Sex & ADHD - Physiological Issues
There is a spectrum of sexual desire when people have ADHD:
Hyposexuality (unusually low sex drive) – research done by Barkley and Murphy suggests that 49% of adults with ADHD experience low sex drive at least sometimes or more often (vs. 25% of the general population). The reasons for this are not covered by the research, though some suggest that medications may play a role for some, as anti-depressants and some stimulants may have the side effect of lowering libido.
Hypersexuality (unusually high sex drive) – a smaller group experience hypersexuality - sexual stimulation mobilizes the brain’s neurotransmitters by releasing endorphins, which calms the active ADHD brain. Some use masturbation or sex as a tool for self-calming.
Distractibility – some report that they are very distractible during sex (“I’m easily distracted. If the dog barks, that’s it…”) This is a physiological and defining symptom of ADHD (distraction is the #1 symptom of adult ADHD)
Sensitivity to touch – some adults with ADHD report being very sensitive to touch in an unpleasant way. This can interfere with sexual pleasure and anticipation.
Sex & ADHD – Psychological Issues
A wide range of psychological factors have been identified as interfering with sexual pleasure, including: depression; low self-esteem; shame; stress; and grief, all of which can impact adults with ADHD.
In addition to these commonly noted issues, couples impacted by ADHD face issues with parent/child dynamics in which non-ADHD partners over-function and lead in the relationship, while ADHD partners under-function and follow. This unequal status is exceptionally detrimental to a couple’s sex life in that it lessens respect and generates significant anger. Parent/child dynamics are, in fact, one of the most destructive patterns in ADHD-impacted relationships. (See The ADHD Effect on Marriage for more information.)
Ari Tuckman's recent research with over 3,000 adults in ADHD/non-ADHD relationships suggests that anger is the top disrupter of sex in ADHD-impacted relationships. See the video below for more on this.
Sex and Growing Up with ADHD
Impulsivity, relative immaturity in decision-making skills, and difficulty anticipating consequences are issues for teens and young adults with ADHD. The result is sexual behaviors sometimes characterized by risk-taking. Research done by a variety of authors suggests teens and young adults with ADHD:
- start having sex about a year earlier than their peers
- are less likely to use contraception
- have almost triple the rate of teen pregnancy or of getting another pregnant than the community at large (38% in the ADHD population, vs. 4% in the community at large)
- have more lifetime sex partners, and
- become parents at a younger age
A slightly larger percentage of young adults with ADHD identify as bi-sexual (7% vs. 1% for the general population) but not homosexual.
ADHD Partners Talk About Sex – From Our Community Forum
On parent/child dynamics
“We get along really well most of the time, but it seems she can be in a great mood and us be having a wonderful time, and BOOM she will notice something not done right by me and my ADHD (putting something in the dishwasher that she’s told me 1838483 times not to put in there) and it’s bad mood and nagging and that “if you cared for me you would just listen…”
“I know for a fact that I have often become moody and depressed when my partner doesn't seem to want to make love because in some way I am associating that with her not wanting to share that intimacy with me. I'm the first to say that's kind of silly and I'm jumping to a conclusion but in my experience ADD people are very good at jumping to conclusions and not always the right ones.
“I want to have sex with my wife, but all that yelling that she does at other times…it means I can’t get excited about being with her. If she would just stop getting mad at me all the time…”
“I don’t like it when my wife tells me what she wants in bed. It reminds me of when she is bossing me around at other times, which she does a lot. She’s always telling me what to do - It’s really unsexy.”
On low sex drive
“I mean this has been a problem all my life. Low sex drive. I guess i should just live with it since it has been with me so long. It’s just that with the new ADD diagnosis i finally have a name for my affliction”
“My husband has gotten a lot better about not getting so frustrated or angry when he is sexually frustrated (let me point out that sexually frustrated means having not had any sexual encounter with me or release with my assistance for at least a week), but I always feel so guilty that I am just not into sex as much as he is and I feel bad that he remains unsatisfied.”
On the need for stimulation & variety
“I (male) am at the beginning of being tested for ADD. So far I know that I had it as a child. I am glad I found this site. I have difficulties with porn and I am ashamed. It is the boost shot for focus and temporary concentration that makes me look at it. I just wanted the female members (on the site) to know that I am sorry for what they have experienced so far and I would like to express my respect for them, and as a married man I certainly will tackle the problem…”
“Sex for me is all about my partner however - my partner and foreplay. Foreplay is engaging and interesting, varied and fun. It's better than intercourse for me and I'm much more interested in a woman's body than in just doing the deed.”
“I'm an ADD man and I guess I was lucky being diagnosed when I was pretty young. Regarding sex though I agree that we are a little like adolescent boys, but not just in that we have a thrill of doing something naughty and that we lose interest when it stops being naughty.”
“I have ADHD, I am married, and I have a fairly high sex drive. According (Ned Hallowell), there are several sexual behaviors that ADHD can affect. For me, I have trouble actually having sex when not medicated because I get distracted and can't get into the moment. However, I also want sex from my wife almost constantly, and it annoys her a lot, which in turn makes me feel bad.”
“I am very easily distracted during sex. Even if the dog barks, that’s it for me.”
A few non-ADHD partner quotes about common problems
“It is validating to know that I am normal for not liking the grabbing, clawing, demanding, and extremely immature behavior. I used to enjoy sex also, but this approach literally makes my skin crawl...it's offensive, unromantic, and totally lacking in respect.”
