Adderall and erectile dysfunction: how are they connected?

Adderall is a prescription stimulant medication that treats attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. It can effectively improve focus, impulse control, and wakefulness, when taken as prescribed. While these benefits are well-documented, amphetamines like Adderall can also have unexpected effects on men's sexual health. Many men report experiencing Adderall erectile dysfunction, but the medication can affect sexual function in other ways, too. 

Read on to learn more about the connection between Adderall and sexual health and what to do if you experience sexual performance issues or libido changes when taking Adderall.

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Adderall (dextroamphetamine/amphetamine) is a prescription medication used to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. As a central nervous system (CNS) stimulant, Adderall increases the amount of neurotransmitters like dopamine and norepinephrine in the brain. This boosts brain activity and promotes better concentration and alertness.  

When taken to treat ADHD, Adderall can help control common ADHD symptoms like difficulty concentrating, restlessness, hyperactivity, and impulsivity.  As a narcolepsy treatment, Adderall can help reduce narcolepsy symptoms like excessive daytime sleepiness and sudden, uncontrollable episodes of falling asleep in the daytime. 

There are two types of Adderall available: immediate-release (IR) tablets and extended-release (XR) capsules. Both forms help manage ADHD symptoms, but they differ in how long their effects last:

• Adderall immediate-release (IR): Adderall IR offers a more rapid onset of effects, typically lasting between 4 and 6 hours. People generally need to take multiple doses throughout the day to maintain steady, ongoing symptom management.

• Adderall extended-release (XR): Adderall XR releases its active ingredients gradually, providing a longer duration of action—usually between 10 and 12 hours. This allows for a single daily dose, which is often more convenient for people who need consistent symptom management throughout the day.

While both forms of Adderall can be effective, their differing release patterns can affect not only how they work but also their potential impact on sexual health. Adderall IR may cause more fluctuations in neurotransmitter levels throughout the day, while extended-release capsules offer a gradual, steadier release. These differences can influence how Adderall affects sexual functioning. 

It’s possible Adderall may contribute to erectile dysfunction (ED) in some men. ED involves difficulty achieving or maintaining an erection long enough to engage in sexual activities. Like any medication, Adderall can cause side effects, including: 

• Insomnia/sleep problems 

• Loss of appetite 

• Weight loss 

• Dry mouth 

• Headache

• Nausea

Although sexual side effects are not always discussed as frequently as common side effects like insomnia or dry mouth, ED is a potential issue for men taking Adderall. In clinical trials, impotence (aka ED) and decreased libido were reported by 2–4% of adults taking Adderall XR for ADHD. People taking Adderall IR have reported sexual side effects as well, including ED, changes in libido, frequent erections, and long-lasting erections—but frequencies weren’t reported.

"Erectile dysfunction is usually more common in older men," says Justin Houman, MD, a board-certified urologist, and fellowship-trained Men's Sexual and Reproductive Health Specialist, "but younger men tend to be more sensitive to the effects of Adderall and are more likely to experience ED when taking the medication."  

Adderall erectile dysfunction may be more common in younger men than older men due to differences in how their bodies metabolize the medication. Age can influence how the body processes Adderall because of changes in liver function, enzyme activity, and overall metabolic rate. Younger men typically have more efficient liver function and higher metabolic rates, so the body processes and eliminates medications like Adderall more quickly. This may lead to more frequent fluctuations in neurotransmitter levels, such as dopamine and norepinephrine, which could contribute to sexual side effects like erectile dysfunction (ED).

Understanding the underlying mechanisms can shed light on why Adderall might contribute to ED. 

Why can Adderall cause erectile dysfunction?

Several factors can contribute to Adderall erectile dysfunction. These primarily involve changes in blood flow and hormonal balance due to the medication's effect on neurotransmitters. "The two main drivers of erectile dysfunction in men who take Adderall are the drug’s impact on hormones (neurotransmitters) and blood flow to the penis," Houman explains. Here's how: 

• Hormonal imbalance: Adderall works by boosting neurotransmitters like dopamine and norepinephrine levels in the brain. These chemicals play a role in numerous bodily functions, including mood regulation, focus, and sexual arousal and function. An imbalance in these hormones can interfere with the body's normal sexual responses, like getting an erection when sexually aroused. This imbalance can also lower libido.

• Vasoconstriction: Both dopamine and norepinephrine are vasoconstrictors, meaning they can constrict (narrow) blood vessels and reduce blood flow to the penis, making it more difficult to get or stay hard. Since Adderall increases levels of these neurotransmitters, it can stimulate the sympathetic nervous system to send signals throughout the body to tighten the blood vessels rather than relax them, preventing enough blood from reaching the penis during sexual activity. 

