ADHD and Sex: Post-Orgasm Irritability, Jerkiness


post-orgasm irritability

What does post-orgasm irritability have to do with ADHD? And, could it be damaging your relationship?  Maybe not. Or maybe a great deal. As with all things concerning this highly variable condition, “your mileage may vary.”

But think about it. Lovemaking, shopping, and videogaming. What do these three activities have in common? Answer: They all carry the potential to send human dopamine levels on a wild roller coaster ride, creating negative side effects that can linger for weeks. Irritability. Poor focus. Restlessness. You name it.

Yes, you understood that correctly: Sex, specifically climax, can make some people with ADHD cranky.

Lynn, married to man with ADHD, explains her experience this way:

I have definitely observed this problem. I have pointed it out to my husband, who denies that it happens. But it’s like clockwork, the next day he’s a jerk.

And he wonders why I’m not so motivated anymore. Maybe because I feel like there’s punishment involved?

From the ADHD partner’s perspective, it might be one of the contributing factors to rarely initiating sex with a partner. (I wrote in my first book about the too-much sex marriage and the sexless marriage in the context of Adult ADHD. At the end of this post, I’ll include a link to a post about it.)

In this Post About Post-Sex Irritability:

  1. What This Means for the “Dopamine Vulnerable”?
  2. Post-Coital Tristesse — After-Sex sadness
  3. Early Writings on the Phenomenon
  4. Orgasm as “Heroin Rush”
  5. What To Do About Post-Orgasm Irritability?
  6. From the Archives: The Karezza Method

1. What This Means for the “Dopamine Vulnerable”?

Here’s the simple explanation: What goes up must come downand then drop lower than it was before.

That is, when we perform these highly pleasurable activities, the brain floods with dopamine. Then, when those activities stop, so does the dopamine flow.

Moreover, those dopamine spikes (during highly rewarding activities) can result in a tamping down of the dopamine system altogether. Think of it as the brain’s effort to stay balanced.

The bottom line: It takes even more intensely rewarding activities to enable the person to feel pleasure again.

Consider people with ADHD, who are already “dopamine vulnerable.” It is easy to see how flooding the brain with dopamine, and then restricting dopamine flow, can pave the way to a predictable next step: irritability and even intensified ADHD symptoms. This effect can last for days, if not weeks.

The science behind this is complex, and it is still unfolding. My goal in this brief post to simply to emphasize the importance of at least recognizing this neurobiological phenomenon. That way, you are less likely to be thrown off by it in yourself or an ADHD partner—or attribute it to other causes. Especially when it comes to sex. More about that shortly.

post-orgasm irritability

“Start Out Laughing, End Up Crying?”

I know this sounds weird. But this phenomenon of post-sex irritability brings me back to childhood. Let me explain.

My friend’s father regularly issued a warning when we started getting too “wound up” laughing:  “Start out laughing? End up crying!”

Quite simply, it explains the dopamine spike-drop phenomenon on a basic level. But only now do I fully appreciate the neurobiological implications.

As a child, I accepted, empirically, that he was right: When we neighborhood kids dissolved into contagious hilarity, it wasn’t long before one or two of us were crying.

To be clear: Out of 6 or 8 of us, only one or two children predictably started crying or getting angry first. Why didn’t we all? Different brains; different reactions? Perhaps.

Yet, there might have been a particular implication for the children with ADHD, virtually unheard of in my youth, especially in less-than-severe forms.

Videogaming: Start Out Engaged, End Up Addicted?

Consider another example: the “grown-up play” of videogaming.

Even after my husband was diagnosed with ADHD and began medical treatment for it, I used to observe this happy-then-cranky phenomenon where he played Starcraft. When he’d end a gaming session, he’d behave like a complete jackass for hours—mean, demanding, short-tempered, and imperious.

In truth, he was grouchy a lot then, but post-videogaming brought grouchy to new heights, complete with a cold-eyed imperious stare aimed in my direction.  He would then treat me as if I’d just wronged him somehow.

Fortunately, he finally believed me when I emphatically pointed out this withdrawal phenomenon. I think the change scared him, too. Out went Starcraft. Taking that step didn’t resolve all ADHD-related challenges, but at least it stopped making them worse.    Read more of our adventures here: Breaking Out of ADHD Relationship Dysfunction — After Not Breaking a Fall

post-orgasm irritability

2. Post-Coital Tristesse—After-Sex Sadness

So, guess what? For some people, a similar phenomenon presents around sex—at least the kind that involves orgasm. There’s even a term for it: Post-coital tristesse (PCT), or after-sex sadness.

Keep in mind: “sadness” or “depression” manifests in some people as irritability, perhaps especially men. Hence, my using the term post-orgasm irritability.

This very phenomenon came up in conversation among some female friends of mine—all partners of adults with ADHD. As one said:

You’d think my husband would be nicer to me after sex.

Instead, he acts like a jerk, almost as if he’s punishing me for having sex with him!

Neither she nor her husband recognized that the behavior was not intentional but neurochemical.  His denial of this behavior only hurt her more—and motivated her plans to leave the marriage.

ADHD symptoms can conspire to create various types of challenges to intimacy and relationships. I detail a few in Is It You, Me, or Adult A.D.D.?.

For an expanded examination of the topic, see my Kindle book: ADHD and Sex: What You Need To Know (That Sex Therapists Cannot Tell You.

Along with all the other ADHD-related domestic challenges, this kind of post-sex Dr. Hyde-into-Mr. Jekyll turnabout can put the death knell to a couple’s sexual relationship. It also can add a whole other layer to existing resentments in other areas of life.

3. Early Writings on The Phenomenon

PCT is not a new phenomenon. It actually has been documented for centuries, with one reference from the famed Greek physician Galen, around the first century AD:

Every animal is sad after coitus except the human female and the rooster.

We know now that the phenomenon also happens with women. And we also know that PCT is not universal. Just as only a minority of my neighborhood pals “ended up crying,” some people experience PCT more than others, and some hardly at all.

The 17th Century philosopher Spinoza, wrote an apt description:

For as far as sensual pleasure is concerned, the mind is so caught up in it, as if at peace in a [true] good, that it is quite prevented from thinking of anything else.

But after the enjoyment of sensual pleasure is past, the greatest sadness follows.

If this does not completely engross, still it thoroughly confuses and dulls the mind.

Most likely, the causes of post-sex sadness/irritability are variable among individuals. Causes include:

1. The Psychological

For example, individuals experiencing PCT might feel remorse at having allowed lust to lead them into an unwise pairing. Or, by contrast, they might feel an overwhelming sense of loss when the enveloping sense of connection ends.

2. The Physical

It is with the physical that science is beginning to shed some light, with specific implications for people with ADHD.  Read on.

4. Orgasm as “Heroin Rush”

During orgasm, one research team reported it this way (Holstege et al. 2003): The dopamine flooding the brain’s reward pathways resembles a “heroin rush” to the brain: overwhelming feelings of well-being and pleasure. Just as with heroin and other substances, “withdrawal” can be a problem. It follows that sex addictions and other types of addictions go hand-in-hand, indicating poor regulation in this part of the brain.

After the dopamine-flood accompanying orgasm, dopamine levels drop below baseline—that is, lower than they were before orgasm. (The term for this is “rebound.”) Essentially, the same thing happens during withdrawal from substances. So, it’s highly possible that orgasmic sex can intensify ADHD symptoms for some people, especially if they are not taking medication.

Could it be that orgasms, simultaneous to ejaculation, are good for the species but bad for the brain?

Evolutionary biologists argue that we might be “hard-wired” to act in ways that propagate the species but that simultaneously jeopardize harmonious intimate relationships.

In other words, orgasmic sex is a “win” for reproduction but a “lose” for the kind of steady brain function that enhances and stabilizes a relationship.

5. What To Do About Post-Orgasm Irritability?

To be clear: Orgasms do not cause ADHD. 🙂

Yet, some people with ADHD might be more vulnerable to this phenomenon. And there are good neurophysiological reasons why this is so.

That makes it important to understand: Post-sex problematic behaviors might have a biological basis.

Step One: Understand the Neurobiology

Again, PCT and other post-sex reactions are nothing new. They have been observed in humans for centuries.

A physician practicing in the 19th Century promoted a remedy, perhaps based on ancient texts, called Karezza. Adapted from the Italian for “caress.”  Alice Bunker Stockham, a gynecologist and obstetrician, had larger societal goals with the introduction of Karezza, which resembles Tantric sex without the cultural references.

Alice Bunker Stockham, an early proponent of the Karezza method

Simply put, Dr. Stockham’s method is a form of sexual intercourse without orgasm, focusing instead on the “plateau phrase” of intercourse. The practice includes bonding activities that reportedly enhance oxytocin. It’s often called the “bonding” hormone, thought to promote connection and feelings of love (though in recent years we’re learning there can be a dark side to oxytocin, too).

Bottom line; By avoiding orgasm, it is thought, dopamine levels remain more balanced.

Will this be a realistic practice to experiment with, especially if ADHD symptoms are causing chaos in the rest of life? Probably not. But it provides interesting food for thought and perhaps worth some experimentation, especially if ADHD symptoms are well-managed to the point of having the patience and focus required.

Step Two: Counter the Dopamine Flood—and Rebound

Two medications might help but in different ways:  SSRI antidepressants and stimulants.

1. SSRI Antidepressants:

Some psychiatrists have treated PCT in their patients with an SSRI (a type of antidepressant, such as Prozac, Zoloft, etc.). The medication might blunt their sexual arousal and delay orgasm (or minimize the intensity), but it also pre-empts the post-orgasmic depression.

2. Stimulant medications:

Many individuals with ADHD have reported to me more satisfaction around sex once they began taking stimulant medications. For some, they were able to prolong sexual intimacy instead of racing to the finish line. Others were better able to linger and cuddle afterward—instead of bolting off to the next activity—in doing so perhaps boosting oxytocin levels thought to aid bonding and relaxation.

