Bipolar disorder is a mood disorder. People who have bipolar disorder experience high levels of both euphoria and depression. Their moods can go from one extreme to the other.

Life events, medication, and recreational drug use can trigger mania and depression. Both moods can last from a few days to a few months.

Bipolar disorder can also affect your sexuality and sexual activity. Your sexual activity may be increased (hypersexuality) and risky during a manic episode. During a depressive episode, you may lose interest in sex. These sexual issues can create problems in relationships and lower your self-esteem.

Your sex drive and sexual impulses during a manic episode can often lead to sexual behavior that isn’t typical for you when you aren’t experiencing mania. Examples of hypersexuality during a manic episode can include:

  • greatly increased sexual activity, without a feeling of sexual satisfaction
  • sex with multiple partners, including strangers
  • excessive masturbation
  • continuous sexual affairs, despite the risk to relationships
  • inappropriate and risky sexual behavior
  • preoccupation with sexual thoughts
  • increased use of pornography

Hypersexuality is a troubling and challenging symptom if you have bipolar disorder. Across several studies they found that anywhere between 25 to 80 percent (with an average of 57 percent) of people who experience mania also experience bipolar hypersexuality. It also appears in more women than men.

Some adults ruin their marriages or relationships because they’re unable to control their sexual urges. Teens and younger children with bipolar disorder may display inappropriate sexual behavior toward adults. This can include inappropriate flirting, inappropriate touching, and heavy use of sexual language.

You may experience the opposite of hypersexuality during a depressive episode. This includes low sex drive, which is called hyposexuality. Depression very commonly causes a lack of interest in sex.

Hyposexuality often creates relationship problems because your partner doesn’t understand your sex drive issues. This is especially true if you have extreme mania with hypersexual behavior and then suddenly experience depression and lose interest in sex. Your partner may feel confused, frustrated, and rejected.

Bipolar depression may also cause sexual dysfunction. This includes erectile dysfunction in men and high levels of sexual distress for women.

Medications that treat bipolar disorder might also lower sex drive. However, stopping your bipolar medication because of this side effect is dangerous. It can trigger a manic or depressive episode.

Talk with your doctor if you think your medication is lowering your sex drive too much. They may be able to adjust your dosage or switch you to a different medication.

There are things you can do to better understand and deal with sexual issues caused by bipolar disorder:

1. Recognize symptoms and triggers

Learn situations that may trigger your shifts in mood so that you can avoid them whenever possible. For example, stress and alcohol might bring on depressive episodes.

2. Learn the side effects of your medication

Ask your doctor about medications that are the least likely to have sexual side effects. There are also medications available that help people with bipolar disorder to have a healthy sex life.

3. Understand sexual health issues

Understanding the consequences of your actions and protecting yourself and your partner from unplanned pregnancy, sexually transmitted diseases, and HIV, is important. This is especially important during periods of hypersexuality.

4. Consider behavioral or sex therapy

Behavioral therapy or sex therapy can help you manage sexual issues caused by bipolar disorder. Individual and couples therapy are both effective.

During a manic phase of bipolar disorder, you may take sexual risks and be less concerned with the consequences of your actions. During a depressive episode, you might feel apathetic about sex or upset by a loss of libido.

Getting your bipolar disorder under control is the first step to improving your sex life. It’s easier to address these issues when your mood is stable. Many people with bipolar disorder have healthy relationships and satisfying sex lives. The key is working with your doctor to find the right treatment and talking with your partner about any sexual issues you may experience.