How ADHD may impact your sex life
Tags: Adhd, Relationships, Mental Health, Sex

For Nayeli, a 27-year-old with ADHD living in Pennsylvania, kink and BDSM is the only reason she has a functioning sex life.

Nayeli and her wife, a he/him non-binary lesbian, have a dom/sub dynamic. For her, this makes sex easier because it allows her to focus.

“My wife lets me use my cellphone during sex [because] I have adhd AND he likes when I ignore him anyway,” she told me over Twitter DM. “But it’s [because] I can’t focus.”

Sophia, a 26-year-old bisexual woman, also mentioned that BDSM activities helping her focus. “I… suspect that I like being choked and spanked because it reduces my area of focus to just the sexual,” she said, “but idk for sure.”

Sophia emphasized that ADHD is much more than “I can’t pay attention,” but that she does have trouble focusing during sex. After seeing my call-out on Twitter for people to share their experiences for this piece, she kept track of what she thought about the next time she had sex with her boyfriend. It was virtually nonstop: She thought about a conflict at work, about who would win the season of Top Chef they were watching together, whether she’d have time to run the next morning — the list went on and on.

People of all genders have ADHD, but the differences lie in societal expectation

Nayeli and Sophia are far from alone. Kathleen Nadeau, a licensed psychologist and founder of the Chesapeake Center for ADHD, learning, and behavioral health, told me that many women report getting distracted during sex and “didn’t know that was wrong with them.”

“They were trying to enjoy it, but also at the same time thinking about a dozen other things,” said Nadeau.

People of all genders have ADHD, but the differences lie in societal expectation. (To clarify, my sources spoke in terms of cis men and women, or at least people socialized as men and women). ADHD manifests differently in girls and boys; since boys tend to be more hyperactive and show less self-control, that could be a “trigger” that leads to diagnosis.

Consequently, men are likely to be diagnosed at a younger age than women. Women with ADHD report struggles with low self-esteem and shame much more than men, according to Nadeau. The pressures that women face — to get married, to maintain a home and have children and “do it all” — occur in conjunction with hormonal changes that men do not experience, either.

Shawna Kirby, a clinical forensic neuropsychologist, also said that gender bias and discrimination impact women with ADHD. Kirby has ADHD herself, and was diagnosed at 23. “It’s more likely that women are going to get diagnosed older, especially if there [was] nothing to trigger it,” Kirby said.

Women have come to Nadeau wondering if they really love their partner because they could not enjoy sex, when it was completely a neurological issue.

This fear can occur to folks of any gender, however. Ross, a 22-year-old in Las Vegas, told me that he gets overstimulated when being intimate with his boyfriend. “We might be casually sitting on the couch and he will get flirtatious and try to touch me a lot or kiss me, and I’ll already be focused on something else, and this starts to overstimulate me,” he said, “making me want to pull away or just overall feel overwhelmed with all of the touching and kissing.”

Sometimes the overstimulation makes Ross uninterested in sex; it seems like a “task that many people with ADHD dread like physical work or paperwork.” It bothers Ross because he loves his partner, but all the tasks that go into sex can feel overwhelming. “I think about having to take all of my clothes off, moving around a lot in bed, having to do the after-math cleanup and putting everything back to normal afterwards,” he said, “and all of this will set me off and out of the mood.”

What does it mean when someone with ADHD cannot focus, even when it’s on something “fun” like sex, and not something “boring” like paperwork? Nadeau simplified the science by describing the default mode network (DMN), which humans fall into when they’re not doing anything in particular. Examples of when the DMN kick in are when you’re staring out a window or waiting for a doctor’s appointment. When neurotypical people have something to do (a task to complete), the DMN shuts off and the task-oriented network kicks in.

For people with ADHD, however, the DMN does not shut off. Both networks function at the same time and thus, those with ADHD have internal distractions. This, of course, impacts people with ADHD in every aspect of life — including sex.

Distraction may be a result of not only ADHD, but anxiety and depression. The two often accompany ADHD in women, according to Nadeau. Psychiatrists may diagnose anxiety and depression but initially miss ADHD. Issues in the bedroom could be caused by a combination of these.

“Having a good sex life requires being able to turn off all of the other cares and considerations,” said Nadeau. “When you’re in a constant state of overwhelm, you’re not going to be feeling very sexy.” And when someone is overwhelmed and anxious, shutting out the world is not going to happen — no matter how sexy your external environment is.

There are also people on the hyperactive-impulsive end of the ADHD continuum, which could lead to hypersexual behavior. Nadeau notes that those who are more impulsive like to do riskier things and seek excitement in their lives.

Hypersexuality can lead to slut shaming, yet another way ADHD affects women differently than men. That was the first thought Kirby had when she considered the topics of ADHD and sex together. “You have ADHD and then you have impulse control,” she said. “You’re talking gender bias and discrimination in terms of sex sludge.”

In terms of her own impulsivity, Kirby’s therapist told her, “You can’t let 15-year-old Shawna drive the bus. You gotta figure out a way to take her out for ice cream.” Impulsivity is not necessarily a bad thing, said Kirby, one just needs to learn to manage it.

“When you’re in a constant state of overwhelm, you’re not going to be feeling very sexy.”

How one’s sex life is impacted by ADHD is “reflective of how they are, how they interact in all areas of their life,” said Nadeau. “If you are more hyperactive and impulsive and stimulation seeking, you’re going to have a very different relationship to your sexuality than a woman who is anxious and… not able to really clearly focus on anything.”

If someone with ADHD wants to change their behavior — in or outside the bedroom — there are tools they can use. Medication is one. Nadeau said that it can turn off the DMN. For some people, though, it can affect sexual performance, such as causing erectile dysfunction.

While not currently on medication, Nayeli said it helped improve her sex life. “I have been on meds previously and it definitely makes a difference in that I have a lot more sex when I’m medicated,” she said.

Sophia takes a low dose of Adderall, and said she does not believe she’s ever had sex while medicated because she takes a low dose in the morning. She does want to try it, however. She told me, “I’ve sexted while on [Adderall] and I think that amped it up so it would be interesting to have sex after medicating.”

But medication may not be right for everyone, and that is just one option. Other tools involve finding non-destructive yet stimulating activities for those who are on the hyperactive-impulsive end; Kirby mentioned that she got into martial arts and changed her diet, which helped her.

Mindfulness meditation is the practice of learning to focus and learning to bring your mind back to the task at hand. It is now even being used as a primary ADHD treatment. Nadeau mentioned the work of Lidia Zylowska, who has a specific mindfulness program for people with ADHD. “She could prescribe medication,” Nadeau said, “But instead she is prescribing meditation.”

In terms of sex, exploring and discovering one’s preferences is a worthwhile venture — ADHD or not. Nayeli and Sophia, for example, know they enjoy aspects of BDSM.

Sophia has learned what brings her to orgasm, with or without her boyfriend. While masturbating with her hand makes it “virtually impossible” for her to come, a vibrator does the job. “The best,” she said, “is if I’m going down on my boyfriend because I literally only have enough brain power for the two things.”

Ultimately, no matter what preferences someone has or tools they use to manage ADHD, it does not mean that anything is wrong or not “normal.”

“Normal is a sitting on the washing machine that still destroys clothes,” said Kirby. Sexuality and sexual preferences are complex, just like every aspect of the human experience. If you’re being consensual and safe, Kirby continued, “Why not take yourself out for ice cream?”