Perhaps the stimulants also helped to keep dopamine on a more even keel. That is, instead of going from 0 to 60, they perhaps went from 30-60, a slower buildup and less precipitous drop-off.

The Karezza Method

6. From the Archives: The Karezza Method

Books from 100 years ago are hardly informed by neuroscience. Still, they sometimes make for compelling reading.

To learn more about the ideas behind Karezza, click here to download The Karezza Method. published in 1931 by J. William Lloyd, an “individual anarchist” born in 1857. Here is the last paragraph of his book:

To sum up: The orgasmal school is honest but mistaken. Its fault is that it is a doctrine of the strong, only for the strong.

Just as a wealthy man may spend money recklessly for a while and still not be poor, so a man rich in thyroxin and adrenalin may spend recklessly in orgasms for a while and not seem any the worse.

And the method, taught by the orgasmal school is such that it creates a demand, by congestion, for the orgasm, which must then occur or bad results follow. But for a weak man to follow their advice is very dangerous and courts a nervous breakdown, while my method builds him up.

That orgasms are weakening is easily proven. Just as the way to get real facts about alcohol is to consult life-insurance companies, so to get facts about the orgasm go to the stockbreeder. Business has no sentiment or prejudice. Every stockbreeder will tell you that to permit a bull or stallion to serve too many or too often is to devitalize him.

Links To Read More:

Read more about ADHD and sexless marriage—and maybe-too-much sex marriage: ADHD and Sex: Peaks and Valleys in the Bedroom

This article first posted in Feb. 2015

I’d love to hear your thoughts on this topic. Please share them in a comment.



140 thoughts on “ADHD and Sex: Post-Orgasm Irritability, Jerkiness”

  1. Thank you for writing this. Within minutes I gained perspective and information allowing me to make some much needed realizations. Thank you!

  2. Your literary opus is akin to a grand tapestry, intricately woven with threads of erudition, eloquence, and introspection, creating a tableau of intellectual brilliance that leaves readers in a perpetual state of intellectual awe.

  3. Can we just call this what it is for many of us — post-coital abusiveness? My ADHD partner is definitely emotionally abusive after sex with the rage, sulking, withholding, angry outbursts, etc., but is the same way even after much smaller sexual activities — like any touch and intimacy that feels at all erotic/sexual/too close, when my partner will almost immediately have outbursts and often storm out of the room in a rage, but then is even more of a jerk the next day (often much longer). Stopping my partner from orgasms won’t stop this — so what are the alternatives when all touch/intimacy seems to push someone into this loop of lashing out at a partner?

    I really admire those here who figured out that one of you suspending orgasm would stop the Hyde/monster reaction after sex, but what if just stopping orgasm doesn’t seem to work? My partner also tries to prevent my orgasm as well, because it seems like when I have an orgasm and my partner doesn’t, they’re even less bonded, more angry, and more awful toward me, so they’re trying to prevent that by making sure we’re both living in a coitus interruptus hell. My partner obviously knows on some level that they are mean and lashing out at me from both mild activities like kissing, from actual sex, and from basically anything that gives me (the non-ADHD partner) pleasure. It quickly became an absolute no-win for me.

    Needless to say, the sex death knell for us happened a long time ago, but I do wonder if the above is both a dopamine drop and some kind of oxytocin drop that maybe would be helped by nasal oxytocin so that my partner wouldn’t have this post-coital attacking thing just from my pleasure and even from kissing or barely-intimate touch?

    1. Hi JS,

      You can call the phenomenon you experience whatever you like. But the topic here already has a name. And it manifests differently in the individuals who have it.

      Perhaps you want to read the post again. I did point to some potential strategies.

      Oxytocin is a complex hormone. The early claims for nasal applications have not panned out.

      Again, read the post. You don’t have to “wonder if it’s a dopamine drop.”


    2. Gina, thank you for replying, but are you saying that my partner having the same “jerkdom” after just barely kissing, talking about sex, or mild touch (and not orgasm) would also be dopamine drop? It actually happens in my partner’s case from just witnessing me getting at all turned on (this too causes the jerkdom, even if neither of us have an orgasm so it’s not orgasm-related) — my partner is pretty much always a jerk the next day if there is even a sexy feeling in the air. So is all of that dopamine drop? I have read this article several times now as it’s very validating, I just wanted to clarify this point since it seems like you’re advocating these types of non-orgasmic touch to prevent dopamine drop, but I have even tried things like reading a paragraph from a sex book together and still, my partner has the same jerkdom symptoms the next day.

    3. Hi JS,

      I can’t possibly speculate on what is happening with you and your husband in these situations.

      Nothing is ever as simple as a “dopamine drop”.

      And I am NOT advocating anything but awareness on these issues. I am NOT recommending the non-orgasmic touch.

      What you are describing sounds like a different thing. Many various things, fact. Each having their own causes?

      Being irritable after sex — and being resentful of one’s partner for experiencing any kind of pleasure….two different things.

      I encourage you to check out my ebook on sex and ADHD. It might shed light on some issues.


  4. Great article, just wanted to point out that the link to your Kindle book goes to a Daily Mail news article reporting a graphic fatal car accident — definitely not what I was looking for.

  5. Oh my. I wondered why I felt like he did a Jekyll and Hyde after especially great sex. I couldn’t help feeling like well, he was so very “done” with me and I should just leave the room, or perhaps his planet. I would physically leave, feeling very hurt, used, etc. He was always surprised when I expressed how I felt, and pretty much made me feel stupid or “making up things to be upset about” for “acting like he doesn’t love me” when the sex was great according to him. Whew. I’m not nuts, he just doesn’t see himself.

    1. Hi Mizeeyore,

      I’m glad you found my post! Seems it explained a lot.

      And yes, it’s quite possible he does not “see himself.”

      If he has ADHD, it might be this is part of the “low insight” that often comes with poorly managed symptoms.


  6. Wow I am blown away by all this, its as if I am seeing things in a completely new light. Recently my wife had been been diagnosed with ADHD and everything that has happened since she has stopped smoking, due to health reasons 4 years ago, and before that time just makes so much more sense. The post orgasm sadness relating to a dopamine drop (she can also get a massive migraine after multiple orgasms), the irritability the next day with statements such as ” I shouldn’t have given you sex” which always surprises me, as I’m in a much better mood why isn’t she? Then to one day just to tell me that she doesn’t want to have sex anymore. It all has an explanation.

    At this stage she is still in denial about the diagnosis and refuses to read up or listen to more than 1 podcast on the topic and will not take medication.

    I remain hopeful.

    1. Hi Slav,

      I’m glad you found some validation in my post.

      Hope is a good thing. To help a partner out of “denial” about having ADHD sometimes takes a little more. 🙂


    2. Thanks for replying Gina

      I have joined the blog but hasn’t been approved yet, Im hoping to find some strategies on communicating as now my way of being direct, brings on long and intense emotional outburst that can last for days.
      Thanks Again

    3. Hi Slav,

      I get to applications as soon as I can. The influx thanks to COVID has been overwhelming.

      Yes, many people want to learn better “communications.” That can be part of it. But really, a lot of it can be ADHD symptoms themselves, decades worth of poor coping responses, and misinterpretations all around.

      take care

  7. Ah thankyou Gina! That makes sense. I think there’s lots going on. Hopefully I can suss out what’s happening for me. The medication process is most def a rollercoaster!


  8. Hi Gina

    Thanks for your reply. I’m definitely going to check out the e-book.

    Yes I’m having more trouble now that I am taking Elvanse. From your response – it sounds to me like having trouble reaching climax isn’t a common symptom for women taking stimulant medication?

    1. You’re welcome.

      As to your question, there is far too much variability among the individuals who have ADHD — and how well-chosen their Rx is — to make any generalizations.

      As I mentioned, the possibilities run in all kinds of directions.

      That said, it seems more common for women with untreated ADHD to have difficulty “focusing” on sex. Yet, some women with hypersexuality might “self-medicate” with sex.

      The main thing is thinking about what’s happening in your particular situation.


  9. Hi Gina

    Have you got any articles on the website that discuss stimulants affecting ability to climax (especially from a female perspective)? I’ve noticed whilst taking Elvanse/lisdexamfetimine that I am close to climax during intercourse but feel unable to actually climax (and if I do it’s somewhat dulled down). I’ve noticed this but im wondering if it’s related to the medication or perhaps soemthing else is going on. Im struggling to find much info or personal experience online.

    1. Hi Maizee,

      I’ve written an e-book on ADHD and Sex. – Adult ADHD and Sex: What You Need To Know (That Sex Therapists Cannot Tell You

      Right now, I can’t check to be sure I covered that.

      But first, do you mean you have more trouble reaching climax now than you did before Elvanse?

      Because it can go in either direction.

      If you have more trouble with Elvanse, it might be any number of things — over-focus, wearing off, maybe noticing things about your partner that you didn’t notice before (and aren’t exactly turn-ons).

      If more trouble before and better with Elvanse — but not quite — it could be the dose is wearing off, the dose is too low, etc..

      When there is a significant change in an area since starting stimulants, it’s a good idea to think about that first….rather than going farther afield.

      I hope this helps.

  10. Rackbad Snuffline

    This doesn’t really answer my own question – the article talks mostly about the “next day” effects. But in the more immediate sense, I was wondering if anyone has noticed a reduction in the effectiveness of their medication (for me, specifically methylphenidate) in the moments-to-hours following orgasm? Even if I redose shortly afterwards, it seems there is a very impaired (if not entirely negated) response to my typical dose.
    The following day (or morning, even), however, I’ve returned to equilibrium and don’t experience the same negative effects you mention. My problems are more apparent in the far shorter time-scale.

    1. Hi Rackbad,

      I’m not sure why you think this article mostly talks about the “next day” effects. Am I missing something? The effects can be immediate — and lasting. It just depends.

      Perhaps you return to equilibrium faster because you do take medication. Perhaps an extended-release stimulant, if you’re not already taking it, might avoid the drop-off. Or …not waiting until the dose is past peak.