"I thought it was just lack of sex, but it's also lack of intimacy - that's how I perceive it. All the things that I believe foster intimacy in a relationship seem to be things that my husband hates to do. They all involve LINGERING." (from Delivered from Distraction)
“I would love to have a great sex life with my husband, but after doing everything around the house, sex to me is just another chore. If my husband helped me out with the chores, curbed his angry outbursts, & made an effort to spend time with me, I'd feel more attracted to him. Right now, I don't like doing anything sexual with him because I feel like I am the only one doing the giving and he is doing all the taking!”
"Where the hell is my sex life? Even when we first met, after a long online/onphone courtship, there was little sex. I took it really, really hard and cried a whole lot and felt really terrible about myself. I thought there was something wrong with me. I mean come on! First days of a new relationship! The thing is he tells me that he thinks about sex all the time - he just never acts on the thoughts.”
“I do not want to ever cheat on my husband, yet I'm not sure I can keep on living in a basically platonic marriage.”
“The simple truth is that many attributes of ADHD in my wife are unattractive In my experience the effects of this are cumulative. Kind of like being exposed to radiation over time, the damage is slow but it is happening.”
“My husband and I have been married 20yrs and he has inattentive ADHD; He has a low to no sex drive. We have a great relationship and family except for this aspect. I am getting tired of talking and asking for change and him not even trying to meet me half way. It's me pretty much going without, getting rejected if I ask, and feeling not desired. I told him in our last conversation that sex isn't just intercourse.... I love my husband and I believe in marriage but I can't just give up on me anymore. HELP!!!!! We start counseling but I fear just like everything else he will just give half effort and revert back to the same old expecting me to pick up the slack and do without my wants.”
Video Interview – ADHD, Sex, and Healthy Relationships
Melissa interviews Ari Tuckman, PsyD, MBA about information that has come out of his ADHD and sex survey. He discusses why it matters which partner has ADHD; the correlations between sex and relationship satisfaction; how to restart having sex after a long time with no sex; anger and sex, and more.
Sex, Romance and ADHD
Dr. Hallowell has written When ADHD Disrupts (and Ruins) the Romance for ADDitude Magazine
How to Improve Your Sex Life with ADHD
Plan or schedule sex
Life is busy – it’s easy to not connect simply because you aren’t ready for sex at the same time. And, if you know ahead of time when you might have sex you can use the run up for foreplay, sexy texts and other ways to get excited.
“With both of us being ADHD and him out of town working (not near women) and having 2 special needs kids, sex becomes difficult to organize. We went over a year once....or twice. But when we figured out we had to plan for sex, have dates so to speak, it became very interesting. Its still not as often as one would hope but the planning ads an element of intrigue that heightens the experience. Its like having a honeymoon every time.”
Get out of parent/child
It’s almost impossible to sustain a healthy relationship when you have a parent/child dynamic going on in the relationship. Good resources for moving away from this dynamic include my couples seminar, and working with a therapist. If you do the latter, tell them specifically that you wish to even up the power structure in the relationship; move away from nagging and reminding; and help the ADHD partner create structures for greater reliability.
Move away from anger
According to Tuckman, anger is the number one reason couples impacted by ADHD give for having problems with their sex life. Anger is often a product of parent/child dynamics. It can also be a part of ADHD emotionality (i.e. having a particularly quick trigger). So counseling may help. Make SURE to work with someone who understands ADHD. See my list of ADHD-savvy counselors for some suggestions.
Make sex more interesting
Broaden your sexual experiences to help keep the ADHD partner engaged. Include toys, new locations, fantasy, erotica and more. One accessible resource for people thinking about sex toys and erotica is Babeland.com.
Optimize treatment for ADHD - and anything else that may be going on
Parenting behaviors develop in response to ADHD partner inconsistency. When you optimize treatment for the ADHD partner, everything in the relationship improves, including sex. See our treatment section and download the treatment E-book as a starting point for this. As Tuckman says, "working on ADHD is a bit of an aphrodesiac." Non-ADHD and other ADHD partners really appreciate it when they see an ADHD partner making a real effort to manage ADHD to make the relationship better. Conversaly, they can become frustrated and resentful when they perceive that not enough effort is being expended.
ADHD often occurs with co-existing conditions such as anxiety and depression. If these are a factor in your relationship, treating them should also contribute to improving your relationship and sex life.
Connect outside the bedroom
Great sex comes when you are feeling playful and relaxed. Find times during the week to laugh together and connect by doing new and interesting things. This will improve your likelihood. Spend some ‘attend time’ just focused on communicating your love. This will help improve your interest in sex.
Learn more about your desire
Desire is about brakes and accelerators, as well as the overall feel of your relationship. Come as You Are, by Emily Nagoski, is an excellent resource for women who are interested in learning more about what drives their own desire, and how to increase it.
Don’t just ‘Love’…Be ‘In Love’
There is a difference between obligatory or habitual love, and the eagerness and desire you feel when you are ‘in love’ with someone. Melissa wrote a post about falling back in love here.
www.ADHDmarriage.com community forum, various dates/posts
Hallowell, E. M., & Ratey, J. J. (2005). Delivered from distraction. New York, NY: Ballantine.
Murphy, K. R., Barkley, R. A., & Fischer, M. (2008). ADHD in adults: What the science says. New York, NY: Guilford Press. pp. 377-380
Orlov, M. (2010). The ADHD effect on marriage: Understand and rebuild your relationship in six steps. Plantation, FL: Specialty Press.