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After having sex that’s satisfying, both partners usually bask in the afterglow and often feel good emotionally. But some people occasionally feel bad after having sex that was good, and not simply because they’ve been sheltering in place with their partner for what seems like an eternity.
When people consistently feel unhappy or bad after having sex that was satisfactory and consensual, they may be experiencing something called postcoital dysphoria. The bad feelings can occur after masturbation, oral sex, dry humping, or finger play and not just intercourse or sex with a partner.
Until recently, it was estimated that fewer than 2% of women and 3% to 4% of men experience postcoital dysphoria on a regular basis. But according to a study in the Journal of Sexual Medicine—a study that I have reservations about—postcoital dysphoria is possibly more common than was previously thought and can have a greater range of symptoms.
Most study participants reported that they experienced sadness, unhappiness, frustration, agitation, mood swings, flu-like symptoms, or low energy at least once during the past four weeks after they had masturbated or had sex with a partner that was satisfactory. There were some differences between the men’s and women’s symptoms, but they did not reach statistical significance.
While I applaud the authors of this study for researching an important and under-studied subject, I was disappointed at how poorly the study was presented. For instance, the authors didn’t define what they meant by “satisfactory sex,” so it's not clear whether the sex was satisfying or merely not hated. Nor did the authors specify whether the sex was consensual
When I was on the editorial board of the Journal of Sexual Medicine, I would never have green-lighted the study report for publication without requiring serious changes. If I were teaching a graduate course on research and study design, this study would be an example of what not to do. Still, there’s a lot to be learned from it.
Are the Findings Right or Wrong?
Do my concerns about the study mean the findings are wrong? I can’t tell you, because the way the authors arrived at them is confusing. Fortunately, we can learn almost as much from studies with flaws as from studies that hit it out of the park. Even the most respected studies in human behavior often have more weaknesses than strengths. This doesn’t mean we should ignore or dismiss them but that we need to be careful about generalizing the results beyond the individuals who were actually studied.
The Internet Must Have Been Down
Internet convenience studies (aka online studies) are known for their large number of respondents. This is, perhaps, their greatest strength. Yet even after posting recruiting ads at a number of hospitals and universities and on social media platforms such as Facebook, only 223 women and 76 men ended up completing the entire questionnaire for this study.
Particularly concerning is that the average male in the study was almost 43 years old, or more than 8 years older than the average female, and 21.1% of the men who filled out the questionnaire “suffered from a clinically diagnosed (but self-reported) depression.” What? According to the National Institute of Mental Health, about 5.3% of U.S. males suffer from major depression, so ia disproportionately large chunk of the few men who completed the online study were unhappy dudes. More important—why, if you could find only 76 men on the entire Internet to complete your study, would you even include males?
Low Energy and Lethargy After Sex and Masturbation?
Since the beginning of time, humans have used masturbation as a way to help speed the transition from wakefulness to sleep. So it isn't clear why this study considers feelings of lethargy or low energy after masturbation symptoms of disorder as opposed to a goal.
Also, what if a man worked hard to please a partner during partner sex? Perhaps that’s not tiring to men in Switzerland and Germany, where the study was done, but it can be for men in the U.S.
It may be that the problem is one of translation from German or Swiss into English. Maybe ”low energy” is not what the authors meant. (I emailed the lead author with questions about this but have not received a reply.) Unfortunately, when a study is only a couple of pages long and doesn’t include the actual questions that were asked, it can leave readers scratching their heads.
Flu-Like Symptoms After Sex?
Unless you were being groped while on the Nitro rollercoaster at Six Flags or the Steel Vengeance at Cedar Point, or you were having sex on the top bunk in a dorm room, I’m not sure why someone would have “flu-like” symptoms after sex. But according to this study, 52.5% of men and women experienced “flu-like” symptoms following sex during the past four weeks. A more detailed explanation of what the authors meant by “flu-like” symptoms would have been helpful.
Questions About Their Questions
One of the most important parts of any study has to do with the questions that were asked and whether they measured what the study says they did. The authors of this study created their own questionnaire “based on previous literature descriptions... and further influenced by face-to-face discussion among three sexual medicine experts.” Given that a validated questionnaire was not used, the authors should have at least included the questions and questionnaire they developed. But no such luck. To their credit, however, the authors did mention such shortcomings in their brief “study limitations” section. But including a quick “our bad” at the end of the report doesn't make improve it.
My Conclusion about Their Conclusion
This is a flawed study with some interesting and fascinating results: 91.9% of the participants reported having had “postcoital symptoms” over the past four weeks, with the most common symptoms being mood swings, sadness, unhappiness and low energy. Other symptoms included frustration, flu-like symptoms, and worthlessness.
I realize that the goal of the authors was to broaden understanding of postcoital dysphoria or postcoital symptoms, but to me, the important takeaway is, if you occasionally experience symptoms like these after having sex that is satisfactory or after masturbating, then you are by no means alone. But if you have such symptoms often following sex, you should consider discussing them with a therapist, depending on the severity of the symptoms and whether they are affecting your enjoyment of sex.
I think it's also important to understand that a study like this or postcoital dysphoria itself should not be used to justify the idea that frequent sex or masturbation is somehow depleting or diminishing to a person or to a relationship. Quite the contrary, for the vast majority of people, sex is one of nature's greatest gifts. And that is just as true whether you are having sex with a partner, as long as it is consensual, or sex by yourself, which is, hopefully, consensual as well!
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