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ADHD Medications

Adderall Sexual Side Effects

Author:

Jessica Men

PharmD

Medical Reviewer:

Dr. Henry Bradford

Updated: 11.19.2025

The medications listed on this website are provided for informational purposes only.

Their inclusion does not guarantee they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. Healthcare providers may prescribe other medications, including non-stimulant options, or recommend non-pharmacological treatment based on the patient’s unique health circumstances and needs. Read more

Boxed warning: Adderall (amphetamine, dextroamphetamine mixed salts)

Adderall has a boxed warning[1] , the most serious type of warning from the Food and Drug Administration (FDA). Adderall’s active ingredient (amphetamines) has a risk of misuse (abuse) which can lead to dependence, increased risks in those with heart conditions, and even sudden death. Adderall is also a controlled substance, indicating its high potential for misuse or dependence. Specific federal and state laws limit the amount of this medication that can be prescribed or dispensed within a certain period of time.

Highlights

Adderall is a stimulant medication that is used to treat attention-deficit hyperactivity disorder (ADHD). It may cause mild to serious adverse reactions, including sexual side effects.
The reason for most of the sexual side effects is the change in dopamine and norepinephrine that Adderall causes. Those neurotransmitters are key players in regulating sexual desire and pleasure.
The sexual side effects have been reported in both men and women and vary in terms of experiences, duration, and reversibility.
If you are concerned or have any questions regarding the sexual side effects of Adderall, speak with your healthcare provider. They may consider a change in dosage, timing, medication, or possibly offering another treatment.

Sexual side effects with Adderall use are rare, but the ones that have been reported remain of interest to many patients because they can greatly disrupt a person’s quality of life. In general, the changes to neurotransmitter levels in the brain caused by Adderall is what leads to potential changes in sexual function. Let’s learn more about the symptoms to look out for and how they can be managed.

Get professional guidance on managing Adderall side effects and optimizing your ADHD treatment.

Why Adderall Can Affect Sex

Adderall (dextroamphetamine-amphetamine) is a central nervous system stimulant medication that is used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy[2] . It functions by increasing the amounts of dopamine and norepinephrine[2] in the body to improve alertness and energy levels.

Dopamine and norepinephrine are key players in regulating sexual desire and pleasure. Since a stimulant affects their levels, this could lead to changes in these functions. Elevated norepinephrine also causes increased vasoconstriction of blood vessels[3] , leading to increases in blood pressure, including during erections.

"Sexual dysfunction with prescription stimulants (e.g. Adderall) is relatively uncommon and, paradoxically, may present as either heightened or reduced sexual drive. While the exact mechanisms are unclear, sexual side effects are generally mild and tolerable. Since many patients are prescribed stimulants for ‘as needed use,’ dose timing can often mitigate most of these concerns. "

Dr. Henry Bradford, MD

Medical provider at MEDvidi

Overview of Sexual Side Effects

Sexual side effects that have been reported in both men and women[4] vary widely in terms of experiences, duration, and reversibility. These effects include[4] :

Change in sex drive/libido
Erectile dysfunction
Changes in arousal/orgasm
Comfort issues
Emotional detachment/performance anxiety
Hypersexuality

Some effects that specifically impact male or female sexual functioning[4] have been reported in clinical trials or observed in other studies. Since Adderall stimulates the central nervous system in order to manage ADHD symptoms, it simultaneously affects these other systems in the body.

Sexual Side Effects in Men

Libido & Arousal

By affecting dopamine and norepinephrine levels, Adderall can change the feeling of pleasure associated with sex[5] and decrease one’s sex drive. Another hypothesis is that the mental stimulation caused by Adderall can lead to subsequent mental exhaustion and less energy for sexual activity. This may result in reduced sexual life satisfaction.

Erectile Function & Penile Shrinkage

Adderall use, through norepinephrine pathways, activates the sympathetic nervous system, which counteracts the typical factors promoting erection. The exact mechanism behind why Adderall can also cause penile shrinkage[6] isn’t entirely clear, but a hypothesis is that the prolonged restriction of blood flow results in a reduced size.

Ejaculation Timing (“Lasting Longer”)

Cases of premature ejaculation are rare[7] but have been reported in male patients taking ADHD stimulants that affect dopamine and norepinephrine. However, these effects seem to be temporary and likely go away after stopping the medication.

Sexual Side Effects in Women

Desire & Arousal

In clinical trials, female patients taking Adderall experienced changes in libido and sexual desire[8] . The underlying mechanism of this effect is unknown, but the logic is that, like for men, the change in dopamine and norepinephrine causes this effect.

Comfort & Orgasm

Estrogen is a hormone that can affect arousal; higher levels of estrogen in the body promote vaginal lubrication and increase sexual desire. However, response to many stimulant medications is associated with low levels of estrogen[5] . This decrease can be associated with a subsequent decrease in sexual desire.