While Adderall’s primary effects on erectile dysfunction (ED) are related to its direct impact on blood flow and neurotransmitter levels, the stimulant properties of the medication can also contribute indirectly to sexual dysfunction. One of the more common side effects of Adderall is insomnia, or difficulty falling and staying asleep. Consistent lack of sleep can lead to chronic sleep deprivation, which can negatively affect physical and mental health, including sexual function.

Another Adderall side effect that can impair sexual function is anxiety. While Adderall is used to treat ADHD, its stimulant effects can also heighten feelings of nervousness, restlessness, or anxiety. Anxiety can affect male sexual performance and lead to a cycle of fear and self-doubt that may inhibit sexual desire, arousal, and performance.

There's not enough scientific evidence to suggest that Adderall will help an individual "last longer" during sexual activity. In fact, it may have the opposite effect in some men. Adderall's impact on sexual functioning is complicated and can vary widely from person to person. While some men may experience reduced libido or difficulty maintaining an erection, others may experience a boost in their sexual experience.

Interestingly, Adderall is sometimes used off-label to treat delayed ejaculation (DE), Houman shares. DE is a condition in which an individual assigned male at birth (for the sake of simplicity, we’ll refer to this as a man or men from here on) has difficulty reaching orgasm or takes an unusually long time to ejaculate. In a study of 35 men with DE, taking low doses of Adderall before sexual activity helped about a third of them reach orgasm faster. In another small study, eight out of 17 men who took Adderall reported a better sexual experience and six men reached orgasm in shorter times. On average, for those who improved, the time to orgasm decreased by over 72%.

One reason Adderall might help some men with DE may be related to dopamine. As a neurotransmitter that plays a role in pleasure and reward, increased dopamine levels could make the sexual experience feel more intense, thus reducing the time it takes to reach orgasm. This effect is not universal, and many men will not experience this benefit.

Adderall can help some men with ADHD have better sex by improving focus and reducing distractions. With better attention, they may feel more in tune with their partner, leading to a more satisfying experience. Basically, Adderall is just doing its job by boosting concentration, which can translate to better performance.

Adderall’s effect on libido and sexual desire vary widely. In some men, the increase in dopamine and norepinephrine levels when Adderall is in the body may heighten and enhance sexual interest. In other men, the same effects may diminish sexual desire and libido. Factors like age and dosage also play a role in Adderall's impact on sexual health.

The effects of Adderall on sexual desire are dose-dependent, meaning higher or lower doses can influence sexual interest differently. At lower doses, Adderall may have minimal impact on libido, and some men may experience an increase in sexual desire due to heightened alertness and focus from the increased dopamine levels in the brain. Dopamine, known as the  “feel-good” neurotransmitter, is involved in both pleasure and reward, which can make sexual experiences more satisfying and intense.

At higher doses, the effects can shift. Elevated doses of Adderall may overstimulate the central nervous system, which can decrease libido in some men. High dopamine levels, while initially increasing pleasure and focus, may eventually lead to reduced sexual desire or difficulty achieving an erection. Higher Adderall doses can also increase other side effects that can affect sexual health and libido, such as anxiety, insomnia, and irritability—not to mention potentially dangerous effects on heart rate and blood pressure. For your safety, don’t take more Adderall than prescribed by your healthcare provider. 

If you’ve experienced erectile dysfunction from taking Adderall, the good news is Adderall's influence on sexual desire and performance is not permanent. If you suspect Adderall may be contributing to erectile dysfunction, it's important to discuss your concerns with your healthcare provider. They can help you explore options that benefit your ADHD or narcolepsy symptoms and your sexual health.  

Medication adjustments

Adjusting your Adderall dosage or taking it at a different time of day may help reduce its effects on sexual function. "A small dose decrease can help maintain the benefits of Adderall while reducing its impact on sexual function," Houman explains.

Changing the timing of when you take your medication could also help reduce the adverse sexual side effects. If you're planning to engage in sexual activity in the morning, Houman suggests that taking Adderall afterward can help lessen its impact on sexual performance. 

If you’d like to decrease your Adderall dose to see if that improves your erectile function, share your concerns and thoughts with your healthcare provider first, to make sure you’re taking the best course of action. 

