust or make a plan to get yourself out of the relationship safely. Then seek out the treatment and support you need to heal.

What should I do about postcoital dysphoria?

The best way to deal with postcoital dysphoria will depend on the potential cause or causes. First, find a way to reflect on your feelings that feels safe and manageable. Do an activity that helps you regulate your emotions, and when you’re ready, see if you can tell where those feelings are coming from. Do some journaling, move your body or create some expressive art. If you’re feeling overwhelmed, find someone you trust and see if they’ll talk through some potential underlying issues with you. Maybe you’ll feel comfortable talking about these things with your partner, and maybe not. If you’re in a long-term or serious relationship, at some point, it’s a good idea to try to establish a foundation of trust so you can be open about what you’re feeling. 

Working through these thoughts and feelings can be tough to do by yourself. Consider talking with a psychotherapist. A psychotherapist can be a helpful ally for building self-worth, processing difficult feelings, talking through relationship issues or healing from trauma. Depending on the source of your postcoital dysphoria, there may be a support group you can go to. There are groups for people who are recovering from sexual assault, a controlling relationship, body image issues and much more.

Do you think your feelings of postcoital dysphoria are attached to underlying mental health concerns? You don’t have to figure it out all by yourself. At Lightfully, we provide whole-person-centered mental health treatments that are tailored to your life and your needs.

If you have questions about treatment, feel free to contact us. We’re here to listen.