“Instead of one clear focus, I get racing ideas and mental loops,” says Stevey, 33. “I can’t really just mentally relax and let things happen. And if I stop actively engaging, my mind drifts. Once that happens, it’s hard to get the vibe back.”
For Stevey, this is sex with attention deficit hyperactivity disorder (ADHD): a constant mental tug-of-war between staying in her body and getting stuck in her head.
By now you’ve heard of the orgasm gap—the disparity in men’s and women’s orgasm rates during partnered sex, given its name in the late 1990s. (If you haven’t, spoiler alert: Women have fewer orgasms.) Without any further analysis, it’d be easy to explain it away as men not caring about or being attentive to women’s orgasms. That may be true in some cases, but for others there are far more complex factors at play. And one of those could be having ADHD.
The link between ADHD and orgasms
Only 4.2% of women are diagnosed with ADHD (compared with 13% of men). But this doesn’t necessarily mean women are less likely to have the mental health disorder than men—they’re just less likely to get diagnosed. One reason for that is because men typically show outward-facing symptoms such as hyperactivity and impulsivity, while women veer toward more internal characteristics including inattentiveness and distractibility. It’s harder to diagnose something that you can’t directly observe. And because of this, when women with ADHD are struggling to orgasm, they might not realize the true cause at first.
Luckily, more research is being done about it: In 2025 the Journal of Sex Research published a study that found that women with ADHD symptomology reported fewer rates of orgasmic consistency. (Translation: Women with ADHD have fewer orgasms.) It’s not just any type of ADHD, though. There are three categorizations of the disorder—inattentive, hyperactive-impulsive, and combined—and women with signs of inattentive ADHD (that is, brain fog, forgetfulness, and an inability to focus) seem to suffer the most in the Big O department.
This makes sense: If you’re a woman who has ever orgasmed before, then you know firsthand how important focus is in the process.
“Human sexuality researchers like to talk about the brain as the sexiest organ,” says Cory L. Pedersen, PhD, the co-author of the Journal of Sex Research study. She points out that women can orgasm in their sleep and that arousal isn’t solely about touch or sensation. “The brain is incredibly powerful. When it comes to achieving orgasm and getting into the mood, the brain is really the place to go.”
Of the brain can help bring you to orgasm in the middle of your REM cycle, why does it struggle so much to do the same when you’re awake? Well, for one, even women with neurotypical brain functioning can experience intrusive thoughts when having sex. If you’ve ever thought things like, Do I look funny? Is my body sexy? Am I making weird sounds? Did I just make an odd face? you know what I mean. According to Dr. Pendersen, this is called spectatoring. It’s when you mentally move outside of your body and the sensations it feels during sex to focus on how you look. We’ve all probably experienced this at some point. The difference is, it’s easier for a neurotypical brain to get back into the moment.
For women with symptoms of ADHD, however, these thoughts can become overwhelming to the point that it’s hard to snap back or even enjoy sex at all. Says the study, “In the context of sex, cognitive distraction can present in a variety of ways such as preoccupation with body image, automatic intrusive thoughts, ‘spectatoring,’ or a general lack of erotic thoughts.” When all of these things are running through your mind, there’s not a lot of room left for pleasure.
“If we can’t focus on the sexual stimuli that we’re presented with, it makes it harder for us to become aroused,” says Tina Jensen-Fogt, the study’s other co-author.
Stevey was only diagnosed with ADHD in the past few years, but she’s been aware of the effects it’s had on her thinking for quite some time. She describes it as her brain being unable to filter thoughts well. Aishah, 28, also recently diagnosed, experiences a similar wandering of thoughts. And for both it tends to put a damper on things during sex.
“I kick myself mentally for checking out in the first place, which—depending on the partner—can completely ruin the mood,” Aishah says. “I’m thinking about focusing and being present rather than actually being focused and present.”
Aishah admits she has even abruptly ended sex multiple times because of the self-condemnation that typically follows moments like these.
ADHD and orgasms: Tips from the experts
While Dr. Pendersen and Jensen-Fogt’s research is a step in the right direction, it’s only one of a very limited pool of studies on sexual functioning for anyone with ADHD. With so little information out there, it’s easier for women whose symptoms may interfere with their sex life (and inevitably their orgasms) to be left feeling shameful or abnormal.
“Sorry to the boys who have experienced me staring at a ceiling wondering what I am going to have for dinner that night,” jokes Aishah. (Kind of.)
Aishah may feel apologetic, but Laura Nolan, a licensed psychotherapist who specializes in clinical sexology, ADHD, and women’s health, insists there’s no reason to be. As she explains, women with ADHD often feel guilt around their sexual interactions, in part because they tend to assume their inattentiveness with a partner is a sign that they’re not interested. Instead, it’s merely a cue that a new approach should be taken.
“Overthinking and distractibility might simply be communicating the need for more organizational structure, transition time, or increased stimulation during sex,” Nolan says. In fact, you may subconsciously already have methods in place to manage your ADHD symptoms when they rear their head during sex.
“Things like eye contact, touching, kissing, or being intentional in some way keep me grounded in the moment,” says Stevey about how she stays present with a partner. Sometimes this means touching herself; other times she tries to tune into the sensations she’s feeling. For Aishah, face-to-face sex positions help bring her back to her body and the moment—which means a higher chance at orgasming.
Ask Dr. Nan, a sex therapist turned neuroscientist, answers all of your burning sex questions.
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Of course, orgasm isn’t the be-all and end-all when it comes to sex. “Women can experience sexual satisfaction, even with the absence of orgasm,” says Jensen-Fogt. If it’s occasionally hard to get in the mood, that shouldn’t be cause for concern. “But it’s the consistent sort of delay or absence of orgasm that’s also commonly correlated with lower levels of sexual satisfaction. So it’s still pretty important.”
Jensen-Fogt hopes that her research is a catalyst for a long-overdue investment into women’s sexual and mental health, and how one may affect the other. She already has ideas on practical next steps in this research, including studying how ADHD may affect orgasm during masturbation and what happens when medication comes into play. In the meantime, she encourages women with ADHD to feel validated in their struggles with sex and to start considering their symptoms more seriously when speaking to mental health professionals and doctors.
“It’s like putting pieces of a puzzle together,” says Aishah when asked how ADHD affects her sex life. “It’s like, Ah, yes, now I understand why this happens.”
Until the research catches up, that validation is a necessary starting point. Learning about the ways in which a disorder like ADHD can affect the brain at least offers an explanation that helps replace self-blame with understanding. And once we do that, it’s easier to confront any sexual “hang-ups” and be empowered to simply meet our bodies where they’re at. How sexy is that?