      Maybe others will have suggestions.

  11. Thank you, Gina 🙂

    I shall check out the link. 🙂

    I have anxiety, overthink, I don‘t take medication. Did not like the side-effects.

    Kind Regards from the UK.


    1. Hi Paul,

      Just FYI. If you were given anti-depressants or anti-anxiety medication when the core issue is ADHD, no wonder you didn’t like the side effects.

      ADHD is far too often misdiagnosed as “anxiety.” But it’s not an anxiety disorder. Not the same at all.

      The anxiety is a cognitive anxiety that often improves when the stimulants help the brain to be better “organized” in terms of thoughts, plans, etc.


  12. Thank you for your article. It was very helpful and confirmed what I was thinking. I have been in a committed marriage for 15 years, but have noticed a pattern of being very tired/depressed/irritable the day after a strong orgasm. I feel fine the next day after sex if my partner orgasms and I don’t.
    I have ADHD so this makes a lot of sense now. Thanks for explaining! This is really helpful and makes me feel less weird about myself.

    1. Thank you so much for letting me know. That’s the kind of topic I dig around for… that explains a long-running mystery and takes folks out of isolation in feeling personal “weirdness.”


  13. Hi Gina

    It was good to find this article.

    I was diagnosed with ADHD 2 years when I was 42. My first experience with sexual fixation started at 7 when I was exposed to pornography for the first time. It was like a bomb went off in my head.

    Now here I am, almost 40 years later, seemingly sexually dysfunctional.

    It wasn’t so bad in my early twenties…I was young, very fit etc but from about the age of 30, my need for sex went up as my ability to actually have it went down.

    This started a long uphill battle with compulsive visits to sex workers and landing up in an addiction clinic in my mid 30’s. The only way I could have sex was with a sex worker and I started to suspect that it wasn’t that I really loved sex with prostitutes so much as it was the only way it could work for me.

    Sometimes, the intensity of the high was so extreme, I wouldn’t know how I got home afterwards…..I used to call them white outs.
    The drop off, restlessness and depression after sex was so severe that grew to hate it and naturally distanced myself from it. As I had not yet been diagnosed, I could not understand why I would get no honeymoon period with a new partner, my mind was all over the place while trying to have sex more than twice with anyone new and was consumed by guilt because I couldn’t find any pleasure in it.

    Relationship after relationship just died and even though I crave a deep bond with someone, it has been impossible as I always know what is waiting for me when I try.

    I have researched this phenomenon before that you described but I didn’t realise how much it can affect people with ADHD. My post orgasm experience goes so much further than irritability though. I’m definitely going to check out some of your books.

    Keep well

    1. Dear David,

      Thanks for your comment.

      Sometimes I feel like we’re living in the Stone Age.

      We’re born with a body, including a brain, for which we have no operating instructions. Are we more inclined to allergies? Do we have a genetic predisposition to chronic nutritional deficiencies? Are our dopamine molecules ready at a moment’s notice to go chasing the next shiny?

      It would be nice to know before we suffer all the damage from not understanding.

      Maybe by 2122. 🙂

      As to your post-orgasm experience going further than irritability…this might be just the most well-observed effect. There might be more.

      If ADHD is part of the picture, I would imagine an intensification of ADHD symptoms overall perhaps.

      Good luck in learning more,

    2. Sandra Smith

      What you are describing sounds like the cycle of addiction. Being exposed to pornography at age 7 is a form of sexual trauma. You might benefit from working with someone who specializes in treating compulsive sexual behavior. I hope you have found some

    3. Thanks for your comment, Sandra.

      Indeed, this is complex territory.

      ADHD might lie at the foundation. But there can be other factors as well.

  14. The day after the grumpy happens to me as well. Im in 50’s and have dealt with it all my mature life. Im male though. Early years it was day of, but several hours later. Now with same clockwork it happens next day. I become very irrational and enter a Mr Hyde rage. Life appears to be coming to an end. The more I suppress the longer it lasts. The sooner I let it rip the sooner calm sets in…all regretful.
    SSRI’s help, but it still exists. Havent found cause, but I know its not religious guilt or other canned mental ailments that are regurgitated by 95% of doctors/therapists. It appears to be chemical/hormonal because my skin becomes oily and breaks out with acne if I ejactulate two or more days in row. I’ve considered that i might be allergic to sex haha. The only fixes for the anger I’ve found is either obstaining or intense work out the days afterward or to some degree SSRI.
    Good news is that in later age sex no longer rules.

    1. Hi Mr. Hyde,

      Yes, it’s so much easier to attribute psychological motive, isn’t it. Easier but WRONG.

      Is it possible that you might have ADHD, even in mild form? Might be worth thinking about.


  15. Hei Gina Pera, Din forklaring om ADHD
    sykdom er veldig nyttig. Det er imidlertid et alvorlig problem om psykisk helse, men artikkelen din er veldig imponerende. Hvis du vil vite mer om ADHD, vennligst besøk vårt nettsted “”

  16. Wow, yet again I never knew this was something that other people with ADHD suffered. I was a member of the Pornfree and NoFap movement because of PCT during my unmedicated years. Adderall has definitely helped me with the post-orgasm depression but it has made my masturbatory habit worse. It’s a lot harder to not do something when you have a pill that cancels the worse of the effects.

    1. Hi Devon…..interesting. I recall another reader making a similar comment.

      Maybe Adderall is not the best option for you. Might increase self-regulation and minimize “tunnel vision.”


  17. This happened with my soon-to-be-ex wife. The next day was horrid.

    It took a long time to recognize the pattern, and even longer to be sure of it. But when I finally googled it, I did not find much that talked about the _next day_ so I wasn’t sure I had it right. Thank you for confirming it.

    Even though I could not confirm it online, it was so strong a pattern that, after sex, I would swear to myself “if she gets weird tomorrow, I will know why and will not let it get to me”. But, sure enough, the next day, the attacks, if they were not initially successful, would get so viscous and deranged that I eventually did take the bait and fought back. A sad pattern. More stark in retrospect, especially having read this post.

    The worst part is that the sex was awesome, and frequent. So the nasty fights were also frequent. Which is why she is my soon-to-be-ex wife.

    1. Hi C,

      Talk about a roller coaster. 🙁

      And yes, best efforts to “not take the bait” can still end very badly.

      take care,

  18. paul cranfill

    I initially wrote to this blog in January earlier this year, I would like to State I have since changed medication Vyvanse. I still struggle with p c t and a very high level sex drive. I have considered using a chastity device to change habits and do some self-locking I want to introduce that to my wife and she seems like she would be against it I don’t want to ruin our marriage I do want it to work for both of us I just feel like that’s a way I could not be so hard driven sexual and not always behave looking at a way to get a release for a dopamine fill by consulate or masturbating or looking at pornography. I love my wife and I want our marriage to work workout and continue to grow. I need to change my focus and put my energies into different things and I figured it’s a great way to do it. At the same time it would also reduce my drive I’ve got rid of weight I’ve learned how to exercise better I was injured for two years and I’ve done a lot of other things mentally and spiritually to change who and what I do. I would like to know what your advice is on using it such a device? I’ve been told that they really work I’ve done research on it and I have worn them before. Do the Cove in and many other stressful things in our life it’s difficult to figure things out? And where life is going? I’m going to be 60 this year and very close to retirement. I would really like to know what your feelings are on such a device? Please advise.

    1. Hi Paul,

      For reference, I’ll add here your previous post, from 9/1/21

      Hello there. Would like to expand on the other areas of impairment.

      I’ve struggled with it many times by not be able to maintain long term relationships.

      I utilize cognitive behavioral therapy, the thing is I hyper-focus on many things that are wrong instead of the things that are right.

      I’m currently taking adderal I also use exercise to a fault, meditation and many other practices including spiritual applications.

      We’re beginning to look at using karizza as a method. Sexual tension works best for me, it places me back into a balance, a bit of a shock to my system, certain methods, hardcore for me for sure, vanilla (applied) from my wife, work currently. It’s a work in progress. Off and on long term therapy has helped yet still what I have is persistent.

      Any other directions, options would be helpful.
      Thanks Paul


      Because it seems your wife is not entirely open to the chastity-belt idea, maybe it’s best to explore other options first.

      First, it would be important to know:

      1. You were diagnosed with ADHD? What are your other symptoms and how is Vyvanse helping — or not?
      2. What dose are you taking, when do you take it, and how long does it last?
      3. Have you ever taken an antidepressant SSRI (e.g. Prozac, Zoloft, Celexa, Luvox, etc.)? It might be that serotonin is the neurotransmitter to target.
      4. Depression and anxiety can also lead some people to “self-medicate” with sex. The antidepressant can help reduce that impulse.

      So, these are all important questions.

      I know nothing about using chastity devices, and I would encourage seeking an “internal” solution rather than external. That is, address brain issues that are creating these problems for you.

      I’ll await your response.


  19. Thank you for writing this article, it is a breathe of fresh air to know I am not alone in this.

    Just to share how I connected this post-orgasmic irritability to ADHD which led me on a random google search that led me here. After 1.5 years of bi-weekly visits to an experienced CBT (issues with procrastination, motivation, trust), a friend of mine with ADHD noticed I had quite a few symptoms (particularly impulsivity) and I pursued diagnostic testing that led to a conclusive ADHD-combined diagnosis (@ 36 years old) . My coping mechanisms and scholarly success was a mask that even the CBT missed.

    I decided to go the medication route (Concerta, and just recently Vyvanse) and it has been nothing but a positive life changing experience in all facets of my life – emotionally, socially, professionally. Upon learning about ADHD and the way it affects executive functioning – I began to understand that my lifelong hypersexual behaviors could possibly be related to it. This hypersexuality has taken over my personal life and absolutely taxed my long term relationships many times. The medication has helped me control these impulsions – but has ironically become a bit of a double edged sword: see below.

