I’ve found that two of the most common sexual problems associated with ADHD are of the orgasm phase: Delayed Ejaculation and Female Orgasmic Disorder. It stands to reason that if one has difficulty concentrating during sexual activity, it will be that much harder to achieve an appropriate level of stimulation to reach orgasm.
Clients with ADHD have told me that they have several things going through their minds simultaneously and therefore find it hard to focus on the task at hand. One male client said: “I have 25 things going through my mind at any given time. When I’m having sex I’m okay for a minute or two and then I start thinking about paying bills or cutting the lawn.”
Boredom, a common issue for those who seek high levels stimulation, can also lead to orgasm dysfunction. A relationship in which at least one partner is ADHD (particularly the hyperactive/impulsive type) typically starts off with great excitement, intensity, and passion. Those with ADHD can also be a lot of fun. But I’ve seen boredom set in the ADHD partner very quickly and in turn, a lack of attraction quickly develops even for the sexiest partner. A decrease in romance and affection tends to follow.
Many people with ADHD fail to see the impact they have on their mates and as a consequence, a parent/child dynamic often emerges. The non-ADHD partner plays the critical, frustrated parent, and the ADHD partner, the rebellious child.
Breaking the parent/child dynamic (p-c) is crucial to repairing the ADHD relationship and improving the couple’s sexual life. Oftentimes the parental partner will blame the ADHD partner for all the couple’s issues. This must be stopped or the circular p-c dynamic will continue.
Many parental figures have been overly responsible in their families of origin. Helping them recognize this may spur them to take responsibility for their own contribution to p-c dynamic. The ADHD partner must learn to stand up for himself or herself in an adult-like fashion rather than rebel like an adolescent.
While not all scholars agree, I tend to view medication as a necessity for the ADHD partner. Taking it signifies the recognition of ADHD, and makes it less likely that the ADHD partner will seek other forms of stimulation such as illicit drugs or even just arguments.
Variety is important in any couple’s sex life, but especially in an ADHD relationship. For some couples, changing positions or even venues (e.g., sex on the couch instead of always in the bed) may help. In some cases, I’ve recommended the missionary position because it’s more difficult for ADHD partners to lose sight of their mates, and allow their minds to wander.
Many who suffer from orgasm problems “shut down” just as they are about to climax. As partners get close to climax, I recommend that they simulate orgasm (e.g., moan and gyrate hips) in order to push themselves over the threshold. In some cases, a vibrator can be used and eventually integrated with intercourse.
And last, many partners of ADHD people have reported to me that lovemaking is too mechanical; that their ADHD mates try to “get right to the sex and get it over with.” Sensate Focus Exercises (e.g., mutually caressing exercises) that reduce anxiety and increase intimacy may help sexual activity to flow.
After comparing the results, the researchers found:
- The most prevalent dysfunctions in men with ADHD included orgasmic problems (14%), premature orgasm (13%), sexual aversion (13%), and negative emotions during or after sex (10%).
- Compared with men in the general population, male ADHD patients more often reported sexual aversion (12% vs 1%) and little desire for sexual contact (6% vs 0%). However, hypersexuality was higher in the male ADHD group than in the general population (12% vs 5%). In general, men in the ADHD group were more sexually active but also less often satisfied with their sex life than men in the general population (27% vs 68%).
- In women with ADHD, the most prevalent dysfunctions were sexual excitement problems (26%), orgasmic problems (22%), and sexual aversion (15%).
- Compared with women in the general population, female ADHD patients more often reported sexual aversion (15% vs 4%) and sexual excitement problems (26% vs 3%), but were equally low in terms of hypersexuality (2% vs 2%). As with the male ADHD group, the female ADHD group was less often satisfied with their sex life compared with women in the general population (35% vs 65%).
Symptoms of inattention and impulsiveness may result in sexual problems for adults with ADHD, the researchers explained. “Sexual excitement problems may be associated with insufficient focus on sexual stimuli, caused by easily being distracted in ADHD,” they noted.
“We also found that quite a few ADHD patients reported sexual aversion, and a lot of male patients also reported negative emotions during or after sex. These men and women do not feel safe and in control during sex,” Dr. Bijlenga and colleagues wrote. “Sexual aversion may be the result of negative sexual experiences in the past and can be associated with low self-esteem, fear of intimacy, and insufficient relational skills, which are all more prevalent in ADHD patients. However, we do not know if this is also the case in our patient sample.”