(863) ADHD, Pornography Use, and the Development of Sexual Dysfunction

Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by inattention, hyperactivity, impulsivity and emotional dysregulation, with established impacts on psychosocial and sexual development. Individuals with ADHD report higher rates of hypersexual behaviors, increased frequency of masturbation, and greater engagement in electronic sexual exchanges compared to neurotypical peers. Problematic pornography use is increasingly recognized as a significant concern in ADHD populations, often serving as a maladaptive coping strategy for stress, anxiety, and mood regulation. Emerging evidence links ADHD symptoms to increased rates of hypersexuality, problematic pornography use (PPU), and sexual dysfunction, particularly in males. The interplay between ADHD, PPU, and sexual dysfunction remains underexplored, despite clinical implications for assessment and management. Objective This study aims to elucidate the associations among ADHD symptoms, pornography use, and the development of sexual dysfunction, with attention to gender differences. Methods The literature review was conducted to synthesize current evidence on the associations between attention-deficit/hyperactivity disorder (ADHD), pornography use, and the development of sexual dysfunction. The review focused on peer-reviewed studies published between 2005 and 2025, encompassing systematic reviews, meta-analyses, large-scale observational studies, and cohort analyses. Results The relationship between attention-deficit/hyperactivity disorder (ADHD), problematic pornography use, and sexual dysfunction is increasingly recognized in the psychiatric and sexual medicine literature. Sexual dysfunction, including orgasmic difficulties, sexual distress, and reduced satisfaction in sexual relationships, is more prevalent among individuals with ADHD. ADHD is associated with a twofold increased risk of distressing sexual function problems, with inattention and emotion dysregulation as possible mechanisms. Stimulant medications for ADHD may exacerbate certain sexual dysfunctions, particularly in males, while non-stimulant treatments have milder effects. Individuals with ADHD exhibit higher rates of compulsive sexual behaviors and problematic pornography use, which are associated with increased vulnerability to sexual dysfunction and distress. Emotional dysregulation and impulsivity are key mediators of these relationships, especially in women.Impulsivity mediated the relationship between ADHD and PPU, and higher physical activity attenuated this effect. Conclusions ADHD symptoms are robustly associated with hypersexuality, problematic pornography use, and increased risk of sexual dysfunction, with notable gender-specific patterns. These findings underscore the importance of routine sexual health assessment in individuals with ADHD and highlight the need for tailored interventions, particularly regarding medication management and behavioral risk reduction. Further research is needed to clarify mechanisms and develop targeted interventions for sexual dysfunction and problematic pornography use in this population. Disclosure No