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Borderline Personality Disorder and Sex

How Does Borderline Personality Affect Your Sex Life?

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Updated May 03, 2010

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Borderline personality disorder (BPD) symptoms can affect your emotional state, your relationships, and your ability to control your behavior. So, not surprisingly, BPD can have a major impact on your sex life. While very few researchers have studied BPD and sexuality, more and more work is suggesting that people with BPD can experience several key difficulties with sex.

BPD and Attitudes About Sex

Research has demonstrated that women with BPD tend to have more negative attitudes about sex than women in the general population. For example, women with BPD report more mixed feelings about sexual relations, and are also more likely to feel pressured to have sex by their sexual partners. In addition, women with BPD report more general sexual dissatisfaction. Much less is known about how BPD affects men’s attitudes about sex.

There may be a number of reasons for these more negative attitudes about sex. First, many women with BPD are survivors of child abuse, which may contribute to overall negative reactions to adult sexual experiences. Also, women with BPD are more likely to experience a great deal of conflict in their relationships, so they may feel less positive about sex because relationships in general feel less fulfilling.

BPD and Reckless Sex

Impulsive behavior, or acting without thinking about the consequences of a behavior, is one of the symptoms of BPD listed in the DSM-IV. Impulsive behavior can include many different types of acts, but reckless sexual behavior may be a common one among people with BPD.

People with BPD are most at risk of engaging in impulsive acts when they are experiencing intense emotional responses, or when they are disinhibited by alcohol or substances. Intense sadness, fear, jealousy, or positive emotions may lead to impulsive sexuality.

BPD and Promiscuity

In addition to engaging in reckless or impulsive sex, there is evidence that people with BPD are more prone to being sexually promiscuous. This differs from impulsive sex in that promiscuity is the act of intentionally having multiple sexual partners (rather than having casual sex on a whim).

Why might people with BPD be more promiscuous? One possibility is that people with BPD use sex to combat feelings of emptiness that are associated with the disorder. When feeling empty, numb, lonely, or bored, sex may generate positive emotional responses.

BPD and Avoidance of Sex

While some studies have shown an increase in sexual behavior in people with BPD, there is also evidence that some people with BPD actually avoid sex. For example, in a 2003 study, Dr. Mary Zanarini and colleagues found that people with BPD reported avoidance of sex for fear of experiencing an exacerbation of their BPD symptoms.

BPD and Your Sex Life

While the research is far from conclusive (and is particularly sparse with regard to men with BPD), there is now evidence to suggest that people with BPD can experience a variety of sexual difficulties, including reckless sexual behavior, negative attitudes toward sex, sexual promiscuity, and sexual avoidance.

It is likely that the impact of BPD symptoms on sex can vary substantially from person to person, and can take very different forms. How your symptoms impact your sex life may warrant some reflection, or a discussion with your therapist or partner.

Sources:

Bouchard S, Godbout N, Sabourin S. (2009). “Sexual Attitudes and Activities in Women with Borderline Personality Disorder Involved in Romantic Relationships.” Journal of Sex & Marital Therapy, 35:106-121, 2009.

Bouchard S, Sabourin S, Lussier Y, Villeneuve E. “Relationship Quality and Stability in Couples When One Partner Suffers from Borderline Personality Disorder.” Journal of Marital and Family Therapy, 35:446-455, 2009.

Hurlbert DF, Apt C, White LC. “An Empirical Examination into the Sexuality of Women With Borderline Personality Disorder.” Journal of Sex & Marital Therapy, 18:231–242, 1992.

Sansone, RA, Wiederman, MW. “Borderline Personality Symptomatology, Casual Sexual Relationships, and Promiscuity.” Psychiatry, 6: 36-40, 2009.

Zanarini MC, Parachini EA, Frankenburg FR, Holman JB, Hennen J, Reich DB, Silk KR. “Sexual Relationship Difficulties Among Borderline Patients and Axis II Comparison Subjects. Journal of Nervous and Mental Disease.” 191: 479-482, 2003.

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