Young Adults with ADHD: What Kind of Medication is Better for Long-Term Sexual Health?

More young people are being diagnosed with ADHD every day. While there is increasing knowledge that its effects on young girls and women are much different from the effects on young boys and men, many questions still remain regarding other psychosocial or pharmacologic differences between each biological sex.

Background

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder that can cause people to be more inattentive, hyperactive, and impulsive. ADHD and its symptoms can interfere with everyday life activities, like home, school, or professional work, as well as relationships and regulating emotion. In a sexual relationship, these symptoms may result in high-risk sexual behavior (HRSB), like having multiple sexual partners or not adhering to safe practices.

Sexual dysfunction revolves around a wide range of issues related to the sexual response cycle (desire, arousal, performance) and can negatively impact one’s ability to experience sexual satisfaction. This is thought to affect up to 30% of American adults.

Namely, sexual dysfunction includes erectile dysfunction (ED), orgasmic disorders, and dyspareunia (pain during sexual activity) as stand-out conditions. Sexual dysfunction can also cause psychological distress to an individual, especially if it begins to develop earlier in life when most individuals are starting to discover their sexuality and learn more about their bodies.

The Study

Unfortunately, stimulant medications for ADHD, like methylphenidate and amphetamines are known to affect sexual function, including libido (sex drive), ED (inability to maintain an erection for satisfying sex), and delayed orgasm. This, along with the recent uptick in research of ADHD for females has sparked several researchers to compare the effects of both stimulant and nonstimulant ADHD medication on the sexual function of young males versus females.

Using a health research network database, which provides electronic medical records from global healthcare organizations, researchers pulled female and male ADHD patient records anonymously. All patients were between 17-20 years old.

They then split each sex into three groups: stimulant medication, non-stimulant medication, and no medication at all. With this information, the researchers were able to also look at sexual dysfunction information alongside HRSB information.

So, What Were the Results?

Overall, most sexual behaviors and dysfunctions were relatively the same across all groups (by sex and by medication type). However, there were slight differences between certain groups:

• The stimulant medication group (both male and female) showed increased libido and compulsive sexual behavior/HRSB when compared to the unmedicated group.
• Males in the stimulant medication group showed more events of ED than males who were not taking stimulant medications.
• The non-stimulant group appeared to use contraception more frequently than the unmedicated group.
• Females in the stimulant medication group showed more events of visiting the clinic for contraception than other groups.

What It All Means

These researchers believe that their results fall in line with previous and ongoing research about ADHD differences between males and females. While both sexes may be participating in HRSB, there are still differences in how often HRSB and sexual dysfunction may occur between males and females.

As far as medications go, it turned out that stimulants had different effects on each sex. In males, sexual dysfunction was higher in those taking stimulant medications than in those who were not taking stimulants. This is probably because of the effects of these drugs on dopamine pathways and blood flow, both of which play a huge role in sexual function.

Females, on the other hand, may have experienced fewer HRSB while taking stimulant medication, despite general levels of hyperactive sexual behavior being elevated.

In general, non-stimulant medications appeared to have better effects on both sexes in terms of HRSB and sexual dysfunction.

These results reveal information that may be very helpful in guiding prescription pathways among clinicians, like making sure that their treatment or management plans for ADHD patients are tailored to the individual patient, rather than being the catch-all solution. Hopefully, with future research, the effects of ADHD and its treatments through adulthood might be able to shed more light on sexual dysfunction in ADHD patients.

References:

Hale, E. W., Igoe, T. J., Bernat, O. R., Cohan, T. D., & Thompson, K. P. (2025). From hyper- to hypo-: ADHD medications & sexual dysfunction. The Journal of Sexual Medicine, 22(5), 701–710. https://doi.org/10.1093/jsxmed/qdaf054