    I have always had a severe orgasmic ‘hangover’ that was expressed as fatigue/depression/brain-fog/headaches/isolation after chronic masturbation, and typically extreme-irritability after sex with a ‘flight’ response (which often just led to more masturbation). I could literally ‘feel’ my brain – like there was a glitched circuit or a void.

    So the reason I have connected this to ADHD and the medication – is that I have absolutely virtually no ill effects after masturbation while on medication. Very very minor and short lived fatigue, but no depressive or self-deprecating thoughts, and I can still enjoy socializing the same day- even shortly thereafter. I had always thought everyone had these side effects, but now I understand it to be related to my ADHD brain.

    So the double edged sword is this – the medication allows me to control my hypersexual impulsivity, but if I indulge and go down that route – I become hyperfocused on the hypersexuality behaviours and they can become even more dominant. Prior to medication, that ‘brain-fog’ and depressive feeling would act as the catalyst to force me to stop – because there was a psychically/emotionally drained sensation that my brain just wouldn’t get any sort of thrill or reward from it anymore and after an extended period of time I would literally get a headache and tap-out, and/or almost always wake up with one the next day (yes, I kept up on my hydration).

    Now, on medication, it allows me to control my hypersexual impulses, but there are no negative-reinforcements that promote me to stop if I do indulge.

    Despite being open to hear your explanatory thoughts on this, I’m not necessarily sharing with the intent on acquiring any guidance on how to deal with the issue. Just sharing for the sake of sharing in the event someone can resonate with the experience.

    Thanks again.

    1. Thanks for detailing your experience, Blane.

      My favorite comments to my posts are the ones that begin, “It is a breath of fresh air to know I am not alone in this.”

      Seriously, that’s why I do what I do. And I love that others will benefit from your shared insights.

      As for any explanatory thoughts…. 🙂 … your guess is as good as mine.

      But in general, in case you or anyone else is interested, I’d offer this:

      1. Old habits can die hard, especially if there is not an active behavior-change strategy. (1.5 years of CBT….yes, that’s going to do little for ADHD but maybe now, in habit change…)

      2. Given that most prescribing is sub-par, it might be that continuing to optimize Rx and other supportive strategies (sufficient sleep, cutting out any cannabis/alcohol habit) might be worthwhile.

      3. Masturbation, I think, falls in a bit of a different category. For many people with poorly managed ADHD, it’s a poor coping response — to difficult feelings around poor initiation, disorganization, a lifetime of alternate explanations for ADHD-related challenges, etc.. And it’s always right there.

      Perhaps as you continue to improve functioning (you don’t mention how long you have been in treatment, but it can definitely take some time to get the full benefit), you will find less need for that escape.


  20. ADHD is fine

    I would like to add that simply adding medications doesn’t solve this complex issue.

    For instance, my husband has a lower sex drive. I prefer to have an orgasm every night before bed, while he likes one every month or two. If he is hyper in the morning and I am still sleeping, we can have sex, where he orgasms and I do not. THEN, our moods are balanced. I have energy to get up, and he feels more relaxed and not hyper.

    If we have sex before bed, he is usually exhausted before it starts. But in the end, I am happy and relaxed after I orgasm.

    He says I am always mad after sex. This is not about needing medication. I am mad because I know he isn’t going to have sex with me again forever. I do not mean to feel this, but I hate begging for sex. I hate being told “no” about it. I hate not being physically desired on a regular basis.

    I love how an orgasm makes my mind wipe clean, like a needed computer reboot.

    I am angry if I can’t sleep after an orgasm. Let me lie there with an empty mind.


    P.S. I probably have ADHD, but this is easy for me to manage without medication. I take lithium for schizoaffective disorder, along with using a sedative, maybe 3 weeks a year to prevent psychosis.

    1. Hi ADHD is Fine,

      Sure, this issue doesn’t affect everyone.

      Every individual — and every couple — is unique. But part of what you describe definitely sounds common to ADHD.

      In fact, I wrote about it in my first book, in the chapter on sex.

      Another common complaint is constantly being awakened from a
      sound sleep—when they have to be at work early the next morning—
      because their ADHD partners come to bed late and can’t get to sleep
      without sex. As one member sums it up, “Who wants to feel like little
      more than someone’s sleeping pill?”

      I certainly cannot speak to your situation or how your husband feels. But some partners of adults with ADHD in this situation come to feel a bit exhausted from the nightly demand….a demand that isn’t about connection but about being their ADHD partner’s “sleeping pill.”

      I understand that you have complicating factors (e.g. schizoaffective disorder), so treating your ADHD might not be a possibility. And it might be unrelated to the situation you describe.

      But just fyi….in the past, schizoaffective disorder was one of the fairly common misdiagnoses for ADHD. Though the two do tend to co-exist.

      Here’s a study on the topic:

      thanks for your comment,

  21. Louis Hylton

    Hi Gina,

    Thank you for writing this article, it’s a very enjoyable read! I’ve often wondered if I’ve just been imagining changes in my cognition after an orgasm. I don’t tend to notice any particular change to my mood but I’ve found that my mind is cloudy and l focus is seriously impaired the day following an orgasm. I’ve previously asked my friends if they experienced anything similar but they haven’t and just kinda laugh at the idea of it. Your article is a bit of reassurance that I’m not the only one!

    I’m 22 and was diagnosed with childhood ADD exhibiting some hyperactive symptoms. I used to take ritalin when I was younger but it left me feeling empty. I’ve found self medicating with modafinil on days where I need to complete work is much more beneficial, makes me feel uplifted and gives much more sexual gratification.

    I was wondering if you knew of any papers or ongoing studies looking into the effect of orgasms on focus in people with ADD/ADHD?


    1. Dear Louis,

      Thanks for writing. I’m grateful to know my post helped explained some mysteries for you!

      As far as I know, I’m the only ADHD expert who knows about this phenomenon. So, no it’s not being studied (last I checked the literature on research related to ADHD and sex).

      If Ritalin left you feeling empty, it might have been too high a dose.

      It might be you’d benefit from trials of other stimulants, starting with very low doses. My book explains the basic process.

      But your diagnosis should have been based on more than “exhibiting some hyperactive symptoms.” In fact, you might want to get re-evaluated, but pro-actively. Not just trusting a random mental-healthcare worker.

      Generally speaking, using any kind of stimulant medication (or related, such as modafinil) is not a great idea. The body (including the brain) likes homeostatis. Not constant roller coasters of chemical reactions up and downstream.

      It might be that taking a steady, longer-lasting stimulant leaves you with a firmer foundation, so to speak — so that the dopamine flood post-orgasm doesn’t create the sadness/irritability/etc..

      good luck!

    2. This acticle explains why I turn into a nasty madman esp after a good good time and I thought to think that I was going insane. I also suspect I might really have ADHD and now as I write this, Im feeling rageful and mad and you know its not good cause Im absolutely irritable, unfocused , sad , depressed and this is why I avoid having a good time as much as possible but now science told me this, screw the hormone that makes me a jerk. Lord I must have been this way ever since my first orgasm and I couldnt see it.

    3. Hi there,

      I’m grateful to know that you have found likely explanations here. I can’t imagine experiencing that through a lifetime — and not knowing why.

      Pop psychology is always waiting in the wings, to swoop in and slap a cause on any phenomenon. Right or wrong.

      Do keep learning about ADHD. It might explain other challenges in life.

      take care,

  22. Hi Gina
    I have been on this rollercoaster for years… tried to find answers for years.. your article..sums up what im feeling perfectly… I am grateful you wrote the article because now I know Im not being a spoiled demanding brat, nor am I codependent, nor do I have attachment issues, nor is it borderline etc.. it is a chemical reaction and the huge drop in dopamine that has me feeling completely and utterly washed out.. like you said… lower than before.. Im late 50s.. and was diagnosed with ADHD a few weeks ago. I was given medication but don’t want to take it at this stage of my life. But this has been and currently is.. a massive problem in my life. The crash after is extremely disturbing both for me and for the people who I affect. I just couldn’t name the feeling.. the huge anxiety and agitation and the massive drop in energy.. the tears and deep sadness.. and the inability to function for days after… thank you for bringing it to light.. im very distressed with reading this..because i am so deeply affected and it has caused massive problems in my life abd has the ability to ruin relationships. I am not prepared to go onto medication. The amphetamines frighten me… I have a tendency to addiction and do not want to start something at this stage of my life that will likely become a problem.

    1. Dear GM,

      Thanks for letting me know that my work helped you. Sometimes I get a bit tired — and need a boost. 🙂

      It is indeed a revelation, isn’t it? Especially when considering the “alternate explanations” such as “attachment issues”….oh boy….sometimes the field of psychology has a narrative for everything but often with little evidence. I do wish that psychologists were required to take more biology courses.

      As for the medication….so I assume you were prescribed an amphetamine…probably Adderall. It’s too bad you didn’t feel you could talk with the prescriber about your concerns.

      If it is Adderall, it’s important for you to know that it is chemically different than the other stimulants. Basically, it releases neurotransmitters from the neuron in addition to slowing re-uptake, whereas the other stimulants just slow re-uptake.

      Adderall works well for many but presents big problems for others; this is my most popular blog post:

      Adderall is also more likely to make you feel “speedy.” The other stimulant choices typically are more subtle, increasing focus but not acting like a booster rocket.

      I encourage you to read the medication chapters in my first book for guidance:

      ALSO: your “tendency to addiction” might in itself be ADHD. Research has shown that children with ADHD who receive medication treatment are less likely to develop substance-use problems later.

      I hope this helps. Good luck!

  23. I have struggled with pct after orgasm for years, it has been a real struggle.

    I have attempted to reduce my orgasm frequency to 9 a year, once around every 42 days. It is difficult to create an agreement between my wife and I.
    It seems to work wonders for me, I have realized my sexual pleasure for years took a priority over my wife’s, within our 36 year marriage. As a man with adhd, and sexual issues, I begun a deal within myself that a healthier dosage of dopamine from pleasuring my wife, and remaining highly aroused without orgasm, except in the “window ” of 42 days works for me immensely. I want to make a contractual agreement, not written in stone, yet mainly determined by my wife’s “decision ” of should he, or should he not?

