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I’ve Lost All Sexual Desire. Is It My ADHD Medication?

Thanks for reading Can We Talk?, a sex and relationships column that aims to tackle the burning questions about sex, dating, relationships, and breakups that you’re too afraid to ask your partner — or maybe even your besties.
Last time, relationship therapist Moraya Seeger DeGeare, LMFT, heard from someone who feels like she’s losing her queer identity in her heterosexual relationship. Today, we hear from someone who fears her ADHD medicine is interfering with her libido.
Dear Moraya,
I've been with my partner for five and a half years and I started taking ADHD medication about two and a half years ago. Before starting my meds I had a ridiculously high sex drive, and I started noticing a difference about three months ago. I believe that my ADHD meds have drastically lowered my libido.
My partner and I try to have sex about once every week or so — we also try having naked cuddle time where there’s no expectation of sex, which is something we’ve done in the past when we’ve had a dry spell, but my body just isn’t responding sexually now. I haven’t talked to my doctor about it yet, but I absolutely plan to.
My partner has been really great about it — she isn’t pushy about sex and understands what’s going on, so she never makes me feel bad for not being in the mood, but I really miss that physical intimacy. My partner actually thinks it’s my therapy work (trauma, healing my inner child, all the deep stuff) that’s killing my libido instead of my ADHD meds, but I don’t know if it’s because my therapist and I really only dug deep into this topic in the last month or so.
I want to want to have sex, but I just can’t get my mind or body to feel any sort of sexy or even horny feeling. It’s weird because I’m very attracted to and in love with my wife, but I just can’t express that with physical intimacy the way I want to. Do you have any advice on how to bring that sexual excitement back without sacrificing my mental health?
Libido Loss
The journey for anyone on an inner healing path — whether that be medication, therapy, spiritual work, or all the above — will change how you are processing emotions and perceiving the world around you. You aren’t only learning your new, healing self, you are also finding your new relationship self, and this includes sex and desire. When we bring in medication to support ADHD symptoms, it often causes life to go from overwhelming to calm, and being still internally can be unsettling for individuals with a history of trauma. Some of those ADHD symptoms might have been exactly how your body had been coping with some of your trauma symptoms. These things have mixed and mingled and played off of one another for most of your life. 
Because how you experience the world is changing, it will also shape how you speak to yourself and deepen your awareness of your body’s sensations. You are reconnecting and rewiring the brain-body connection, and if you have a history of trauma, your body knows what it’s like to feel disconnected from itself. This journey is less about a side effect of medication and more about meeting and learning to love your new self in this healing body.
When we feel significant emotional change, it’s often from things compounding one another. It could be a side effect of medication, or your body coping in a new way as you bravely venture into deeper trauma work, or it could be things in your marriage waiting to be said. Even wonderful, positive things need to be voiced, and when they’re trapped, it can cause disconnection. You might be less overwhelmed now due to your medication, but it means talking about what really turns you on, especially if some feelings are less intense as a side effect.
It’s important to consider what feels unsafe or unsettling about being still for you. The goal of your medication is to bring a sense of calm and internal order, but perhaps what feels most challenging is your mind being more focused when you are having sex. I know that sounds perhaps silly, but if this is not how you are used to having sex it could be really significant.
Pleasure is an intense emotion that can be overwhelming. It connects the body and mind, oscillating between reality and fantasy, often triggered by physical stimulation and accompanied by emotional feelings. The experience of pleasure may feel entirely different now, as if you’re discovering it in a whole new way.
Consider how ADHD has impacted every aspect of your life, from work and education to friendships, romantic relationships, and your sex life. Reflect on its effects, and try to recognise how these symptoms have shown up for you. This might come with some tears, shame, or even an understanding of how you have over functioned in some areas. The fact that you felt motivated to try medication and explore new options suggests that you have experienced the impact of ADHD significantly. In addition to the negative impacts, it’s essential to recognize the strengths that come with how your brain works naturally. Perhaps the hyperfixation was how you would focus on sex and not get distracted, or on the flip side, being easily distracted during sex was what actually made it very stimulating for you. You might be someone who easily feels deep emotions and empathy when it comes to intimate moments, and part of the disconnect now is missing that feeling, and it really turned you on. Exploring this through journalling, talking with your wife, and discussing with your therapist can be helpful in seeing what underlying things might be coming up for you.

Reducing pressure doesn’t mean reducing pleasure; it means letting go of expectations and discovering new ways to connect with your partner and yourself.

Moraya Seeger Degeare, LMFT
It’s crucial to give yourself time to create a safe space for your body to reconnect with your mind. By doing so, you can bring pleasure back into your life by shifting from a mindset focused on performance to a mindset of curiosity. How can you deeply enjoy your body with its unique thoughts, energy, and new needs? It can be frustrating to realise that your needs may have changed and that the strategies that used to work no longer do, especially when you desire to regain a physical connection with your partner and experience physical pleasure on your own.
One of the hardest parts right now is finding a balance between overthinking and making space to ask yourself important questions. This is a struggle for a lot of us. You may discover that you don’t have all the answers like you thought you had, and that you need to explore how your body will respond right now, in this moment. Trying past methods that worked may not be what you need right now — instead, it might be helpful to create a fresh list of new fantasies or kinks to explore together with your wife. Before diving in, enthusiastic consent from both of you can determine whether trying new things together or exploring solo stimulation first feels safer. Reducing pressure doesn’t mean reducing pleasure; it means letting go of expectations and discovering new ways to connect with your partner and yourself.
In order to move forward, it’s important to address any feelings of shame. It may not be about sex itself, but rather moments when you felt bad about something and the validation from your partner made it all melt away. In your trauma work, you might realise that sex may not be the way you want to be connected and comforted by your wife right now, and that’s okay. Trying non-sexual ways of comfort, such as talking or engaging in fun activities together, can help you feel back in sync. Trauma work is heavy work — you might just be in a season where everything feels a little heavier, and it’s hard to get back to a playful place as instantly as you did before. 
Your medication may be uncovering something worth discussing with your wife. Did you feel obligated during sex in the past, pushing past those feelings or rushing to the end for release? Now that the urgency associated with a good sexual experience is potentially gone, you might be experiencing a shift. And just because sex feels different emotionally and physically right now does not mean it is bad: it’s important to first check that internally with yourself.
Discussing these side effects with your prescriber and therapist is a great step. They can provide insight into how trauma work and medication changes may impact your feelings of desire, especially how it relates to your personal history. Make sure to mention all medications you’re taking — even blood pressure medication! — as it’s all relevant. Your therapist can also share ways in which this type of work impacts people in similar situations, and can help you make connections that may not be obvious, but are important for your journey.
While frustrating at the moment, this is a chance to embrace the opportunity to meet your body in a new place, engage in deeper conversations with your wife, and explore your pleasure. Lean in with curiosity to the changing patterns, and know that although our minds tend to find discomfort in moments of change, you will find security again in this part of your love life as you feel safe in your body again.
You are not broken, and your sex life is not doomed. Be tender as you get to know this new you in this present body.
DeGeare is a licensed marriage and family therapist, who specializes in intimacy, LGBTQ+ relationships, mixed-culture couples, and racial identity development. The advice in this column is to point you in a direction that encourages healing and creates safety for you in this world. It is not to replace the relationship with a licensed mental health professional who knows your personal history.

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