(357) The Importance of Assessing Adult ADHD/ADD Diagnoses in Patients Presenting with Concomitant Sexual Disorders and Sexuality Related Challenges to Both Sex Therapists and Medical Providers
Authors: Cooper S 
Published: February 2024

Abstract

Introduction
A 2020 literature review in The Journal of Sexual Medicine concluded that research subjects with ADHD reported more sexual desire, more masturbation frequency, less sexual satisfaction, and more sexual dysfunctions than the general population. Another study showed that all participants with self-reported ADHD showed higher rates of avoidant attachment while males with ADHD and anxious attachment reported using a greater amount of online pornography/sexually explicit media. There are unique challenges that affect singles’ and couples’ sex lives when a partner has Adult ADHD/ADD. Many patients seek out medical treatment of sex therapy for Erectile Disorder, Delayed Ejaculation, Premature/Uncontrolled Ejaculation, Genital Pelvic Penetrative Pain Disorder, and low desire and seek out sex therapists for the above diagnoses as well as infidelity, out-of-control-sexual-behavior, orgasmic disorders or sexless relationships. These patients seek to address what they regard as exclusively a medical or a relational problem. However, only through accurate assessment and treatment by both sex therapists and doctors of an intersectionality of an adult ADHD diagnosis impacting the sexual disorder will the client or couples’ challenges fully improve.

Objective
Many patients show up in both sex therapists’ and doctors’ offices with sexual complaints without either having been formerly diagnosed with ADHD or by sharing with the provider that they have this disorder. The ADHD/ADD diagnosis can be a treatment blind spot for both sex therapists and medical providers that can be greatly improved upon due to the integral impact it has on both a single patient's concomitant sexual disorder and a couples’ sex life. In this talk, the presenter hopes to improve participants assessment skills to treat the co-occurring symptoms that impact both sexual functioning and health.

Methods
In this presentation, an overview of common sexual issues occurring in single clients and couples where one partner has ADHD/ADD, will be presented along with clinical case examples. The presenter will offer some key questions to pose when assessing a patient to yield more information regarding how their sexual functioning has been impacted over the course of various stages of their adult life. This talk will also assist in educating providers on how to provide sexuality education so clients can protect their sexual health, understand the interplay of ADHD and their sexual functioning problems, and provide referrals needed to sex therapists, ADHD-specialized psychiatrists, urologists, gynecologists, and pelvic floor therapists so the patient has a holistic treatment plan.

Results
Clinical experience suggests assessing and treating comorbid adult ADHD in single and coupled patients may be a key to treating a common matrix of sexual comorbidities: Erectile Disorder, Anorgasmia, Out of Control Sexual Behavior, Premature Ejaculation, Anxiety and Depression. In this group these hard-to-treat problems may become more responsive to directed treatment if the disability of ADHD can be mitigated. Addressing adult ADHD provides an opportunity to reverse demoralization and open up doors to effective sexual functioning for a portion of our patients who have struggled to get a full-spectrum treatment plan.

Conclusions
As a sex therapist in practice for over 25 years, I have found that many adults have not been formally be diagnosed with ADHD and that their previous experiences with medical providers and general couples counselors have missed out on the impact the disorder's symptoms has on their sexual functioning. There is still scant research on ADHD and sexual functioning in the literature and I feel that our patients would improve more quickly if this disorder were taken into account by their medical and sex therapy providers.

Disclosure
No.