Tuesday, 28 January 2020

Feeling Sad After Sex? Postcoital Dysphoria & Symptoms

For most people, sex is fun. Whether you engage in it with a partner or by yourself, sexual activity usually results in feelings of satisfaction and positive feelings (Sadock & Sadock, 2008).

But some people feel sad after sexual activity. Researchers call these kinds of negative feelings “postcoital dysphoria” or just postcoital symptoms. A new study sheds further light on these symptoms.

Postcoital dysphoria is characterized by “inexplicable feelings of tearfulness, sadness, and/or irritability” according to the new research (Burri & Hilpert, in press). According to prior research, men appear to experience these feelings more regularly than women — 3-4% of men say they feel sad or irritable after sex, compared to 2% of women (Bird et al., 2001; Schweitzer et al., 2015).

A significant minority of men and women have experienced such feelings at least once in their life. Forty-one percent of men have reported such feelings at least once, and just over 46% of women, according to previous research into this topic (Bird et al., 2001; Schweitzer et al., 2015).

The researchers set out to better understand these negative after-sex symptoms, so conducted an online survey of 299 men (25%) and women (75%). This was a convenience — not a randomized — sample, meaning that the sample was biased by how the researchers advertised for the study. Since the researchers advertised at “different hospitals and universities across Switzerland and Germany and via the internet” it’s like the sample is not reflective of the general population.

A large minority of the sample also self-reported being diagnosed for clinical depression — 21% of men and nearly 19% of women. This characteristic of the sample may also bias the researchers’ findings.

The researchers conducted an exploratory study to determine if postcoital dysphoria might be more complex than just a feeling of sadness or irritability. So they identified 21 potential symptoms they wanted to see may be associated with postcoital dysphoria and placed them in a questionnaire they had participants answer. These symptoms include:

  • Regret
  • Sadness
  • Symptoms of depression
  • Mood swings
  • Worthlessness
  • Unhappiness
  • Frustration
  • Low self-esteem
  • Hopelessness
  • Irritability
  • Agitation
  • Psychomotor agitation
  • Restlessness
  • Reduced energy
  • Fatigue
  • Headache
  • Feverish
  • Cold
  • Shivering
  • Dizziness/Vertigo
  • Difficulty concentrating

They grouped these symptoms into four potential problem areas: (1) depressed mood, (2) agitation, (3) lethargy, and (4) flu-like symptoms.

Many Experience Postcoital Symptoms

Keeping in mind the researchers had a biased convenience sample and were using an unvalidated questionnaire, here’s what the researchers found:

Most (73.5%) participants experienced postcoital symptoms after consensual sexual intercourse, but a considerable proportion of participants said that the symptoms also manifested after general sexual activity (41.9%). Similarly, almost half of participants said that they also experienced postcoital symptoms after masturbation (46.6%).

These numbers are far larger than what previous research has suggested. This is due to the fact the researchers greatly expanded the definition of what postcoital symptoms might be, and the use of a convenience sample that seemed to be heavily populated by people with depression.

Significantly more women reported at least some sort of postcoital symptom over the past 4 weeks than men. Women also reported more lifelong “depressive mood” and “flu-like” symptoms, as well as any lifelong postcoital symptom than men.

The sample size was biased toward women, so this may be an artifact of the small sample size with respect to men participants. It also disagrees with the previous research into this concern, which has generally found that it appears more in men than women.

All in all it was interesting to learn that the researchers find far more people than previously thought experience postcoital symptoms. This finding may not hold up with further research with larger, randomized samples. However, feelings of sadness, agitation and lethargy after sex may be more common than previously understood. It may be a more common occurrence in people who are already coping with an existing mental health concern.

And if you’re one of the people who feel this way after sexual activity, know that you’re not alone. Like many things regarding sex, it’s just one of those things that most people don’t feel comfortable talking about.

 

My thanks to ScienceDirect and Elsevier B.V. for access to this article.

 

References

Burri, A. & Hilpert, P. (In press, 2020). Postcoital Symptoms in a Convenience Sample of Men and Women. The Journal of Sexual Medicine, In press.

Bird B, Schweitzer R, Strassberg D. (2001). The prevalence and correlates of postcoital dysphoria in women. Sex Health, 23, 14-25.

Sadock BJ & Sadock VA. (2008). Kaplan & Sadock’s concise textbook of clinical psychiatry. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins.

Schweitzer RD, O’Brien J, & Burri A. (2015). Postcoital Dysphoria: Prevalence and Psychological Correlates. Sex Med, 5, 235-243.



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