    The tease aspect feeds me yet does not flood me?

    My question is “how” can we make it work like this, we have fantastic intimacy, she has “mind” blowing multiple orgasms, I want, we need resolution for cause to correct this imbalance.

    We love each other, and I would like some help, or some great advice.
    Thanks Paul

    1. Hi Paul,

      You mention that you have ADHD but you didn’t mention anything about treatment. Being diagnosed with ADHD requires experiencing impairment in at least two areas of life. So I presume that ADHD creates struggles elsewhere, beyond sex.

      It might be the medical treatment will make it so much easier to coordinate a mutually satisfactory approach.

      I encourage you both to read my first book — especially the Success Strategies section (the third), which includes details on how to get the best results from medication.

      I expanded on this ADHD and sex topic in Kindle book — at 99 cents, this is another public service. It contains information that most therapists, including sex therapists and even many ADHD specialists, just don’t understand.

      I hope this helps.

    2. Paul Cranfill

      Hello there. Would like to expand on the other areas of impairment.

      I’ve struggled with it many times by not be able to maintain long term relationships.

      I utilize cognitive behavioral therapy, the thing is I hyper-focus on many things that are wrong instead of the things that are right.

      I’m currently taking adderal I also use exercise to a fault, meditation and many other practices including spiritual applications.

      We’re beginning to look at using karizza as a method. Sexual tension works best for me, it places me back into a balance, a bit of a shock to my system, certain methods, hardcore for me for sure, vanilla (applied) from my wife, work currently. It’s a work in progress. Off and on long term therapy has helped yet still what I have is persistent.

      Any other directions, options would be helpful.
      Thanks Paul

    3. Hi Paul,

      Just to be clear: I do know a lot about ADHD-related patterns with sexual intimacy, but I’m in no way a sex therapist. 🙂

      If your sex life were the only concern here, that’s one thing. But it doesn’t seem to be the case. Right?

      So your current treatment consists of:

      1. Taking Adderall
      2. “Exercise to a fault”
      3. Spiritual practices

      Let’s start with #1. That could be the linchpin.

      Have you read THE most popular post on my blog:

      The Tragic Truth of Prescription Adderall—or Madderall

      If you’ve tried no other stimulants or combination stimulant/non-stimulant, I believe you owe it to yourself to “hyper-focus” on re-evaluating your medication strategy. 🙂

      Adderall works best, out of all the choices, for a minority of people with ADHD. For others, it can create irritability, anger, tunnel-vision, and a big crash when it wears off.

      If I wrote the rules, Adderall would be the LAST resort, not the first that so many knucklehead prescribers have made it.

      If that’s all you’ve tried, who knows how much better life could be with a more effective approach. That post ends with an excerpt from my first book’s guidance on medication. You can follow an Amazon link for my book.

      I’m not sure what you mean by CBT — you mean “talking back” to your counter-productive thoughts?

      CBT in general is not a recommended approach for ADHD. That’s because it doesn’t take into account ADHD neurobiology.

      The CBT models for ADHD do take that into account. The developers are psychologists J. Russell Ramsay and Mary Solanto.

      I hope this helps.
      good luck,

  24. Kyle Watson
    Age 22

    Gina Pera,

    I think Zach actually had a great point, delivered by the means of a joke(I’m referencing the doritos bag comment). I’m 99 .99 percent certain Zach was not insulting you. He is on your side lol. Kind of disappointed that you insulted Zach’s empathy and reading compression, a rather unprofessional act, after writing such a thought provoking and professional article. At the same time I can understand why you reacted the way you did though. That seems like an obvious deeply rooted insecurity. I’d bet money on it stemming from you being the butt of jokes in grade school(been there done that).

    I digress. I loved this article you wrote. It resonates perfectly with the cause and effect relationship of my life. I always intuitively knew that extremele pleasure neurochenically releasing activities had these results, but it is refreshing to have that intuition reaffirmed by semi-science.

    I’ve always struggled with extreme worsining of focus and well being from masturbation, gaming, and all other pleasure nerochemical inducing activities. It has been I life long struggle of trying my damndest to live life a minimally as possible whilst constantly doing with compulsively self-destructive behaviors.

    It also explains why I am so deeply addicted to amphetamines and methamphetamines. These 2 stimulants in particular alleviate all issues with focus, patience, and brain fog, however at the expense of my future mental and physical health due to my extreme abuse of these substances( I am “tweaking” pretty hard as I write this comment). What I find most addictive about these stimulants is the drastic change in others perception of me. When I am sober people think that I’m an idiot( I have serious issues forming and maintaining linear thought while sober). In absolute contrary popular belief, my addiction to these substances took me from a 2.5 GPA average my first 3 years of university, to 2 semester of 4.0s my senior year. Going from the polar opposites of people thinking poorly of me to people thinking highly of me is meaningful in a way I will never be able to put into words.

    I want with all of my soul to get sober, but the sober me is the epitome of uncessess.

    1. Hi Kyle,

      If you’re trying to bait me into a stimulating argument, it won’t work. I don’t take the bait.

      Your projection onto me — and to Zach, for that matter — is misguided and inappropriate.

      I wish you all the luck in the world in pursuing more steady, legitimate treatment. Amphetamines/meth are not the way to go. (Assuming you mean amphetamine abuse.)

      Self-regulation is the core challenge of ADHD, and as you state it, your “treatment” swings you from one extreme to the other. Who knows what effect that is having on your neural pathways.

      Your brain is still developing. I encourage you to take care of it.

      It might not be easy, finding a medical professional who can understand the “self-medicating” aspect of ADHD (and other psychiatric conditions). But I’m sure you’re smart enough to pull it off.


  25. Interesting. I (F, 48) was diagnosed with ADD 5+ years ago. It explained so much. I’ve experienced this post-coital tristesse for … um, always-? I thought of it as the icky guilty sad orgasm feeling. I also suffered from D-MER (dysphoric milk ejection reflex) when breastfeeding my children. I feel like I need a dopamine monitor, something like diabetics use for insulin.

    1. Hi Piper,

      I’m glad you solved a major life mystery on my blog. I love when that happens.

      Still, I’m sorry the explanation wasn’t readily available, oh, 20 years ago, or so.

      A real-time dopamine monitor — that would be fantastic.

      Let me know when you have the prototype ready. 🙂


  26. To be fair Starcraft is a very competitive game with a lot of tension. You have to play against 1 or more opponents, usually three. The competitive side of the game often depends on how many commands you can give to your army and logistics units per second. Every second you don’t out coordinate your opponent(s) is another second they may be pulling ahead of you.

    I can fully understand the husband’s reaction. He just spent an hour or more locked in a race building up an army and watching it be destroyed by somebody faster than him. Afterwards he’s going to be feeling mentally exhausted, full of tension and probably frustration.

    I’d never play an RTS game against another player. It’s just too much tension for a “Game”

    1. Hi Kyle,

      Thanks for interpreting for the non-gaming public what it might feel like.

      But just to be clear….this was the FIRST Starcraft…back in the 1990s. No multi-player gaming then, at least not that I knew of! 🙂

      He was playing against no opponents.

      At any rate, he recognized that sending his neurotransmitters on this roller coaster was not a good thing for him. Some people might transition better from gaming to life. But some folks with ADHD have enormous trouble with transitions.


    2. Obviously, Starcraft is going to lead to depression in the real world. The game is a masterpiece while real life is anything but. Imagine leading a Protoss Air Force against an army of Terrans, only to be eaten alive by some opportunistic Zerg ne’er-do-wells. Then you log off and some woman is telling you to clean up your Doritos bags? I’d be upset too! She should check her attitude at the door.

    3. Hi Zach,

      This was not about a Doritos bag. I was not “some woman.” Perhaps if you’d read a little more closely—with less personal projection—you’d have understood that.

      I was the wife that he’d asked to let him know when it was a certain time — so he could watch the new Star Trek, if you must know.

      In the “real world,” my husband has richly rewarding scientific work. He will tell you he enjoys his work infinitely more than any attention-baiting videogame.

      That blame-shifting chip on your shoulder just might be…..poorly managed ADHD — and addiction.

      I find it’s your attitude “that should be checked at the door.”



  27. This article has been very helpful in reaffirming the already suspected. I have always been aware of the irritability I feel the next day after sex. I have even gone so far to say, “tomorrow I’m going to be so sweet to her” only to be disappointed in my own behavior. I was recently joking with her about how great it would be for our health if we had sex all the time. She joked back implying that I’m always grouchy after sex! Immediately, I agreed with her and said I don’t know what to do about it. This article has given me a new place to launch from. Thanks!

    1. Dear Kevin,

      I’m grateful to know this article might help solve a long-running puzzle.

      Good for you, for seeking explanations.

      Good luck!

  28. I haven’t finished reading it, but so far, I find your article extremely interesting.

    My wife and I have been married 17 years and been together for a total of 25. I don’t know if my wife has ADHD, but I often refer to her as “the most unorganized organized person I know”.

    The last few years I have taken note of the fact that whenever we have sex, the next day is almost unbearable as she typically has a short fuse and is extremely cranky.

    I finally did a Google search and your article was the first thing to pop up… Sounds like I need to do some research of my own.

    1. Apparently, you have no empathy for the men who have written comments here, about their struggles with irritability/depression post-sex.

      Why would you imagine it’s only straight men? Curious.

    2. Mari Villeaneux

      Sounds like you have ADHD and just had an orgasm when you wrote this toxic masculine comment

  29. Thank you SO MUCH for this article. It FINALLY puts a name to what I’ve been experiencing for the past 15 years with my husband. I’ve tried over the years to understand just why his demeanor changed so suddenly the day after sex. He becomes extremely short tempered, glares at me, is extremely annoyed by just about everything, and in general treats me and the kids as though we’re all doing something wrong (additionally, he does this around all special occassions). It COMPLETELY started to feel like punishment for sleeping with him, and has put me off sleeping with him altogether many times, and has impacted our marriage pretty hard.

