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. 2023 Feb 3;11(1):5.
doi: 10.1186/s40345-023-00285-9.

Bipolar disorder and sexuality: a preliminary qualitative pilot study

Helle B Krogh  1 , Maj Vinberg  2   3 , Gitte Lee Mortensen  4 , Ditte Skakke  5 , Dorthe Nielsen  6 , Annamaria Giraldi  5   7
Affiliations

Bipolar disorder and sexuality: a preliminary qualitative pilot study

Helle B Krogh et al. Int J Bipolar Disord. .

Abstract

Background: Individuals with mental health disorders have a higher risk of sexual problems impacting intimate relations and quality of life. For individuals with bipolar disorder (BD) the mood shifts might to a particular degree affect their sexual function with possible hypersexual interest during manic episodes and low sexual interest during depressive episodes. The diagnosis is often given in late adolescence, which may impact sexual identity and development. Only a few studies have looked at BD and sexual life, with no qualitative research on the topic. We conducted a qualitative pilot study exploring sexuality in connection to mood swings in five participants with BD.

Results: Thematic content analysis revealed five themes: (1) sexual drive and impulses, (2) sexual behavior, (3) thoughts and feelings in relation to sexual issues, (4) intimate relationships, and (5) sexuality and identity. During manic episodes the participants described having a higher sexual drive, leading for some to more sexual interactions. During depressed episodes, the sexual drive in the three female participants was low, however, in the two men, rather than a reduced sexual drive, a more self-destructive way of engaging in sex prevailed. The sexual outgoing behavior during manic phases was described as joyful, with no feelings of shame connected to it. However, the shifts in sexual drive connected to mood shifts affected the participants' relationships negatively. Further, all the participants described having outgoing sexual behavior in their youth.

Conclusions: Overall, changes in sexual drive may act as a trigger or early warning symptoms of new episodes, pinpointing the clinical relevance of addressing sexuality in individuals with BD. In general, sexual drive followed affective episodes. However, during depressive episodes sex could be, instead of reduced drive, associated with negative feelings. All participants described having an outgoing sexual behavior in their youth before the onset of BD, which might be essential to consider if there is a clinical suspension of BD in an individual.

Keywords: Bipolar disorder; Hypersexuality; Qualitative research; Sexual dysfunction; Sexual function; Sexuality.

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Conflict of interest statement

MV has received a consultancy fee from Lundbeck, Janssen-Cilag and Sunovion. AMG has been a speaker for Pfizer, Astellas, Viatris, and Eli Lilly, on the advisory board for Futura Medical and OvacoBio, consultant for Eli Lilly, and stockholder in Novo Nordic. The remaining authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Main themes on BD and sexuality
Fig. 2
Fig. 2
Perceived domains of sexuality based on the qualitative interviews with individuals with BD
Fig. 3
Fig. 3
Key factors affecting sexuality in BD
See this image and copyright information in PMC

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