Do women experience sexual side effects from Adderall?

Some women report a decrease in sexual desire when taking Adderall. Here’s what you should know.

By David Hopper | May 2, 2024 Medically reviewed by Anne Jacobson, MD, MPH

Key takeaways

Adderall is a prescription drug that’s made with a combination of amphetamine and dextroamphetamine. It’s prescribed to treat symptoms of ADHD and narcolepsy.
While most adult women who take Adderall do not experience sexual side effects, some have reported reduced sexual desire. This is primarily anecdotal, as research on the female sexual side effects of Adderall is very limited.
The sexual side effects of Adderall can be managed by lowering the drug dose, skipping the medication on days when sex is planned, or trying another ADHD medication.

Many women with attention deficit hyperactivity disorder (ADHD) count on prescription stimulants like Adderall to help them focus and concentrate in their daily lives. Adderall is the brand name of an amphetamine, a type of central nervous system (CNS) stimulant that works by increasing levels of dopamine and norepinephrine. These two neurotransmitters in the brain play an essential role in attention. But for some people, Adderall may come with an adverse sexual side effect: reduced libido (sexual desire).

Does Adderall affect sex drive in females?

Studies are limited on the impact that ADHD prescription medications have on sexual function and desire. However, some women have reported lowered sex drive when taking Adderall (amphetamine and dextroamphetamine) and other ADHD medications.

“There’s very little systematic research on this,” said New York City-based sex therapist Stephen Snyder, MD, author of Love Worth Making. Some women note an increase in libido, while others notice a decrease.

Psychiatrist Tom Xia, MD, said although he has read about women reporting sexual side effects after taking Adderall, he doesn’t often see it in his clinical practice.“In fact, I have seen patients that have difficulty staying in the moment during sexual activity report improvement in their sex life after starting ADHD medication,” said Dr. Xia, who has a private practice in San Francisco, California.

Sexual side effects of Adderall in females

According to the United States Food and Drug Administration (FDA), the most common side effects of Adderall include:

Nervousness
Stomachache
Decreased appetite
Weight loss
Constipation
Insomnia
Dry mouth
Mood swings
Headache
Chest pain
High blood pressure

Changes in libido have been reported in clinical trials, but there is little information on how often this happens. Mayo Clinic reports changes in sexual drive and performance as a possible side effect of Adderall, but the frequency is unknown.

Stimulants effect on sexual well-being

In general, Adderall and other stimulants are not associated with sexual side effects for most people, according to Ari Tuckman, PsyD, a psychologist and sex therapist based in West Chester, Pennsylvania, who specializes in diagnosing and treating people with ADHD.

Tuckman surveyed about 3,000 people, examining different aspects of their relationships and sexual well-being. The survey, which was published in his book ADHD After Dark, focused on couples consisting of one partner with ADHD and the other without the condition.

One of the questions in the survey was, “What effect does stimulant medication have on a sexual encounter while the medication is active?” About half of respondents said it had no effect. Five percent endorsed each of the other answers, which ranged from small positive or negative effect, to moderate positive or negative effect to significant positive or negative effect. Tuckman concluded that stimulant medications probably do not have much of a direct effect on sexual functioning but that people reporting a positive effect were likely less distracted during sex.

Irwin Goldstein, MD, a urologist and the director of San Diego Sexual Medicine, said he often prescribes Adderall off-label to women with sexual dysfunction “with great success.” Off-label is when a drug is prescribed for a medical condition other than that for which it has been FDA-approved.

Dr. Goldstein will have women take a low 2.5-7.5mg dose of Adderall as needed an hour before they have sex.

“I’m using it off-label as a neurochemical that provides excitation,” Dr. Goldstein explained. “That’s hugely important for sexual activity.”

Dr. Goldstein said female patients will tell him they can’t focus during sex because they’re thinking of all the things they need to do in their busy lives. The low dose of Adderall helps to mimic excitatory neurotransmitters, such as adrenaline.

How soon do the sexual side effects of Adderall start?

Adderall immediate release (IR) starts working 20 to 30 minutes after it is ingested, and it reaches its peak effectiveness in about 1 to 2 hours. If side effects occur, they are likely to be at their height when the drug is at peak effectiveness. Adderall extended-release (XR), on the other hand, starts working after 30 minutes and has a longer-lasting effect.

Both the IR and XR versions contain the same active ingredients: dextroamphetamine and amphetamine. Adderall IR typically lasts for about four to eight hours, while Adderall XR may last up to 12 hours. The timing of the side effects may vary. Because XR releases its active ingredients more slowly into the body over a longer period, the side effects may start later than they would with Adderall IR.

How long do the sexual side effects of Adderall last?

Adderall tends only to be effective while it is in one’s system, Dr. Xia said, which means as the medication fades, so do the potential side effects. Some people notice side effects for the duration of the medication. Other people will notice a return of sexual function as the medication is leaving the system.

“I have not seen any sexual side effects that were not reversed by stopping the medication,” Dr. Xia said.

Managing the sexual side effects of Adderall

For some women struggling with low libido, medication may not be necessary. A licensed sex therapist or mental healthcare professional can help one learn ways to manage low sex drive with non-medication treatment options. Lifestyle modifications can naturally increase libido as well.

Some tips for managing the sexual side effects of Adderall include:

Lowering the dose
Skipping the medication for days of planned sexual activity
Switching to alternative medication, including non-stimulants for ADHD
Getting a good night’s sleep
Reducing stress
Making time for leisure

Dr. Tuckman said that it is important to figure out what you would like your sex life to look like so that you may figure out what is getting in the way. He added that finding ways to have more fun is important. If you’re not having fun together, the stresses of life can feel worse. And you may feel less of a connection with your partner.

The bottom line

The exact mechanisms underlying Adderall-induced changes in sex drive in women remain unclear. The adverse effects of the stimulant can vary from person to person. Some women may even have more libido while taking the medication. If you experience sexual side effects with Adderall use, talk about it with the prescribing healthcare provider. They may adjust the dosage or prescribe a different ADHD medication.