CHEATING ON YOUR partner can leave you with a lot on your mind. You might be racked with guilt. You might be consumed with covering your tracks, and constantly anxious or stressed that they’ll find out and your relationship will end. In some instances, these intense emotions can trigger a range of physical and sexual symptoms.
Laurence Levine, M.D., a urology professor at RUSH University in Chicago who focuses on men’s sexual wellness, has seen this time and again.
“I would see these men who would come in with all kinds of sexual dysfunctions,” he says. “‘I can’t get an erection; my penis is numb. My penis looks different.’ They were creating, in a sense, their own pathology about what was happening to them.”
After digging into their history, Dr. Levine says he found they’d often been involved in “sexual indiscretion outside their relationship,” including having sex, kissing, or building a deep connection with someone else. And, that’s when their symptoms started—however, tests revealed no medical problems.
This phenomenon was described as “spousal revenge syndrome” in a 2016 case study published in The Canadian Journal of Urology. In the study, men presented with symptoms of sexually transmitted diseases or chronic prostatitis/chronic pelvic pain syndrome despite testing negative for these conditions. Subjects reported that their symptoms started after an “extramarital sexual encounter.”
While it hasn’t been studied extensively, spousal revenge syndrome is likely related to somatic symptom disorders, where someone believes something is physically wrong, which causes mental distress, but there’s no scientific evidence, according to the American Psychiatric Association.
Patients often don’t like to hear that their sexual problems are sparked by something psychological, Dr. Levine says. That doesn’t mean the symptoms aren’t real. Mental health issues can manifest physiologically.
“The brain is a tremendously powerful structure—it regulates everything we do,” he says.
What is spousal revenge syndrome?
Spousal revenge syndrome isn’t a diagnosable condition—meaning it’s not listed in the Diagnostic and Statistical Manual of Mental Disorders, which is used to diagnose mental health conditions—and the case study on the subject only included 10 men.
Still, it suggests men could have “psychosomatic symptoms” linked to cheating, explains Larry Josephs, Ph.D., a psychology professor at Adelphi University in Garden City, New York, who researches conflicts in adult romantic relationships.
“They were being unfaithful; they’re worried they have STDs and they have symptoms,” he says.
Someone who cheated might feel anxiety, hypersensitivity, or worry over getting caught, and that could manifest as physical pain or other symptoms, Josephs said. It could also stem from someone knowing they didn’t use protection and worrying about STDs or unintended pregnancies.
In the case study, men reported pelvic floor spasms that began after having an affair. But their STD tests were negative, and symptoms didn’t improve after taking antibiotics.
The term “spousal revenge syndrome” implies that a partner is getting revenge for the infidelity, which Josephs says often happens, sometimes by them cheating in retaliation. However, the name actually refers to a fear of spousal revenge, which may be why the men experienced physiological symptoms, not their partners, Dr. Levine says.
What is a somatic symptom disorder?
A somatic symptom disorder, which has been known as psychosomatic disorder, is a mental health condition where someone has excessive thoughts, feelings, or emotions about physical symptoms, which often don’t have a medical explanation. These feelings might affect their ability to function normally, according to the American Psychiatric Association.
These individuals might see multiple doctors, believe their problems are caused by medical conditions, and feel frustrated and distressed when they don’t receive a medical diagnosis.
However, experiencing pain or erectile dysfunction after cheating doesn’t necessarily mean someone has SSD. Also, having an illness without a medical explanation doesn’t automatically bring an SSD diagnosis.
“Some people exaggerate their physical discomfort and are always running to doctors,” Josephs says. “Other people deny, and they’ll never go to the doctor because they don’t want to know.”
An SSD diagnosis is based on whether the thoughts and feelings about physical symptoms are excessive and interfere with someone’s daily life.
How Doctors Evaluate Pelvic Pain and Related Symptoms
When a patient comes in for pelvic pain, erectile dysfunction, or other sexual health problems, Dr. Levine says he first gets a detailed history: when did the symptoms start, how severe are they, and do they interfere with daily activities?
He also does a urinalysis, blood test, and physical exam.
Patients with suspected prostatitis (inflammation of the prostate gland) or other prostate problems should undergo a digital rectal exam to check for abnormalities in the rectum, anus, and prostate gland, Dr. Levine says.
He also examines the penis for evidence of a structural abnormality and checks the urethra to ensure there’s no evidence of pus, which could signal an STD.
If any problems are discovered, Dr. Levine says he prescribes the appropriate treatment. That might include antibiotics for STDs or a referral to a pelvic floor physical therapist for a pelvic floor problem.
When all medical tests come back normal, however, he says, “I just confront them directly and say, ‘You’re feeling guilty that you did this thing, and your body is playing this game with you that you have something wrong. I think you have to understand that all the medical testing that’s been done is negative.’”
If they continue experiencing distress and cite physical problems, he refers them to a therapist.
When to Seek Mental Health Treatment
Treating somatic symptom disorders might involve talk therapy, cognitive behavioral therapy, mindfulness-based therapy, medications, or regular contact with medical providers, according to the Cleveland Clinic.
Seeking individual therapy could help men deal with physical symptoms related to stress or guilt from infidelity, Josephs says.
Research suggests that some couples who choose to stay together after sexual infidelity benefit from couples therapy, especially when it centers on establishing accountability, rebuilding trust, communicating, reconnecting, and working toward forgiveness.
The bottom line, Dr. Levine says, is to see a doctor for medical evaluation if you’re experiencing any distressing symptoms. But understand that psychological factors could be at play.
“There’s a point you have to trust that the physician and the testing are legitimate,” he says. “The mind is very powerful and can sometimes deceive you in terms of what’s really going on.”
