Sexual Health and Bipolar Disorder
Sex is a basic human drive. We want to eat. We want to sleep. And we want to have sex. These are the things that bring us pleasure in life. Almost everything boils down to those three things.
But unfortunately, bipolar disorder and bipolar medication can affect all three. Bipolar disorder and its associated medication can make you eat. Or make you not eat. It can make you sleep. Or it can make you not sleep. And it can affect your sex life the same way.
But for some reason, doctors often take the effect on your sex life least seriously.
I Want Too Much Sex
Sex is fun. It's pleasurable. Which is great. But unfortunately this intense pleasure is something that can be overly sought in a hypomanic or manic state. This is known as hypersexuality.
And when I say "overly sought" I don't mean "preferring to have sex." I mean writhing, clawing, howling kind of need for sexual contact, the kind of feelings that cause reckless sexual behaviors and sometimes costs relationships and marriages.
Hypersexuality is a concern that quite a few people have confidentially asked me about because they're scared to admit to it. They're scared to admit that their mood drives them to desires that they don't want to have and that can ruin their lives.
I Don't Want Sex
And depression can do just the opposite. While a mania can fuel a desire, depression can squash all interest in sexual activity. While it can be hard for some people to imagine, sexual thoughts just vanish. It's like seeing pictures of your grandmother in your head all the time. You just can't get turned on. And often the very idea of sex is notably unappealing.
Medication and Sex
Perhaps worse is that the medication used to treat mental illness can also affect sex drive and while it's possible that the medication could make you want more sex, it's more likely medication will in some way hinder your sex life.
Typically either the desire for sex or the ability to climax is gone. Either one can be very distressing and can easily happen to men or women.
Concerns about Sex
And unfortunately, sex is often one of the very last priorities for doctors. In fact, doctor don't ask about it and many patients don't consider it part of the health equation. But staying on a medication long-term means being able to live with side effects and if one of those side effects in an inability to have sex with your lover, this may not be something you find acceptable.
Which is OK.
It's OK to say that sex matters and that your sex life is important to you. It's OK to say to a doctor that you're concerned about your sex life. It's OK to admit that sex is a part of being a healthy adult and that you want it! It's not about being "slutty" (which is a judgement some women may find) or "frigid" (another unfair judgement), it's just about asking for what you want and what you need.
Similarly, if hypersexuality is an issue for you, it's important to address it with your doctor. Hypersexuality is literally something that can destroy your relationships, your physical health and your life. It's not something to just ignore because discussing it is uncomfortable.
Can Sexual Concerns be Addressed?
Sexual issues may be something with which therapy can help, or a change in medication - but you can't know that if you never talk about it.
Tracy, N. (2011, November 21). Sexual Health and Bipolar Disorder, HealthyPlace. Retrieved on 2023, November 29 from https://www.healthyplace.com/blogs/breakingbipolar/2011/11/sexual-health-and-bipolar-disorder
Author: Natasha Tracy
I'm on 4 bipolar meds and I have absolutely no sex drive. It hurts my marriage. I'm stable for the most part but I'm missing sex. I was extremely hypersexual before the meds. I'm scared to get off of Lithium because I never have been able to. I need help.
I'm glad to hear that you're stable but it's unfortunate it comes at such a cost. Have you talked to your doctor about your sex drive? Sex is a very important part of relationships for many people and if you're finding that you are missing it, that's completely understandable and a medical issue. I know it can be hard to talk about, but it's worth it.
You might talk to your doctor about reducing your lithium and seeing if that helps. Maybe you can't get off of it entirely, but maybe reducing it will improve your sex drive. There's also the option of changing the lithium to another medication or reducing the lithium and augmenting that with an additional medication. Either of those options might help too.
No matter what, be upfront with your doctor and don't make any changes without their supervision.
- Natasha Tracy
Hyper sexuality is an issue for me. My ex was a [moderated] who used sex covertly to control me. He would dish it out as reward and punishment like I was a dog and I didn't realise. He lied about meds he didn't take causing him erectile dysfunction to make me beg, make me feel guilty and it was humiliating.
I have not cheated on any partner and maybe the new guy has a chance of keeping me happy sexually (he had a high sex drive)and I'd want to be with him even if I was sexually frustrated because we are wonderful outside the bedroom too.
Additionally, hypersexuality often accompanies other manic behavior which totally exhausts and/or turns off your partner.
I don't need to add the job title of concubine to my list of other bipolar caretaker jobs: emotional whipping post, housekeeper, home health aid, nanny, secretary, financial manager and mediator...
Besides, even if I wanted to have sex with him when he's 'like this', I don't have it in me physically to satisfy him... because it takes sex multiple times a day to satisfy the bipolar beast with two backs.
before i started taking meds for bipolar disorder i had a healthy libido and the ability to reach great orgasms now though i have a muted libido i fantasize and enjoy the thoughts of sex with a man but am now unable to reach climax even when self stimulating i am single and 48
You don't mention why your husband is getting testosterone shots, but I assume there is a medical need. If not, then stopping them would seem like the logical course of action.
If he does need them, then this sounds like the kind of thing that you need to have a conversation about. It's really hard when one person wants sex significantly more than another and it'll probably take a little give-and-take on both your parts to come up with a compromise you can both live with.
One thing I will say is that people often take their partner's not wanting to have sex with them as a personal affront - like you don't love them any more. This is likely not anywhere the truth, but it can feel like that. Addressing this needs to be part of the conversation.
