Maybe you’re one of of those guys who feels particularly insightful after an orgasm. You know, one of those “post-nut clarity” guys. And, honestly, great for you.
But what if that sense of clearheadedness only helped you hone in on the darker parts of your psyche? Yes, “post-coital dysphoria” is a real thing. One study even found that up to 41 percent of men have experienced the condition in their lifetime. Inexplicable feelings of sadness, crying, feeling pissed off even if the sex was great?
Both post-nut clarity and post-coital dysphoria are common responses to climaxing. They represent “two ends of the same physiological spectrum,” says Justin Houman, MD, a practicing urologist and assistant professor of urology at Cedars-Sinai Medical Center.
“Some men experience mental clarity and relief. Others experience irritability or sadness, and some alternate between the two depending on context, sleep, stress, or baseline mental health,” says Dr. Houman.
The question is, how do you orgasm your way to clarity instead of doom? The thinking online, at least, is that testosterone can make all the difference. On Reddit, there are multiple conversations about men who experience sadness after sex. Several comments pointto low testosterone as the potential culprit.
Likewise, on a recent episode of the podcast “Stavvy’s World,” comedian Stavros Halkias and fellow comic Joe Derosa advised a listener struggling with feelings of shame after sex. Derosa brought up low testosterone as one potential explanation.
READ MORE: 7 Foods That Can Boost Low Testosterone Levels (Naturally)
And, unlike most things you see on the internet or hear on podcasts, there might be something to the link between testosterone and post-coital dysphoria.
Dr. Houman says that low testosterone levels can contribute to post-coital sadness in men. Healthy testosterone levels play a key role in regulating men’s mood, energy, and libido. Therefore, low-T may make men “feel flat, irritable, or even down after sex,” Dr. Houman says.
That said, testosterone is a part of a super-complex combination of brain chemicals, as well as psychological factors like stress, performance anxiety, and relationship issues.
Here’s what you need to know.
Testosterone, Dopamine, and Other Neurochemicals: Sex on the Brain
When you’re sexually excited, dopamine surges through your brain’s reward pathways. Then there’s a natural and fairly abrupt decline in dopamine post-orgasm. This can cause a temporary feeling of lowness or emptiness as dopamine levels eventually rebound.
As a major sex hormone for men, testosterone may also affect this sexual process. However, testosterone levels do not fluctuate in the same way as dopamine after ejaculation. The issue, Dr. Houman says, is that lower testosterone levels can cause problems with mood and emotional regulation. These problems can intensify post-coital dysphoria. In other words, testosterone may not be to blame for the dopamine decline, but low-T can cause the crash to hit harder.
And dopamine and testosterone aren’t the only brain chemicals at play when orgasms trigger bad moods. Oxytocin, serotonin, and cortisol all shift post-O. In addition, prolactin, a hormone, can cause feelings of relaxation in some men but feelings of irritability and dysphoria in others, depending on individual brain chemistry.
READ MORE: How To Do the ‘Squeeze Technique’ and Avoid Premature Ejaculation
So there’s a lot of wild chemical stuff going on during and after sex. (No wonder humans love it?) But in summary, Dr. Houman says, “testosterone sets the background tone, dopamine drives the reward cycle, and other neurohormones help explain why men’s experiences differ.”
Except that when it comes to sadness after sex, there are other complicating factors at work.
Relationship Status and Mental Health
As much as dopamine, testosterone, and prolactin play roles in your mood after sex, it’s also crucial to consider other contributors.
For instance, Dr. Houman suspects that partnered sex (as in, within a committed relationship) may buffer against negative feelings after orgasm through the release of oxytocin. Buuuuut, if there are unresolved conflicts or underlying intimacy issues in the relationship, the opposite can be true. In those cases, post-coital dysphoria might be worse.
And even though this is kind of obvious, your general mental health—including anxiety and depression levels—has an affect on how you feel after orgasm.
READ MORE: The Subtle Signs You Have High-Functioning Anxiety
Look, no one wants to feel sad, irritable, or blaaah after sex. So if you’re concerned about post-coital dysphoria, consulting with a urologist is the best course of action.
But what about testosterone?, you ask.
Testosterone and Post-Coital Dysphoria
Yes, low testosterone levels can cause or worsen post-coital dysphoria, Dr. Houman says. “But it’s important to confirm the diagnosis with labs and a full evaluation before assuming hormones are the sole cause.”
If blood tests do indicate that low-T is, in fact, contributing to post-orgasm dysphoria, healthy lifestyle changes such as exercise, sleep, cutting out alcohol and smoking, and weight loss can stimulate the natural production of testosterone. For some men, testosterone replacement therapy is an option as well. It’s worth noting that TRT can shift the production of other hormones like estrogen and prolactin, which can further aggravate emotions after an orgasm.
And also testosterone replacement therapy is a Big Decision. This decision should be made with a doctor who closely monitors the process to manage T levels and side effects.
READ MORE: 13 Sneaky Low Testosterone Symptoms To Look Out For
But if healthy habits alone can shift post-nut dysphoria into a state of clarity, that may be enough of a motivator to eat better. Exercise and sleep more, and throw back fewer beers in for the sake of a happier ending.
This article by Lauren Vinopal was originally published on Men’s Health US