Switching medications 

If dose or timing adjustments don't help improve sexual functioning, you may want to consider switching to an alternative medication for treating ADHD or narcolepsy. "Different stimulant medications can have varying effects on sexual health," says Houman, so “switching to another option might be helpful if Adderall is affecting your libido or performance." Non-stimulant medications, such as Strattera (atomoxetine), may also be considered but may also cause sexual side effects. 

If you're considering switching medications, discuss potential alternatives with your provider to find the best option for your needs.

Lifestyle habits 

In addition to medication adjustments, Houman advises that certain lifestyle habits can naturally boost testosterone levels and may improve sexual functioning, including:

• Regular exercise. Incorporating cardiovascular (aerobic) exercises and weight training into your routine may boost testosterone levels and improve circulation, including blood flow to the penis.

• Balanced diet. Consuming a variety of nutrient-dense foods, such as lean proteins, healthy fats, and plenty of fruits and vegetables, can help optimize hormone production, including testosterone. 

• Prioritize sleep. Aim for 7–9 hours of quality sleep each night to help restore hormonal balance and improve energy levels, mood, and sexual health. Poor sleep or sleep deprivation can disrupt hormone production, including testosterone, and increase levels of stress hormones like cortisol, which can negatively impact libido and erectile function. 

• Stress management. Stress can increase the body's cortisol levels, and cortisol inhibits testosterone production. Activities that help manage stress, like breathing exercises and mindful meditation, may decrease cortisol levels, which can improve sexual health and function. 

Prescription medications 

For men who experience persistent erectile dysfunction, prescription medications may offer relief. Phosphodiesterase type 5 (PDE5) inhibitors like Viagra (sildenafil), Cialis (tadalafil), Stendra (avanafil), and vardenafil are highly effective ED medications that increase blood flow to the penis, helping achieve long-lasting erections. 

When a man gets sexually aroused, his body releases a substance called nitric oxide in the penis. This helps start a process that relaxes and dilates (widens) blood vessels in the penis. Dilated blood vessels help boost blood flow to the penis, leading to an erection. PDE5 inhibitors work by keeping the blood vessels in the penis relaxed, encouraging consistent blood flow to the penis so you can achieve and maintain an erection.

But PDE5 inhibitors don't automatically cause an erection. They only help you get and stay hard with sexual stimulation when you're aroused. Taking ED medications provides assurance you'll be ready for sexual activity when the mood strikes without the worry of walking around with an unwanted erection.

Some PDE5 inhibitors are available in alternative forms for added convenience. Ro Sparks, for example, offers a combination of tadalafil and sildenafil in a sublingual tablet that dissolves under the tongue for quicker effects. Ro's Daily Rise Gummies provide 7 mg of tadalafil per fruit-flavored gummy, making them an easy, discreet, and flavorful option for daily use.

Adderall is effective for managing ADHD and narcolepsy, helping improve focus, impulse control, and wakefulness, but it can cause side effects, including erectile dysfunction (ED) and decreased libido in some men. Here’s a recap of what we learned about the relationship between Adderall and ED: 

• Sexual side effects may occur because Adderall affects neurotransmitter levels (like dopamine and norepinephrine) that play a role in sexual desire, arousal, and function. Adderall’s stimulant properties also cause vasoconstriction (narrowing of blood vessels), which can reduce blood flow to the penis and make it harder to achieve or maintain an erection.

• Adderall side effects, such as insomnia and anxiety, may worsen ED. Sleep deprivation and anxiety can lower testosterone levels, increase cortisol (a stress hormone), and negatively impact mood and sexual function.

• Effective strategies to address Adderall-induced erectile dysfunction include medication adjustments, such as changing the dose or timing of Adderall with the guidance of a healthcare provider. Switching to alternative medications for ADHD or narcolepsy, either different stimulants or non-stimulant options, is also an option.

• Lifestyle changes can further support sexual health, including regular exercise to improve circulation, a balanced diet to optimize hormone production, adequate sleep to promote hormonal balance, and stress management practices to lower cortisol and improve overall well-being. 

• Talk to your healthcare provider if you're concerned that Adderall may be causing ED or low libido. They will help find a solution that works for your sexual health and overall well-being.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Editorial Guidelines | Medical Review Process

Current version

January 29, 2025

Written by

Lindsay Curtis

Fact checked by

Patricia Weiser, PharmD

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About the medical reviewer

Patricia Weiser, PharmD

Patricia Weiser, PharmD, is a licensed pharmacist, health content writer, and medical reviewer with more than a decade of clinical experience in community and hospital pharmacy.