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Recently, someone asked me about a possible connection between ADHD (Attention Deficit Hyperactivity Disorder) and sexuality. “Sex can be challenging sometimes,” they wrote, “and I’m wondering if it’s linked to my ADHD.” The answer here is that sex can be challenging, and one reason for that is that it’s not a stand-alone bodily function. Like other physical systems, it links up with all the other elements of our well-being, from circulatory to socioemotional. So yes, it is certainly possible that ADHD could connect with your sexual experiences and libido.

According to the National Institute of Mental Health, ADHD is marked by “an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development,” and those qualities could show up sexually in a variety of ways. For one, impulsivity could have lots of sexual and relationship implications for a teen or an adult, and youthful experiences in particular can set expectations and leave marks that impact a person’s sex life going forward.

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Another thing to take into consideration is medication. Stimulant versions of ADHD meds can impact sleep and raise anxiety or irritability levels, and both of those side effects can be felt in one’s sex life. (In fact, they could reinforce each other!) I’m reading tons of articles about sleep these days and they often don’t say a word about libido; like other discussions of human experience, sex is just left out. This is one reason why your doc might not tell you what to expect when it comes to possible changes to your sexual experience, whether from meds or the condition itself. And if antidepressants are also a part of the mix, you can expect libido, arousal, and orgasm challenges as well. It is an evil irony that both depression and meds that treat it can have these effects. (Wellbutrin is often cited as the one with the least-worst side effects.) And since I mentioned sleep, let me also mention that (healthy) diet and exercise can improve sexual functioning in any person.

If you are in a relationship and notice interpersonal challenges associated with your ADHD that spill over into sex, cognitive-behavioral therapy might help (particularly mindfulness work, which can help retrain your brain and impulses). Couples therapy might be good, too, but seek out someone who knows about both sex and ADHD. In these times of Zoom therapy sessions, you might find someone with this kind of focus just about anywhere. Psychology Today maintains a therapist database, but you can also check the listings at the American Association of Sexuality Educators, Counselors, and Therapists (AASECT.org).

Spacing out, losing focus, or experiencing anxiety during sex can happen even to people with no ADHD. Mindfulness work might be useful to most of these folks, actually, and there is a very particular kind of practice that’s been developed in the sex therapy world: sensate focus. It involves paying attention to bodily sensations as you go—not your cognitive thoughts and feelings about what’s happening, and definitely no self-talk like, “Am I gonna get turned on enough? Am I gonna stay focused enough to please my partner?” These things just mess with your ability to experience your own sexual response, and if a problem arises, it can be tough to get back to the pleasure and connection you supposedly are trying to achieve! (I’m aware that people have sex for many reasons, and I don’t mean to denigrate those experiences by saying this.) The other thing sensate focus can do is help you and your partner learn what kind of touch you (and they) do and don’t like, so there’s less guesswork.

Mindfulness does another important thing here: it teaches you about you, and helps you understand whether there are things about sex that trigger anxiety, loss of focus, sudden libido loss, or loss of desire. If your ADHD shows up in sex with a hypersensitivity response, that can be the opposite of a turn-on. The next step along the path of mindfulness and sensate focus is to tell partners what your deal is, so they don’t unknowingly stimulate you to the point of irritation. (If sensate overwhelm is part of your life in general, maybe negotiate lower lights, less outside noise or distraction, and no extraneous scents in the room.)

I realize I’ve been addressing this as though sexual functioning is a problem, but sometimes it’s the opposite. Folks with ADHD can also experience a tendency towards hypersexuality—fun, right? But maybe not, since this can feel largely out of your control, and high sex drive can itself be mixed up in relationship issues.

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Either way, like many other people for whom sex has proven challenging, you might benefit from switching up what it means to have sex in the first place. If there is a pattern of experience you’ve learned (and have issues with), is there anything else you and your partner or partners could do differently? Thinking about this lets you consider what might bypass your current triggers, whatever they are. Talk to them about that and negotiate. Try to experiment and explore. This could put you in a different mindset and keep you out of the rut of worrying about sex just because it has been challenging in the past. Good luck! –Carol Queen

Carol Queen’s latest book (written with Shar Rednour) is The Sex & Pleasure Book: Good Vibrations Guide to Great Sex for Everyone

This article originally appeared in the Spring 2021 print edition of BUST Magazine. Subscribe today!

Photo by Roman Odintsov / Pexels

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