Navigating sex with ADHD

Although everyone’s brain operates differently, brain functions, behaviors, and ways of processing are generally expected to meet a certain standard dictated by society. Those who swerve outside of these parameters—whether slightly or drastically—may be classified as neurodivergent. Neurodivergence can include a wide range of conditions—attention-deficit/hyperactivity disorder (ADHD) among them.

ADHD is generally defined as a neurodevelopmental disorder characterized by high levels of inattention, hyperactivity, and impulsivity. While children with ADHD who could not behave appropriately in a classroom used to get all the airtime, recent years have shown a growing awareness of the ways in which it can alter life experiences for adults.

Sex, for instance.

How ADHD can affect sexual experience

Research suggests that about 40% of people with ADHD will experience some form of sexual challange.

If you have ADHD, you may have experienced the following sexual challenges at one point or another:

A wandering mind. You might find you have trouble paying attention when having sex, in the middle of foreplay, or when cuddling. If you’re with a partner, they may understand it as a lack of interest. Your distractedness can make it difficult to reach orgasm as well—some women report not being able to reach orgasm at all sometimes, even with prolonged stimulation, while other times, they’re able to have many orgasms in quick succession.

Mood swings. Mood swings and hypersensitivity are common, and can impact your sex drive and your relationships. Certain sensations, like touch, may feel overstimulating. You might like a certain sex act at one point, only to abruptly decide you dislike it. You may feel like cuddling one day, but be turned off by it the next. You may also find sex acts that feel good for your partner to be annoying or unpleasant.

High sex drive. Studies show that people with ADHD report having a higher sex drive than participants in control groups. If your sex drive is sky high, you might experience compulsive sexual thoughts or behaviors, an obsession with porn, and/or desire discrepancies with your sexual partner.

Low sex drive. Alternatively, your sex drive may take a nosedive. After all, sex is no different from other activities that present a challenge for people with ADHD. Executive dysfunction (a ADHD behavioral symptom which disrupts your ability to manage your thoughts, emotions and actions), can make it feel as though initiating sex is too much effort. You also feel under stimulated at times, as though the sex has lost its novelty.

Medication side-effects. Some medications, such as antidepressants, which are sometimes used to treat ADHD, can also be a cause of your lower your sex drive, as can other commonly used meds, like Ritalin, which can additionally cause frequent or painful erections, and priapism in men (when an erection is sustained for several hours). Priapism is quite a rare and serious side effect requiring immediate medical attention.

Risk-seeking sexual behaviors. People with ADHD often have lower levels of brain chemicals called neurotransmitters, which in turn make them more likely to be impulsive and take risks—like having unprotected sex. Though not everyone with ADHD gravitates toward risk, it’s worth understanding that at some point, you may feel pulled toward sexual acts that are not safe or healthy.

Anger and loneliness. ADHD can make you susceptible to feeling angry or lonely, which can  in turn be draining and decrease your interest in sex. Coupled with mood swings or a lack of focus during conversations, both of which may make arguments with your partner more likely, it’s easy to end up stuck in somewhat of an anger and loneliness loop

How to live your best sex life with ADHD

Get your meds right. Up to 80% of people with ADHD also have another mental health condition like anxiety, depression, personality disorders, and substance use issues. These issues and their treatment can affect ADHD, and vice versa, so be sure to discuss your meds and your mental health openly with your doctor. The good news: most ADHD medications won’t hurt your sex drive. On the contrary, they can help you focus, and keep risky impulses at bay, which can improve your sex life. If you notice that taking your meds closer to when you have sex (i.e., evenings) helps you stay in the zone, you might talk to your provider about splitting your dosage between morning and early afternoon. Of course, if you find that your medication is affecting your libido, don’t hesitate to speak to your doctor about switching it up!

Communicate, communicate, communicate. Cultivating open and honest communication with your sexual partner offers endless benefits. Let your partner know about your ADHD symptoms and how they might manifest during sex, so they know it’s not a sign of disinterest. Also, let your partner know what you like, what you’d like to try, and what mood you’re in—you know, in the heat of the moment. Being direct about your feelings can help avoid arguments and misunderstandings. Not to mention, strong communication can help foster trust, intimacy, and an incredibly exciting sex life!

Exercise. Regular physical activity can help you focus, raise your neurotransmitter levels, and lessen your symptoms, in turn helping you enjoy intimacy with fewer distractions and unruly impulses getting in the way.

Get rid of distractions. Doing away with distractions that are in your control (i.e, leaky faucet, bad/bright lighting, TV or music) can go a long way toward keeping your attention on the sensations of the present moment, and the person you're sharing it with. You might try calming exercises together, like yoga, deep breathing, or a tantric approach to sex. Making sex dates can also help ensure you carve out the time and attention for proper partnered pleasure.

Consider therapy. The right therapist can help you learn skills to better communicate with your partner, both in and out of the proverbial bedroom. You (and your partner) may also benefit from speaking with a sex therapist, or a couples counselor.

If your partner has ADHD

Encourage them to get a diagnosis. If you suspect your partner has ADHD, but they are undiagnosed, you can try gently encouraging them to see a qualified professional. A professional can help your partner learn more about ADHD, explore how symptoms affect their life and relationships, learn skills to better manage symptoms, and find suitable treatment options. While your support might encourage them to reach out, keep in mind it’s ultimately their choice.

Be sensitive to their needs. If your partner has ADHD, try to be attuned to their needs. For example, you might turn off the lights and refrain from using lotions or perfumes if they’re sensitive to light or strong smells during sex.

Work on communication. Miscommunications can create problems in any relationship, but they can be even more common in relationships affected by ADHD. If your partner is forgetful, inattentive, or distracted, you may feel neglected, ignored, or disrespected. While it is 100% important to express your feelings, try to avoid doing so in an accusatory or critical way.

Propose couples counseling or sex therapy. It can be challenging to remain attuned to your partner’s needs and emotionally grounded in the face of their behaviors—because chances are, you’re a human being with your very own set of issues. Many couples coping with ADHD greatly benefit from couples counseling and sex therapy. The right therapist can help you and your partner navigate your unique challenges…together, baby.