Relationship problems are a fundamental issue for many (if not all) adults trying to deal with their ADHD. These problems can be anything from doing the chores or childcare to simply listening to your partner. One area where this is seriously problematic is with sex itself.
Sexual problems are very common in the general population. Research has suggested that as many as 40% of women and 30% of men suffer from some form of sexual dysfunction.
Sexual problems can really vary from person to person. These can range from being generally sexually unsatisfied to risky sexual behaviours (RSBs) such as unprotected sex, multiple sexual partners or the intriguing sounding “hazardous sexual activity” (such as sex while ‘intoxicated’).
Despite these high numbers, It seems that adults with ADHD suffer even more issues with sex than non-ADHD adults. Issues seen include less sexual satisfaction, more sexual desire, increased masturbation frequency, and more sexual dysfunctions in general. It is important to note that most of the research in this area has focused on adolescents. This is partly because RSB is a public health problem during adolescence. RSB can lead to issues such as sexually transmitted infections (STIs) and unwanted pregnancies.
ADHD has also been associated with ‘early sexual debut’ (losing your virginity earlier) and ADHD adults tend to have more sexual partners, more partner pregnancies and an increased risk of ‘extra-marital congress’.
Other issues around sex and ADHD probably warrant a mention. Fear of physical intimacy is increased in those with more symptoms of ADHD. Possibly linked to that, people with more ADHD symptoms have lower expectations for intimacy in their relationships. Sensory issues, common in ADHD, may lead to hypersensitivity to touch which can have an effect on arousal. Rejection-sensitive dysphoria, or RSD (as opposed to RSB) can have a huge impact on sex, as feeling criticised or rejected for sexual performance or lack of arousal can lead to significant issues in a relationship. Finally, hyperfocus, whether on part of the sexual act or on masturbation may potentially lead to relationship issues.
There is help available. Sex therapy can help with problems such as lack of desire, difficulty achieving orgasm, pain during sex, erectile dysfunction and other issues. ADHD medication may also potentially help if it reduces distraction and allows those with ADHD to ‘stay in the moment’. Be aware though, that the effect of medication is complicated. The stimulant medication lisdexamfetamine may increase or decrease sex drive depending on the person and the non-stimulant medication atomoxetine has been shown to decrease libido in some.
Addressing relationship concerns when dealing with sexual problems is essential for healthy outcomes. The success of more traditional sex therapy techniques is determined by a couple’s ratings of communication prior to treatment.
Sadly, there is almost no scientific research into ADHD and sex in non-heterosexual relationships, and this should be a focus of future studies.
Author: Alex Conner PhD.
Editor: James Brown PhD.