Table of Contents

July 9th, 2019

The first section shares the results of the ADHD Relationship Sex Survey, the first of its kind to look at how ADHD can impact a couple’s sex life and relationship satisfaction. This covers the differences between those with and without ADHD, as well as how gender influences it all. I also share how the 3,000 respondents rated various treatment options and why treatment effort is important in more ways than you think. Finally, I share the lessons learned from the happiest couples so that we can all have a more satisfying sex life and relationship.

In the second and third sections, I extend the results from the first section by covering all sorts of topics that will help you overcome whatever is holding you back from a more satisfying sex life and relationship. I talk about how creating a better sex life means also working on your relationship and that you will both benefit from the process. I talk about how to resolve differences and negotiate a sex life that works for both of you, including how to deal with problems with performance and pleasure. I also get into some hefty topics like masturbation, porn, infidelity and even consensual nonmonogamy, so that you and your partner can navigate potential pitfalls.

There is definitely a progression of topics from one chapter to the next, but you can also skip around if there are some topics you want to read first.

Introduction: Good Sex is Extra Important for Couples with ADHD

Sex is Important

The Double-Edged Sword of Sex

How to Read This Book

Some Disclaimers


Introduction: Better Sex through Statistics: The ADHD Relationship Sex Survey

The ADHD Relationship Sex Survey

Take the Survey Yourself

Nice Numbers!

I Only Care If It’s Useful

Some Minor and Major Number Crunching

              Types of comparisons

              Four Kinds of People, Two Kinds of Couples

              Descriptive and Suggestive Results

Remember, Everybody’s Got Something

It’s All Good

Cut to the Chase: Give Me the Important Lessons

1. In Their Own Words

Non-ADHD Women

ADHD Women

Non-ADHD Men


In Conclusion

2. How ADHD Impacts Sex and Relationships

Surprising Findings

From Bad to Worse?

Early is Easy

Early is Easy in Bed, Too

Sexual Frequency

              Desired Sexual Frequency

Masturbation to Make Up the Difference?

Sexual Barriers and Masturbation Frequency

Porn Use Frequency

Partner’s Porn Use Frequency

Sexual Barriers and Porn Use

Porn Use Feelings

Huh? Distracted Sex

Sexual Effort is Imbalanced, Too

Sexual Variety


Physical and Emotional Infidelity

Consensual Nonmonogamy

Barriers to a More Satisfying Sex Life

The Sexual Eagerness Cluster

The Big Three: Sexual Frequency, Sexual Satisfaction, & Relationship Satisfaction

Bridge the Divide

Take Away Lessons

3. Make the Most of Treatment

How Hard Are You Working At It?

I’m Working Harder than You Are

Treatment Effort Matters More Than You Think

Maximizing Treatment Effectiveness

              Which Treatments Work Best?

Is More Treatments Better?

Take Away Lessons

4. Role Models: What Can We Learn from the Happiest Couples?

Beware of Negative Momentum

              The Power of Positive Attending

The Big Drivers of Satisfaction

Follow the Leaders

              Work Hard at Treatment

              Find Effective Treatments

              Have More Sex

              Have Better Sex

              Masturbation and Porn are OK

Take Away Lessons


Introduction: Your Sex Life is Worth Working On

5. Sex Makes You a Better Person

Peace Sometimes Requires War

Happy Couples Fight Better

The Double-Edged Sword of Desire

Self-Esteem, Self-Acceptance and Other-Acceptance

Between the Hammer and the Anvil

Take Away Lessons

6. Respectful Communication and Productive Negotiation

Be Accepting

              But Maybe Not Too Accepting. . .

              The Rich Tapestry of Sexuality

              What Do You Want to Do and Who Do You Want to Do it With?

From Thought to Action

              Step 1: Identify Your Sexual Desires

              Step 2: Understand Each Other’s Sexual Desires

              Step 3: Negotiate the Differences: Create Our Sexual Desires

              Step 4: Negotiate the Differences: How Often Do We Do It?

              Step 5: Negotiate the Alternatives: What Can I Do When You’re Not in the Mood?