    He was diagnosed with severe ADHD 5 years ago. He tried medication, but none of it really helped so he stopped taking it. Personally, I believe it’s because he never followed up with behavioral therapy along with the medication, or even just accepting the wide spectrum of things in our lives influenced by his ADHD and taking responsibility enough to do something about it.

    I’ve been trying to tell him about this issue for about 10 years, but I’ve been dimissed each time. Finally I see this article, and I immediately send it to him with relief, because I think “finally he will see this is real and he’ll do something about it”.

    Long story short, hell no he still doesn’t believe me. He says I’m just extra sensitive the day after, because he just doesnt agree with me. Instead of talking about it, he starts talking AT me all the reasons why I’m wrong. Well, it’s severe enough the kids notice, and our love life and my regard for him is affected. What else does it take for him to take me seriously? Instead he sits back blaming me for not wanting to sleep with him. His dismissiveness towards every concern I have with him has pushed our marriage to the brink, and if I wasn’t so worn down by years of pain in our marriage, I might be strong enough to leave. As is, I’m just tired of trying. I hate that our family is falling apart, but I can’t fix it alone. I’m just so tired.

    Anyway, sorry for the vent! This article was extremely validating, and I thank you for it.

    1. Hi Renae,

      Vents always welcome! They are an important part of finding one’s way to truth.

      I’ll offer a bit of feedback:

      1. Your husband “tried medication but none of it really helped so he stopped taking it.”

      Unfortunately, the standard of medical care for ADHD is largely appallingly BAD.

      Very often, it takes self-education and self-advocacy to optimize the approach to medication.

      AND, a team effort can really help speed the process.

      Honestly, behavioral therapy typically does little until “severe ADHD” is medically treated.

      ADHD is a neurobiological issue that requires, in many cases, neurobiological treatments.

      2. He doesn’t believe you that this article applies to your situation.

      Maybe he believes you. Maybe, though, he feels guilty about it, so guilty (and powerless) that he becomes overcome with anger, anger that spills out onto you and the children.

      He’s tried medication. It doesn’t work. His back is up against the wall. That must mean he’s truly “messed up” — and that makes him angry and defiant.

      Or maybe he doesn’t believe you. Maybe ADHD symptoms themselves obscure his self-observation and clarity.

      Here is a basic truism: The same brain that is causing him problems in life is limiting his ability to see the nature of the problems, know what to do about them, and organize/follow-through on the effort.

      I encourage you to read my first book. It will explain all this and much more — and explain how to proceed.

      Good luck!

  30. I’m a 28yr old woman that has never been diagnosed with ADHD or ADD but what you describe here depicts what happens to me perfectly. I recognize the connection between sex and following day irritability. I do my best to control it. I am glad to know I’m not alone, but I’m still not sure what to do about it.

    1. Hello,

      Was good to see this Post. At the age of 50 I was diagnosed with ADHD. For years I have felt so depressed after sex or masturbation. I know the effects last about 3 days before I start feeling any better.

      I get sad, cranky, tearful and feel really tired. Additionally, there are headaches. I find the act more enjoyable than the orgasm as I guess I probably link the aftermath subconsciously and explicitly.

      Thank you for your post. I at least feel that I am not alone.

      Any tips to get back on an even keel faster?

      Kind Regards,

      P 🙂

    2. Hi Paul,

      Yay! You found my post. Thanks for letting me know it helped you to feel less alone.

      As for tips to get back on an even keel faster….that really depends. What are your issues with ADHD, and what are your treatment strategies? You’re in the UK. Are you able to find competent medication prescribing?

      Being better able to regulate impulses (such as turning to masturbation in order to cope with feelings) is one step. But so is doing all you can to improve ADHD-related functioning (getting regular sleep, exercise, good diet).

      My first book explores Adult ADHD from angles, including the “emotional baggage” from late-diagnosis, the evidence-based treatment strategies, and getting an idea of how poorly managed ADHD can affect loved ones.

      You can find it at Amazon US and UK.

      There is a chapter in that book about ADHD & Sex. My shorter Kindle book expands on that topic.

      take care!

  31. Hi ,

    Thanks a lot for this article. In this lockdown time, I can sense that, I am definitely suffering from it (I don’t have ADHD, not that I know of). At least earlier, one would have a challenging day at work the next day which would induce some form of fullfillment and calmness.

    But these days , after weekend sex, I am angry the next day and beyond. She is suffering from this and I absolutely feel sad about it. Adding to all this is my 3YO son who constantly on high energy and sucks up all our energy. I can’t be mad and angry to my wife always as that might affect him adversely as explained in “I’m OK , You’re OK” book.
    I feel angry and sad about it all the times. Thanks for this article. It atleast made me realize that I am not alone.

    1. Hi AD,

      You are definitely not alone. Knowledge is power — though I know, in itself it’s not a solution.

      I would imagine that depression/anxiety might have a similar effect.

      I hope things get better for you.


  32. THANK YOU for this info.

    I’m not crazy, its a thing! ugh. another thing. its definitely true for my husband with ADHD and has all but eliminated our sex life.

    I don’t sleep with jerks. and on the rare occasion that I do (silly me), I protect my heart for a good couple weeks afterward. Sadly, being vulnerable seems like an invitation for him to be one.

    1. Hi Susan,

      I’m grateful for your comment — and that my work has helped to validate your perceptions.

      I hope the situation improves for you — and your husband.


    2. hi thanks for this.
      I have only been diagnosed 12months ago. now aged 33…

      I was just courious, after sex/self pleasure – I get depressed, sad, anxious/stomach cramps… not sure what is the stronger factor, but it seems to be amplified if I do this in the morning and then take my adhd medication (Ritalin) shortly after. I feel like crap all day sometimes. like a gut renching feeling.

      just wondering if others have experienced something similar. it’s not as bad if I skip my meds. but then I get nothing done..

      thanks in advance.

    3. Hi Jon,

      Sounds like an awful feeling.

      I wonder what would happen if you took the Ritalin first.

      —How does the Ritalin work for you in general?
      —Do you have signs of an anxiety disorder or depression the rest of the time?

      The stimulants can exacerbate an underlying anxiety/depression disorder. Some folks do best on a stimulant and another 24-7 medication such an antidepressant or Strattera (at a low dose, 25-40 mg).

      I hope others have stories to share.

  33. Pingback: After-Sex Sadness: ADHD Sex Life – J {A} N

  34. Many “nofappers” report huge mental benefits from abstaining,this problem might be more frequent than we know.

    1. I did ‘no fap’ for 4 months – pretty much went straight back to post orgasm irritability

    2. Hi Mitch,

      Did you read the article? If you have ADHD, maybe medication treatment would help with that — and other things in life?


  35. Very interesting.

    From the very start I’ve noticed a sudden total emptiness after orgasm, from very loving to nothing. It happened way back, before I even had sex with my first girlfriend — I suddenly lost the loving feeling immediately upon orgasm through solitary masturbation.

    I’ve also noticed that I get irritable after orgasm. I’m fine if I’m left alone, but if she does something that annoys me or puts me off (like wanting to window shopping, ugh, pestering me, or talking nonsense), I get irritated. I don’t think I’ve got ADHD (well, I hope not) but I am definitely rather highly-strung at times.

    Refraining from orgasm seems to help — I enjoy positive, loving feelings for a long time. On the other hand, I’ve also noticed times when prolonged arousal without orgasm can still leave me with irritable feelings. (As I write I’m trying to figure out which, but I’ve noticed both). Unfortunately I’ve found that many women want their partner to come and can’t understand why I would want to hold off, or at least prolong the pleasure. I thought women were the ones who wanted to go slowly!

    1. Thanks for your comment, Greg.

      I suspect the behavior is so unusual it might leave some women uneasy, as if there is some kind of powerplay or withholding.

      Perhaps it will go better if you provide an explanation and share some reading material. So they’ll know there is a great deal of thought behind it.

      good luck,

  36. I just wanted to add another thank-you to your comments. I ended up on a hormonal roller coaster after a miscarriage, got the birth control implant in my arm, stabilized for about a year, and realized I’m really angry within an hour after sex. Now, my mental health is acting up again, and it’s worse. I know your article and research focus on ADD/ADHD, but while I was diagnosed and treated years ago for ADD, I don’t seem to have the symptoms anymore thanks to therapy and medications. I think that maybe, even though I’ve perhaps “grown out” of my ADD, I’m still more “vulnerable” than others (maybe it’s because I already have depression, I don’t know), and it means a lot to know I’m not crazy. I’ve always blamed it on past trauma, so to know that this is relatively common and there are things I can do about it is honestly relieving, because this anger has led to me only being intimate with my partner maybe twice a month at best.

    Long story short. I’m tearing up right now, knowing I’m not alone and that this is an actual thing and not just my busted brain being busted. Thank you for your time, effort, energy, and research into the subject.

    1. Dear Harris,

      Bless your heart. I just hate it when neurobiochemical issues are dismissed as resulting from trauma. It’s so easy to use that as the answer to everything. But it can be so destructive, because it leaves people hopeless, as if the situation is just something they must live with for the rest of their lives.

      Yes, if you have ADHD, even if you are taking medication, you could definitely be a candidate for this syndrome.

      You don’t mention what kind of medication. But if it’s stimulant medication, maybe you could time your intimacy for when the medication is still in effect.

      At least now you have a better chance of coping with “self-talk”….reminding yourself what is happening.

      You mention that you still have depression….I’ll just point out that ADHD can “look like” depression. And the stimulants can exacerbate depression. It’s important to treat the full range of symptoms. Most physicians simply do not understand this, so self-advocacy is a must.

      Thanks so much for taking the time to write and letting me know that my work helped you. That’s what it’s all about for me.

      good luck!

