There is another type of dysphoria called post-coital dysphoria, which clinical psychologists categorize as a female functional disorder, where the person experiences negative emotions characterized by crying, sense of melancholy, anxiety, agitation, or aggression after sex. While it is mainly reported in women, there have been some rare cases of men experiencing it as well.
Dr. Rullo says this phenomenon is caused by both physiological responses, resulting from the “come down” of all the juicy neurotransmitters that flow during intimacy, and emotional ones, which can result from a decreased sense of excitement and closeness when sex is over.
Sexual aversion disorder
Sexual aversion disorder, or SAD, was once categorized as a sexual desire disorder in the fourth edition of the DSM (Diagnostic and Statistical Manual of Disorders, a manual classifying and defining mental disorders) and defined as a “persistent or recurrent extreme aversion to, and avoidance of, all or almost all, genital sexual contact with a sexual partner.”
Psychiatrists speculated that SAD overlaps with vaginismus, sexual desire disorder and phobias but it was eventually removed from the fifth edition of the DSM due to lack of evidence and extremely rare cases of diagnoses. These days, it’s rare to receive SAD as a diagnosis. “In my opinion it is a highly stigmatizing label, because it pathologized two very normal things: libido differences and asexuality or demisexuality,” Dr. Goerlich says. “’Sexual Aversion Disorder’ assumes that sexual desire is normal and that the absence of desire is problematic.”
While it may not be its own clinical diagnosis, avoidance around sex is real and can be attributed to trauma or negative associations with sex as a result of cultural, religious or societal conditioning. Having treated many patients with similar symptoms, Dr. Rullo mentions that these intense aversions around sex can also be attributable to a phobia. If that’s the case, patients may benefit from a type of exposure therapy called sensate focus, which is a series of increasingly more sensual, and then sexual, exercises with one’s partner in their home.
How to overcome sex anxiety
To repeat myself: It is normal to experience moments of anxiety around sex. As a society, we are slowly beginning to understand the link between mental health and its effect on our sexual health. “Given that anxiety about sex is a natural response to tons of oppressive messaging about sex, sexuality, and relationships, I rarely think about sexual anxiety as pathological,” says Tanner. In other words, the issue is likely not just the act of sex, but rather our thoughts and feelings about it. In most cases, we’re unconsciously projecting those feelings whenever we engage in sexual activities.
