Sex is supposed to leave you feeling satisfied — but if you’ve ever felt sad afterward, you’re not alone.
“Usually sex uplifts the mood due to dopamine release and serotonin increases, which prevent depression,” says Lea Lis, MD, a psychiatrist who specializes in sex with a practice in Southampton, New York.
And yet, she says, feeling depressed after sex — even consensual, good sex — is something that many people feel at some point in their life.
“Postcoital dysphoria (PCD) refers to feelings that range from sadness to anxiety, agitation, anger — basically any bad feeling after sex that isn’t typically expected,” explains Gail Saltz, MD, associate professor of psychiatry at the NY Presbyterian Hospital Weill-Cornell School of Medicine.
It can even make you cry.
PCD can last anywhere from 5 minutes to 2 hours, and it can happen with or without an orgasm.
“The short answer is that we don’t know what causes PCD,” says Daniel Sher, clinical psychologist and online sex therapist. “There hasn’t been enough solid research conducted yet.”
Researchers have some theories though:
“It could be related to hormones that are involved in love and attachment,” Sher says. “During sex, your hormonal, physiological, and emotional processes are peaking.”
“You’re experiencing an unbelievable level of stimulation, physical and otherwise,” he continues. “Then, suddenly, it all stops and your body and mind need to return to baseline. It’s this physiological ‘drop’ that can bring about a subjective sense of dysphoria.”
Your feelings about sex
“Another theory is that people who harbor a lot of unconscious guilt about sex in general might experience PCD as a result,” says Sher. “This is more likely in people who have grown up in harshly critical or conservative contexts, where sex has been framed as bad or dirty.”
You might also just need a break from sex.
“Feeling depressed after intercourse could simply result from the fact that you aren’t physically or emotionally ready for sex,” says sex therapist Robert Thomas. “Feeling guilt and emotionally distant post-sex might be an indication that you don’t have a deep enough connection with your partner.”
Your feelings about the relationship
“Having sex is a highly intimate experience, and intimacy can make us more aware of unconscious thoughts and feelings, which includes some sad or angry thoughts,” says Saltz.
If you’re in an unfulfilling relationship, harbor feelings of resentment toward your partner, or otherwise feel let down by them, these feelings can crop back up both during and after sex, making you feel sad.
Negative communication after sex can also be a trigger.
“Not being happy with the sexual experience could be emotionally burdening, particularly when your expectations were not met during the intercourse,” says Thomas.
If it’s a one-night stand or casual hookup, you might also feel sad if you don’t really know your partner. Maybe you feel lonely or maybe you regret the encounter.
It can be hard to forget about body image issues you may have.
If you feel embarrassed or ashamed about how you look, it could trigger symptoms of PCD, sadness, or depression.
Past trauma or abuse
If you’ve experienced sexual assault or abuse in the past, it can give rise to a lot of feelings of vulnerability, fear, and guilt.
“[People] who have experienced sexual abuse [may] associate later sexual encounters — even those which are consensual or occur within an intimate relationship — with the trauma of the abuse,” says Lis.
This can lead to feelings of shame, guilt, punishment, or loss, and it can affect how you feel about sex — even a long time after the initial trauma.
Certain ways of being touched or positions can also be triggering, particularly if you also experience PTSD.
Stress or other psychological distress
If you’re already feeling stressed, anxious, or unhappy in your day-to-day life, sex might only offer a temporary distraction. It’s difficult to really set those feelings aside for long.
First, know that whatever you feel, you shouldn’t feel like you have to pretend to be happy for your partner or hide how you really feel. It’s okay to let yourself experience the sadness.
“Sometimes the pressure of trying to eliminate sadness makes it even harder for a person to feel OK,” says Sher.
Next, check in with yourself and make sure you feel safe, physically and mentally.
If you feel comfortable, try talking to your partner about how you feel. If you know, tell them what’s bothering you. Sometimes, just giving voice to how you feel will make you feel a little bit better.
If you’d rather be alone, that’s okay too.
Here are some good questions to ask yourself:
- Was there something specific that my partner did to trigger my feelings of depression?
- What is it that I feel depressed about?
- Did I relive an abusive or traumatic event?
- Does this happen a lot?
“If this happens on occasion, don’t worry about it, but do think about what might be going on or being brought up for you emotionally. It can be helpful for you,” says Saltz.
Reach out to a healthcare provider
While depression after sex isn’t uncommon, it’s pretty rare to feel depressed after regular sexual activity.
A 2019 study found that 3 to 4 percent of penis-having folks felt depressed on a regular basis. In another study, 5.1 percent of vulva-having folks said they felt it a few times within the previous 4 weeks.
According to Lis, “if it happens very frequently, it shouldn’t be ignored.”
This is especially true if your post-sex depression is interfering with your relationship, causing you to fear or avoid intimacy altogether, or if you have a history of past abuse.
A therapist, psychiatrist, or other mental health professional will be able to help you figure out what’s going on and explore treatment options with you.
If you notice that your partner is feeling depressed after sex, the first — and best — thing you can do is take stock of their needs.
Ask them if they want to talk about it. If they do, listen. Try not to judge.
Ask if there’s something you can do to help console them. Some people like to be held when they’re feeling sad. Others just want someone to be nearby.
If they don’t want to talk about it, try not to take offense. They might not be ready to open up about what’s bothering them.
If they ask for space, give it to them — and again, try not to be hurt that they don’t want you there.
If they say they don’t want to talk about it or ask for space, it’s okay to follow up with them later that day or even in a few days. It’s important to let them know that you’re there for them when they’re ready.
If this happens a lot, it’s okay to ask them if they’ve thought about talking to a therapist or other mental health professional. Be gentle when you ask, and try not to get upset if they reject the idea. You don’t want to make them feel like you’re saying they’re broken or invalidate their feelings.
You can always ask them about getting help again later if you’re still concerned.
The best thing you can do as a supportive partner is to be there for them in whatever way they need you to be.
Feeling depressed after sex is pretty common. But if it’s happening regularly, interfering with your relationship, or causing you to avoid sex and intimacy altogether, consider reaching out to a therapist.