    2. I’m wondering if the anti irritability day after response could be mitigated with almost daily or more regular sex because if the frequency is enough it may curb or train the body to expect the dopamine differences? I don’t have sex with my husband very often and even though he has e.d. he wants more lovemaking. Anyways I have noticed that the morning/day after sex he will find something to complain about ie home projects and if I offer a dissenting opinion, he will get testy and cuss when normally he does not. Even of he starts out trying to be nice ex. making me a coffee, his fuse is shorter and seems to want me to agree with everything he says. It’s disconcerting that he exerts so much energy on me during sex but also one of the reasons I cant deal with frequent sex because i get too sore, and he gets easily irritable the next day that he can get over fast but i cant. I notice myself having to assert myself saying I don’t know that I can talk about “xyz” because I don’t feel like I can handle it if I’m going to get yelled at for it.

    3. HI Cindy,

      I guess you could try it — “mitigating with almost daily or more regular sex”.

      But you wrote that you “can’t deal with frequent sex because I get so sore” and more…

      It might be that focusing on a foundation of ADHD treatment might be a more reliable, comprehensive strategy.

      Good luck and take care of yourself,

  37. I know someone with this condition. Here in Australia they call it something else but it’s the same thing. My friend’s now ex partner has cyclothymia which is a mood disorder. Either he also has ADHD which is undiagnosed or the condition in the article can potentially be linked to people with some kind of mental disorder as well.

    1. Hi Linda,

      Thanks for stopping by.

      ADHD is often mistaken for a mood disorder, including cyclothymia and bipolar disorder. And ADHD is often accompanied by a mood disorder, anxiety disorder, or other conditions.

      Cyclothymia is, in simple terms, sub-clinical bipolar disorder. That is, cyclothymia can look like a milder version of bipolar disorder.

      Whatever causes the phenomenon, I point to two potentially helpful medication approaches:

      Step Two: Counter the Dopamine Flood—and Rebound

      Two medications might help but in different ways:  SSRI antidepressants and stimulants.

      1. SSRI Antidepressants:
      Some psychiatrists have treated PCT in their patients with an SSRI (a type of antidepressant, such as Prozac, Zoloft, etc.). The medication might blunt their sexual arousal and delay orgasm (or minimize the intensity), but it also pre-empts the post-orgasmic depression.

      2. Stimulant medications:
      Many individuals with ADHD have reported to me more satisfaction around sex once they began taking stimulant medications. For some, they were able to prolong sexual intimacy instead of racing to the finish line. Others were better able to linger and cuddle afterward—instead of bolting off to the next activity—in doing so perhaps boosting oxytocin levels thought to aid bonding and relaxation.

      Perhaps the stimulants also helped to keep dopamine on a more even keel. That is, instead of going from 0 to 60, they perhaps went from 30-60, a slower buildup and less precipitous drop-off.



  38. I seriously thought I was the only one whose husband was an asshole to her the day after sex. I truly have PTSD because of it and don’t initiate often at all because subconsciously I expect to be punished afterwards. I thought it was a function of his porn addiction for a long time. We literally had sex maybe four times last year.

    1. Hi there,

      I’m so sorry that you suffered for so long. I hope this information helps.


  39. Very interesting and rings true with me too. I like your phrase ‘dopamine vulnerable’! I have ADD and have definitely felt the dopamine low after sex and even just after spending time with a guy I am dating and falling for. I notice at the end of the date during which I was on a high, I then crash and suddenly crave a cigarette, as if I need the rush of nicotine to push me back to the previous dopamine level. If I sleep with the guy this reaction becomes even stronger, I’m more likely to get melancholy and fixated than angry though.

    1. Hi Bryony,

      I’m glad this post (and my expression…”dopamine vulnerable”) resonated for you.

      Life makes so much more sense when we are aware of such things!


  40. I thought I must be crazy to see this pattern. I had no idea it could actually be a thing. Of course, it caused a fight when I tried to discuss it years ago.

    1. Of course it did. 🙁

      And yes, it’s a thing. 🙂

      I’m glad you found my blog.


  41. Thank you for this article. I just Googled ” Why is my husband so angry after orgasm?” and this article came up.

    I could not figure it out… 12 years of this… He can “disappear” for days weeks even months in a a cloud of anger and depression…Just dark, after a few days of feeling super attracted to me and close and having great sex….

    IT has been a demoralizing mind f*** for me. I am a shell of a person. But I am seeing it and seeing that (finally) it is not my fault even though we were both willing to pin it on me for so many years.

    It isn’t me.

    We just had sex for the first time in 4 weeks (argh! I love sex!) and he woke up and poor guy felt awful and angry ALL day!

    I have no idea whether to bring this up to him or not… I don’t think he will handle it well… He doesn’t do therapy….particularly not today! Can this also happen in people who are bi-polar? His dad is and I suspect he is. (OR could this while PCT just look like bi-polar???!) Is it inherited/ genetic? Thank you again… another clue in all this relationship confusion.

    1. Hi Olivia,

      I’m glad this post helped you zero in on some explanations.

      ADHD has long been misdiagnosed as bipolar disorder (and many other things). It is also frequently co-existing to bipolar disoder. (Meaning, a person can have both ADHD and bipolar disorder.)

      I imagine this PCT can indeed happen with bipolar disorder. And perhaps even in people who have neither diagnosable ADHD or bipolar but maybe “sub-clinical” ADHD or bipolar.


  42. Hi
    After looking up about this
    As a husband/father who feels like you wrote after orgasim for about a day or two ” and it realy hurts everyone around.
    Id like to hear if there is a solutuon ?

    1. Hi Seymour,

      If you re-read the article, you’ll see this (short story: If you have ADHD and/or depression/anxiety, it’s worth considering treatment for either or both):

      Some psychiatrists have treated PCT in their patients with an SSRI (a type of antidepressant, such as Prozac, Zoloft, etc.). The medication might blunt their sexual arousal and delay orgasm (or minimize the intensity), but it also pre-empts the post-orgasmic depression.

      Certain individuals I know who have ADHD report more satisfaction around sex once they began taking stimulant medications. For some, they were able to prolong sexual intimacy instead of racing to the finish line. Others were better able to linger and cuddle afterward—instead of bolting off to the next activity—perhaps boosting oxytocin levels thought to aid bonding and relaxation.

      Perhaps the stimulants also helped to keep dopamine on a more even keel. That is, instead of going from 0 to 60, they perhaps went from 30-60, a slower buildup and less precipitous drop-off.

    1. Hi Betty,

      I’m glad you found this post useful. In case you missed it, you can download an e-book about The Karezza method, linked in the last section of the post.


  43. Ashley Rooney

    Thank you thank you thank you! While my husband doesn’t have adHD, He is bipolar and has mild schizophrenia. I have noticed over the course of our eight years, that we fight more after we have sex. It was no recent years that I realized the reason we fight, after sex, is because his agitation and and blaming etc. etc. is heightened. It has gotten to the point where we have sex about only once a month on average, because of this. And what you mentioned about video games so so true. My husband loves playing these two particular games for hours on end, open world exclamation type games. After a couple hours He becomes agitated with me and the kidsLooks for things to complain about or find fault with, where as earlier today there’s that same things that he’s complaining about now he had no issues with. Currently he’s not under medication because of missed diagnosis and a Doctor Who didn’t really care about him kind of ruined him to doctors. I know it’s been several years I’m hoping that once our insurance kicks in I can find a Doctor Who really cares about his patients and will take the time to get to know him and get to the root of the issues and hopefully if medication is needed Will find the right one. I have been looking all over the Internet and I found your blog, thank you so much for your informative and insightful information. I’m going to try to share it with him, hopefully he will be open minded.

    1. Hi Ashley,

      I wish you all the best in finding a competent doctor. It will probably be a good idea for you to “screen” the doctor first….to get a sense of their competency, compassion, professionalism. Some graduated in the top of their class, and some, the bottom. 🙂

      With bipolar disorder and mild schizophrenia, I’d think his and your life could be much improved with the right medication treatment.


  44. A friend of mine has “cyclothymia” – a mood disorder which presents the same symptoms of irritability after sex – is it possible that these symptoms can present in cyclothymia as well as adhd – mind you he is the type who always has to be doing something so perhaps he is undiagnosed adhd. I don’t know. Any thoughts?

    1. Hi L. I don’t know if this phenomenon is also common with cyclothymia.

      I do know, however, that ADHD is often misdiagnosed as cyclothymia and everything else under the sun.

      Also: ADHD is commonly co-existing to bipolar disorder, etc.

      IN other words, it’s well worth your friend investigating the presence of ADHD.

      A quick search revealed this paper. I’m sure there are more.


  45. We had a big problem with this for the first seven years of our marriage. I also had a problem with frequent masturbation. Between the masturbation keeping my desire levetfor my wife low, and my post orgasm bad attitude, my wife thought our sex life was hopeless.

    Just before our seventh anniversary, I experienced a kind of personal crisis where I started to feel very guilty about my masturbation. I had always blamed it on a number of things, but I realized it was all me and I really, really wanted to stop.

    I tried and tried bust just couldn’t make it more than about a week before I would cave in to the old temptation. I was searching the internet for things that could help me stop. I found a website that advocated using a chastity device to help men stop masturbating. I was intrigued by the idea of something that could physically stop me from doing it.

    I ended up purchasing one, and with my wife’s support it was very effective at stopping masturbation. My sex drive and desire for my wife began to climb as I wasn’t able to spend my libido at will. But when we had intercourse, I was still a jerk afterwards.

    One night I was pestering my wife for sex and she informed me that she was menstruating. Intercourse was off the table. So she suggested that I should just leave the chastity device on and we could do “everything else”.

    We had the best sex we had ever had up to that point in our marriage, even though my penis was not involved at all. My wife noticed I seemed very happy and energetic the next day. We started to connect the dots and experimenting with not letting me orgasm.

    Sure enough, without regular orgasms, my mood became very stable, my desire for my wife stayed very high, and my self esteem was soaring because I didn’t feel out of control with masturbation any more.