And if you feel like you can't be honest, try counselling. Sometimes people communicate better when there's a facilitator.
In the end, you're not going to solve this problem talking to me, you're only going to solve it talking to your partner.
interesting read. My libido is in the toilet with all the meds I am on. Hubby goes and gets testerone shots!! he is chasing me all over the house and would take it every night if there was a chance. Im feeling I cant relax, go to bed with being fondled, in the pool without being chased around and groped, being in the same room with him, he just wont leave me alone. Love him very much but these shots have created a monster. HEEEEEEEEEELP!!!
The depression caused me to have a low libido to begin with, but then the medication really finished it off. My interest in sex with my partner, rare as it is, is mental. I like him as much as I love him and enjoy pleasuring him when I'm able to feel my feelings.
The weight gain from the medication and lack of activity during so many depressive episodes impacts our sex life greatly as as much as my low libido, due to my self-consciousness as well as his not being very happy with my weight. But we work through it.
Over the years I've been able to educate him about my lowered libido and help him understand that I can enjoy the simple pleasure of warm skin on skin, of massages, of togetherness, of the kind of intimacy only we share with each other, and we add a lot of humour in there too. When I'm hypomanic he gets to enjoy the vixen in me, but elsewise he has had to learn - because he loves me - to enjoy me, the person, his friend, as a gentle, relaxed lover without the sexy panic of frantic lovemaking.
He has a high libido and it is very hard for him and it is important for me to understand and accept that without feeling guilty for not being different than I am. It's taken us many years to accept each other and our needs and limitations. We're okay as long as we keep our promise to each other to never stop trying or being patient regarding our sex life. It is very important.
Just to let you know, different doctors differ in their opinions about what medication is safe during pregnancy. Of course, being off all medication is always safest, but there are medications that are generally considered safe as well that may be an option for people who can't go without medication at all.
It's true docs don't seem to think this is of any importances. Not only that, in the past I only found from my own reading that being pregnant would mean I would have to come off all my meds. My last doc didn't even mention this even though I am a woman of child bearing age. My new doc is great and brought it up right away.
I would definitely choose being well over a good sex life, but I will also try some of the things you mentioned. Thanks for the advice.
can one have a good sex life and not be well I personally would chose sex
"My doctor says I have to weigh what’s more important, being well or having a fulfilling sex life. I want both! Any suggestions??"
He's right. You do. It's a tough reality that we may not be able to have both.
That being said, I would suggest at least giving psychotherapy a shot. I've found that many people (especially women) have issues with sex that psychologically hinder climaxing - not prevent it, per se, but possibly make it more difficult. And I don't mean major issues, such as abuse, but just small psychological issues that make it more difficult to truly enjoy sex. Psychotherapy might be able to remove any issue and help you overcome the physical barrier the meds are putting on you.
And then there's always being more sexually adventurous and trying new things you haven't done before. There are, for example, six or seven types of orgasm possible for a woman (theoretically) perhaps another kind than you're used to would work for you? Maybe it's time to think a bit outside the circle.
I hope that helps.
Even before the symptoms appeared, I have had a very high sex drive. The hypomania/mania just incresed it even farther. The depressions and the meds have so far not decreased to to an undesireable point, but rather to the point of, what I guess, most humans experience. I guess I'm lucky.
Thank you Natasha for bringing this topic up. This is a critical issue and it is not addressed often enough. So many people do get embarrassed and won't even speak with their partners or doctors. We have to - We are important and all aspects of our lives are that important. I thought I was alone with my extreme hypersexuality. I have learned recently that I am not alone....
My medication has lowered my sex drive. Unfortunately, it is the only medication that has worked for me and I have tried many others over the 17 years that I have taken medication. I still enjoy cuddling and being affectionate. I love my boyfriend, so I just focus on satisfying his sexual needs. I used to be extremely hypersexual, and I would rather be the way I am than the way I was. Having sex with multiple partners and cheating on boyfriends I loved led to a lot of grief. I wish I could find a happy medium. It's true that psychiatrists don't consider this issue to be very important.
I think the trade off for me taking psyche medications was a decrease in sex drive. It is hard to talk about with a doctor but sometimes you have to do it especially if it is a quality of life issue.
My family doctor is super empathetic and see's me regularly and I finally got the "nuts" to bring it up just recently(very prescient post Natasha).
There are options and it is worth talking about them.
re: Amy I agree with you, if you have this diagnosis doctors should be stuffing your pockets with condoms and they should be more comfortable themselves bringing up the subject of hypersexuality. I ruined a marriage for me, among other things.
Good point to bring up Natasha.
I can totally relate to this article. I am on medication that causes me to not be able to climax, but still have a normal sex drive. It is so frustrating, for me and my husband. I have talked to my doctor about it. I have tried many different medications and seem to have found the right combination to control my bipolar symptoms, but it leaves me with no satisfying sex life. My doctor says I have to weigh what's more important, being well or having a fulfilling sex life. I want both! Any suggestions??
That is absolutely true and absolutely integral to remember. Thank-you for bringing that up.
I found out the hardships of my manic sexdrive caused me to need it, want it, do anything for it... For a while it was great. Until the test results came back positive... I think drs should force condom be kept with us during a manic episode. I found if it was gonna happen, it was usually not planned out and no condoms were involved. Please I ask you all to use protection. You won't regret USING a condom.