16. Sexual behavior with ADHD
Author: Ulrich Brennecke
Review: Dipl.-Psych. Waldemar Zdero
Women with ADHD have significantly1
- Used to have their first sexual intercourse
- Her first live birth earlier
- Her menopause earlier
ADHD is associated with riskier sexual behavior.2
One study reported significantly reduced scores in adult women with ADHD in relation to3
- Desire
- Arousal
- Orgasm
- Satisfaction
- Pain
- Lubrication
In adult males with ADHD, the study reports significantly lower levels of
- Orgasm
- Erectile function
- Sexual satisfaction
- General satisfaction
Only desire was not affected in men.
Dopamine is associated with erectile function and male sexual behavior, and both too much and too little dopamine can be harmful.4 Dopamine appears to stimulate male sexual behavior and inhibit female sexual behavior.
Systemic administration of dopamine agonists by microinjection into the paraventricular nucleus of the hypothalamus (PVN) induces penile erection in male rats via dopamine D2 receptor activation. When microinjected into the medial preoptic area, they facilitate copulatory behavior. This is an activation of the inzertohypothalamic dopaminergic system, whose neurons originate in the catecholaminergic cell groups A13 and A14 of the hypothalamus.4 Unlike sildenafil, D2 agonists act directly in the CNS. The erectile response to D2 agonists is significantly reduced by the oxytocin antagonist d(CH2)5Tyr(Me)2-Orn8-vasotocin when it is administered intracerebroventricularly or into the VTA.
In the 1990s, a D4 agonist for the treatment of erectile dysfunction came onto the market. However, its success was limited, partly because orally active phosphodiesterase type V inhibitors were more effective and partly because the D4 agonist triggered vomiting.
Ni, Amare, Zhou, Mills, Gratten, Lee (2019): The genetic relationship between female reproductive traits and six psychiatric disorders. Sci Rep. 2019 Aug 19;9(1):12041. doi: 10.1038/s41598-019-48403-x. ↥
Spiegel, Pollak (2019): Attention Deficit/Hyperactivity Disorder and Increased Engagement in Sexual Risk-Taking Behavior: The Role of Benefit Perception. Front Psychol. 2019 May 22;10:1043. doi: 10.3389/fpsyg.2019.01043. eCollection 2019. ↥
Amani Jabalkandi, Raisi, Shahrivar, Mohammadi, Meysamie, Firoozikhojastefar, Irani (2020): A study on sexual functioning in adults with attention-deficit/hyperactivity disorder. Perspect Psychiatr Care. 2020 Feb 11:10.1111/ppc.12480. doi: 10.1111/ppc.12480. PMID: 32043624. ↥
Melis, Sanna, Argiolas (2022): Dopamine, Erectile Function and Male Sexual Behavior from the Past to the Present: A Review. Brain Sci. 2022 Jun 24;12(7):826. doi: 10.3390/brainsci12070826. PMID: 35884633; PMCID: PMC9312911. REVIEW ↥ ↥