    We have come to the conclusion that for men, or at least men like myself who get moody after orgasm, that the wife should prohibit the man from orgasming most of the time and only give the man an orgasm as a special treat on rare occasions. 2016 was our first full year of controlling my orgasms, and I think I had a total of 4 or 5 (I didn’t keep track, but it wasn’t more than 5). And that was the best year of our marriage so far.

    Now that I have adjusted to life mostly free of orgasms, I couldn’t imagine going back. I don’t crave them at all anymore and actually don’t want them because of the way I am afterward.

    1. Hi CH,

      Wow, that is a fascinating story. And to think that you discovered this on your own.

      Congratulations for figuring this out!


  46. Thank you for this post…so helpful. I suffer with this and wondered whether it was “a thing”. My mood swings are so wild, it does put me off. Understanding this really is a relief in some ways.

    Again, thank you for pursuing this very important research.

    1. Hi Jillian,

      I’m so happy that this post has given you understanding.

      It’s one thing to suffer from something. It’s quite another to lack an explanation, and so the mind reels with all possible interpretations.


  47. I tried to join your on-line support for partners of ADHD people and I couldn’t get past the authentication that wants to see if I am a machine. I must have tried 20 and I know SOME of them were correct. Any suggestions?

    1. Thanks. I just tried it again and even though I did everything the same, this time it worked. Technology… always a love/hate relationship. 🙂

  48. I cannot thank you enough for this article.

    My boyfriend struggles (and me along with him) greatly with this exact condition. I can’t get him to admit he has ADD, let alone that it affects his orgasm. He seems to think the post coital anger is related to psychological scar. I, of course, practically see the chemistry unfold in front of me every time.

    As a former therapist and as someone who has siblings with both ADHD and bipolar disorder, I know psychological reactions are much messier than chemical ones. Sure, they affect one another, but chemical reactions with certain disorders are quite…well…orderly. Rhythmic. Predictable. Although he avoids orgasm with me most of the time, his post orgasm anger looks exactly the same every time.

    His unwillingness to get his ADD assessed and treated damages our relationship. There is so much he just doesn’t see or remember that leaves me feeling neglected and over-burdened, unloved. He is a deeply kind, caring and giving person, and when we aren’t fighting, we have such so much fun when we are together. But too often unless something is smacking him right in the face, it is invisible to him.

    I understand intellectually that he has a beautiful heart and soul, but the end result is still very difficult to accept over and over again and my pain and resentment build.

    I sometimes think that people with ADD struggle so much with memory and attention that they can’t see patterns and that makes them more inclined to make false associations (like blaming a salient event, like something painful, for their reactions simply because that is what they remember), rather than seeing they have a condition that needs treatment. Or maybe they are just too proud or too close “to the see the forest for the trees”. He struggles to trust anyone I believe because everything outside of him seems so random — he knows his heart, his intent, much better than his impact on others.

    Life and relationships are hard enough. If only he would seek professional guidance for his own sake and for the great potential that lies in our relationship.

  49. Marnia Robinson

    “Peace Between the Sheets” is out of print now that its successor “Cupid’s Poisoned Arrow” has been published. Since I first began writing on this subject, dozens of studies on animals and humans have begun to reveal that there may indeed be a neurochemical basis for mood swings following orgasm. This page lists many of the relevant studies:

    I think of the “orgasm hangover” as a sort of “PMS” that affects different lovers to different degrees, and even differently on different occasions. There are various ways to manage it. Chastity isn’t the only one. Another is Diana Richardson’s version of “Slow Sex” (see trailer with couples discussing it here: or karezza, a similar approach developed in the States a century ago (the subject of “Cupid’s Poisoned Arrow”). The practice itself has turned up in different traditions for thousands of years. Definitely worth exploring as a means to much increased harmony and sexual satisfaction. (It’s very different though!)

  50. Wow, I thought I was the only one who got depressed, irritable and “jerky” after an orgasm. My wife calls it “bitchy”. We both hate how I am after an orgasm which prompted us to explore Chastity. That led to long term chastity and using a chastity cage to at least give me pause before I did something foolish, like masturbate. We work together to make sure I do not have an orgasm. We are both happier when I do not orgasm so we are down to about 2-3 orgasms a year now and my wife would like that to be zero but it may not be practical.

    To tell the truth, I was surprised at how chastity made me feel better and improved our intimacy. We still have sex regularly, maybe even more so now that all sex focuses on my wife so she can have a quick orgasm and get back to what she was doing. Most times though she enjoys edging me for an hour until I am begging for release. It took her over a year to stop feeling guilty about denying me but we feel it is better to give up those 10 seconds of an orgasm than weeks of feeling and acting bad.

  51. Pingback: TDAH y sexo: irritabilidad y conducta idiota tras el orgasmo | Dra. Elena Díaz de Guereñu

  52. So I read most of this article. Haha And yes I very much have ADHD. I have to say I do experience the irritable feelings after sex. I got to say I will need to pay better attention now. After we will finish if he doesn’t give me the loving attention I down right am craving I will fall and fast. Immedietly I see him as a complete jerk. Even though we just had sex he didn’t get close and kiss me he got up to do whatever and now I feel all left alone all “used up” and all “unloved”. This is deemed his fault in my mind. Why does he always have to seem so insensitive and unloving? And my “high” goes to what feels like depression. And I get pissy and am probably mean and treat him like he is a using, insensitive, unloving jerk with no feelings to speak of and why does he always have to change into such a person.II’ve been trying to work on not letting my ups and downs get so out of control. But I will get made at him for a week when I am excited about something and I can’t get the proper reaction from him. He tells me “you got to quit feeaking out so much.” I tell him i feeak out because of your behavior. Thank you for the article. I think sometimes my eyes need open to my behavior.

    1. Hi Melissia,

      Well, hey, if you are craving that attention, maybe he could try giving it to you. Does he really need to hop up and go do something?

      Just because you have ADHD doesn’t make you “wrong” in your reactions. And, if extra snuggle time enhances your sense of well-being and your bond as a couple, well, what the heck. 🙂

      But yes, if you “freak out” on a regular basis at other things, then maybe a little more reflection your part might help.

      Good luck sorting it out. I think we all need our eyes opened to our own behavior. Glad I could help!

  53. Pingback: Can A Pulitzer Prize Offset Entry to The ADHD Roller Coaster Hall of Shame? You Decide. - ADHD Roller Coaster

  54. Marnia Robinson

    Hi Gina,

    I applaud your continued willingness to bring this potential connection between ADHD symptoms and climax to people’s attention.

    Since I suspect I’m the author you refer to, I’d like to correct a misunderstanding. Here’s what I was trying to share with you: Men sometimes report that giving up orgasm eases their ADHD symptoms. Some find karezza a particularly helpful change, as you point out. Some have even been able to give up their ADHD meds entirely by switching to karezza.

    Since our correspondence years ago, my husband an I have also seen men on porn recovery forums (who often give up orgasm for months as part of recovery) report big improvements in ADHD-like symptoms. See this page:

    Also of possible interest – a new longitudinal study showing deterioration of academic performance in young guys related to internet porn use: “Early adolescent boys’ exposure to internet pornography: Relationships to pubertal timing, sensation seeking, and academic performance” (2014)

    I have never thought orgasm is the “cause” of ADHD, but I do think many guys would be surprised at how much their symptoms abate (and by how much better they feel over all) by learning to manage their sexual behavior with less emphasis on orgasm.

    Finally, in the years since our exchange, dozens of studies have come out confirming neurochemical events after climax, which make the hypothesis that climax contributes to changes in perception and behavior for some period of time quite reasonable. List of studies:

    All the best,

    1. Hi Marnia,

      Thanks for stopping in. I appreciated your work more than 10 years ago, and I still do.

      I recall our exchange about ADHD a little differently, though. 😉


  55. I plan to study this topic thoroughly and will get back to you after a couple weekends with some data – summarized, not detailed.

    Seriously, Gina, you’ve come up with yet another topic that I know little about, simply due to lack of published studies. Kudos for pushing the envelope…


    1. Thanks, Oren. I’ve been studying this particular topic for about a decade, and I plan to go into more details in an ebook or seminar.

      I’ve intentionally simplified the “brain chemistry stuff” here in this short blog post. It’s complicated, highly variable, and in many ways still speculative.

      My goal was to simply be aware of the potential pattern and to know it might be “neurochemical” instead of “behavioral.”

      Will look forward to learning your thoughts. I welcome a guest post!


    2. P.S. Oren, I’ve been observing closely very large numbers of ADHD-challenged couples since 1999. 😉

    3. I am weeping while reading this. I just found the article while searching for “angry after sex” because I just connected that the huge blowout fights I have with my husband are always the day after a lot of sex. We have a great marriage and almost never fight but this is about to end it and I don’t know what to do.

      Our sex life is amazing, married 10 years. We do have 3 kids so lately only once every couple of weeks but I noticed that instead of being affectionate after sex, he withdraws, is grumpy and downright mean and hateful. I tried telling him today that perhaps it was a testosterone thing from orgasm and he denied it. I def think he has ADHD and maybe on the spectrum of autism. I just don’t know what to do, I feel hopeless.

    4. Hi Amanda,

      I’m glad you found my work so helpful to answering a big question in your life.

      There is no need to feel helpless.

      Twenty years ago, maybe there was reason to feel helpless. There was very little out there on Adult ADHD, much less on being relationship with an adult with undiagnosed/poorly managed ADHD.

      But I did a lot to change that.

      The issue here is not a “testosterone thing.”

      If you think he has ADHD, given to other issues in life, you need to get educated. Check out my books and my course.

      Maybe he also has autistic-spectrum traits. But you are not qualified to assess for that. And, unfortunately, neither are many mental healthcare providers.

      My advice is, learn about ADHD. If it hits many points, pursue evaluation and treatment. And only then, see if there are still autistic-spectrum traits. Many therapists confuse ADHD-related issues around social anxiety, literalism, black-and-white thinking, avoiding eye contact while speaking as autistic-spectrum traits.

      good luck,

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