Sexual disorders are frequently found in adults with ADHD

Sexual dysfunctions and other sexual disorders are highly prevalent in adults with attention-deficit/hyperactivity disorder (ADHD), according to results of a recent study conducted at an outpatient adult ADHD clinic in the Netherlands. Researchers found that 39% of men and 43% of women with ADHD had symptoms of a sexual dysfunction, while 17% of men and 5% of women ADHD patients had symptoms of a sexual disorder.

“Screening for sexual disorders should be therefore standard procedure during diagnostic assessment” of adults with ADHD, the authors wrote in an article in the journal ADHD Attention Deficit and Hyperactivity Disorders.

Previous research has suggested that impulsive behavior, exposure to risky situations, proximity to motivated offenders, and poorer guardianship may lead to decreased sexual health and well-being in adolescents and young adults with ADHD.

“We believe that symptoms of ADHD may lead to sexual disorders and sexual dissatisfaction,” wrote senior researcher Denise Bijlenga, PhD, and colleagues from the PsyQ outpatient adult ADHD clinic in The Hague, Netherlands. “For example, continuous distractedness and inattentiveness may result in decreased sexual arousal and orgasmic problems.”

Because sexual functioning hasn’t been well studied in adults with ADHD, Dr. Bijlenga and colleagues sought to assess the prevalence of sexual dysfunctions and other sexual disorders in adults with ADHD by comparing these patients with members of the general population.

The researchers recruited 136 patients age 18 and older (76 men and 60 women) diagnosed at their ADHD clinic. The patients filled out two questionnaires that screened for sexual problems and sexual dysfunctions. For comparison, the researchers used two large studies on sexual health in the Netherlands for a representative sample of the Dutch population.

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.”

The researchers further investigated whether sexual dysfunction was associated with depression, anxiety, or a substance use disorder (or the use of stimulants or antidepressants) in any of the patients with ADHD. But they found that none of the associations were statistically significant.

One limitation of the study was that it was conducted among adult men and women treated in an outpatient ADHD clinic, and therefore can’t be generalized to all adults with ADHD in the general population, the researchers noted. In addition, the ADHD patients in the study were younger than the respondents in the general population studies.

Nevertheless, further research—such as the etiological relationship between ADHD and sexual problems—should be investigated, Dr. Bijlenga and colleagues recommended. “Sexual arousal may temporarily increase dopaminergic function and diminish the severity of ADHD symptoms (like concentration difficulties, restlessness, difficulty to relax, or sleep). In this respect, it should be studied if sexual behavior is used as a coping strategy in ADHD.”