While not specific to Adderall usage, it may be interesting to note that in a study[9] in patients with ADHD, females showed significantly poorer scores when assessing desire, arousal, orgasm, satisfaction and pain during sex, and vaginal lubrication.

Factors Influencing Sexual Side Effects From Adderall

Dosage Effect

Research[5] has found that while the dosing frequency of Adderall was associated with its impact on sexual functions, the duration of its use had little association with that. This can explain why decreasing the dose can help decrease the side effects of Adderall. However, any dosage changes should only be made under medical supervision.

See a licensed healthcare provider online to review and personalize your ADHD treatment plan.

Other Medications & Conditions

It may be beneficial for patients taking Adderall who are concerned about sexual side effects to also keep track of other medications[10] that could also be the cause. These include many antidepressants, blood pressure medications, oral contraceptives, and anti-androgens.

Cardiovascular disease[11] has also been an important risk factor; the severity of heart disease increases the occurrence of sexual dysfunction. In addition, symptoms of depression associated with this can contribute to the impairment of sexual responses.

"Stimulants and erectile dysfunction medications (e.g. Viagra, Cialis) both impact cardiovascular function. It is important to discuss the risks of using these classes of medications in combination with your medical provider and to review baseline cardiovascular function. "

Dr. Henry Bradford, MD

Medical provider at MEDvidi

Lifestyle

Research[12] has shown that sexual dysfunction can also be affected by certain lifestyle habits. In men, greater cigarette smoking increases the risk of erectile dysfunction, while greater physical activity decreases it. In women, increased physical activity was also associated with a lower risk of sexual dysfunction. In both, there was evidence that a healthy diet is related to a lower risk of erectile dysfunction and female sexual dysfunction.

Coping With and Managing Sexual Side Effects

Most of the sexual side effects mentioned above are dose-dependent, temporary, or treatable. If you or someone you know is experiencing issues because of Adderall or another ADHD medication, it’s important to consult a healthcare professional. Some possible solutions that the provider may attempt include:

Adjusting Adderall dosage or the timing of the medication.
Trying alternative ADHD medications.
Adding targeted treatment options, such as medications for erectile dysfunction, lubricants for dryness, or therapy for performance anxiety/relationship issues.
Waiting for the effects of Adderall to wear off before engaging in sexual activity.
Lifestyle changes, such as changes in exercise, sleep, and smoking.

At MEDvidi, you can get ongoing support and personalized medication management, including timely adjustments in the case you experience side effects. Book your appointment to start online ADHD treatment with a qualified provider.

When to Seek Medical Care

All CNS stimulants can cause[13] :

An increase in blood pressure and heart rate.
Psychiatric adverse reactions in patients with pre-existing disorders.
Weight loss and growth suppression in children.

These can cause serious negative effects[13] , and patients taking Adderall should be monitored for these risks accordingly. Please consult a healthcare provider immediately if any of the above reactions occur. For the sexual side effects that aren’t as urgent, please consult your provider at your earliest convenience.

Do not stop taking Adderall without consulting your provider first. They will tell you how to decrease your dose gradually[14] and will monitor you carefully in the event that you develop withdrawal symptoms.

Conclusion

The sexual side effects of Adderall can be disruptive to quality of life in both men and women, but they are uncommon and usually treatable. If you are concerned or have any questions regarding these, it is important to speak with your healthcare provider and discuss personalized options for solutions. A provider may recommend a change in dosage, timing, or possibly switching to another medication or adding another one. Book an appointment today to get personalized medical advice.

FAQs

Does Adderall constrict blood vessels or restrict blood flow?

Yes, a side effect of how Adderall works is the constriction of blood vessels, which can lead to an increase in blood pressure.

Does Adderall affect testosterone levels?

Some research[15] has shown that chronic Adderall use was found to be associated with testicular hypofunction.

Does Adderall increase estrogen levels in males?

No, there has been no research associating Adderall with estrogen levels in males.

Can Adderall cause hypersexuality?

Yes, a potential side effect of Adderall is hypersexuality.

Does Adderall make you sexually aroused?

It depends; a side effect of how Adderall works is a change in sex drive. The change that Adderall causes to dopamine and norepinephrine levels can either decrease or increase sex drive.

Can Adderall cause premature ejaculation or help with it?

Cases of premature ejaculation in male patients taking Adderall are rare but have been reported.

Does Adderall ED go away?

Yes, the sexual side effects of Adderall are generally dose-dependent and treatable.

Why does Adderall make it difficult to get or keep an erection?

Because Adderall increases blood pressure and heart rate, it can restrict the amount of blood reaching the penis, making it difficult to achieve or maintain an erection.

How to get erect on Adderall?

Some solutions could be adjusting the dosage of Adderall (after consulting a medical provider), adding a medication for erectile dysfunction, waiting for the effects of Adderall to wear off before engaging in sexual activity, or making certain lifestyle changes. Do not make any changes to your medication regimen without consulting your healthcare provider.

Sources

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