The Importance of Being Good at Rejection

              Desire Killer #1: Guilting

              Desire Killer #2: Avoidance

              It Takes Two to Tango

Take Away Lessons

7. It’s All Foreplay

It All Spills Forward

The Sex Funnel

              Overcome Sexual Barriers

              Boost Sexual Enhancers

Quality, Not Just Quantity

Take Away Lessons

8. Make it a Priority

Make and Protect Good Feelings for Sex

Make and Protect Time for Sex

Make and Protect Energy for Sex

Make It Happen

              Make That Move

              Roll with It

              Plan B

Take Away Lessons

9. Sex 101 (and 201, and 301. . .)

Healthy Body, Horny Mind

              Still Got It!

              Reasonable Expectations, Both Ways

Exciters and Inhibitors: The Sexual Gas and Brake

              Context (Really) Matters

              Spontaneous and Responsive Desire

The Importance of Foreplay

Enjoy the Process

Most Women Don’t Orgasm Just from Intercourse

Share Your Toys

Fantasy vs Action

Sex into the Older Years

Everything is Better with Lube

Specific and/or Narrow Sexual Interests

Whips and Chains and Floggers, Oh My

Take Away Lessons

10. Taking Some Personal Time: Masturbation

The Ethics of Masturbation

Men Masturbate to Make Up the Difference (But Women Don’t as Much)

Are Sex and Masturbation the Same?

Is Masturbation Cheating or Criticism?

Masturbation as Path of Least Resistance

Masturbate Together

Take Away Lessons

11. What about Porn?

Porn Within Your Relationship

              Talk It Out

The Benefits of Porn

Some Things to Keep in Mind

              Why Does Most Porn Suck?

If Porn Is a Personal Problem

If Porn Is a Relationship Problem

              Which Came First—The Porn or the Problem?

Porn May Be Problematic, But It Isn’t Addictive

Take Away Lessons


Introduction: The Double-Edged Sword of Sex

12. When the Negotiations Break Down

Disagreements About Our Shared Sexual Repertoire

Disagreements About How Often We Do It

              Close (or Shrink) the Gap

              Generosity Always Helps

Difficult Sexual Negotiations

Seriously Irreconcilable Differences

Take Away Lessons

13. Problems with Performance and Pleasure

It’s All Connected

Genito-Pelvic Pain/Penetration Disorder

Erectile Disorder: Not the End of the World

Premature Ejaculation: Learn to Slow It Down

Delayed Ejaculation: Almost, Almost, Almost. . .

Problems with Specific Desires

Take Away Lessons

14. Problems with Desire: Not Enough Sex

Desire Downers: Many Potential Sexual Drains

What Does History Teach Us?

What Are Your Goals?

Start Slow

              Maybe Start by Yourself

What About Asexuality?

When Desire is Lacking—And Also the Desire to Desire

If You Want to Want It

Where Do Solo Activities Fit?

Take Away Lessons

15. Secret Stuff with Other People: Hook-Ups and Affairs

Fidelity Agreements: What Is and Isn’t Acceptable?

Preventing Infidelity

              Address Relationship and Sexual Problems

              Know Your Slippery Slopes

Surviving Infidelity

              To Tell or Not To Tell?

              First, Calm the Storm

              Learn From It

              Restore Trust

              Restore Normalcy

Take Away Lessons

16. Consensual Sex with Other People: Other Arrangements

Covering the Range

The Fantasy versus the Reality

Not the Solution for Relationship Problems

Maybe the Solution for a Specific Problem

Communication—And Lots of It

Take Away Lessons

17. Lessons for Dating: Begin with the End in Mind

Lessons from Your Past

              What Role Did ADHD Play?

Lessons from the Survey

What Are You Looking For?

              What Do You Deserve?

Dating Apps for the Impatient and Impulsive

              Truth in Labelling

              Fish in the Right Waters

              Invest the Time

              Resist FOMO. . .

              . . . But Know When to Move On

To Tell or Not to Tell?

Survive and Thrive

Take Away Lessons

18. Final thoughts

Appendix A: The ADHD Relationship Sex Survey

Appendix B: Provider Directories



Appendix C: Recommended Reading



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