What Is Sexual Addiction?...

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Medically reviewed by Soma Mandal, MDMedically reviewed by Soma Mandal, MDSexual addiction, sexual compulsivity, hypersexuality, and sexual impulsivity are all terms people commonly use to describe compulsive sexual behavior disorder (CSBD). This is a psychological disorder characterized by an inability to control sexual behavior. Sexual addiction may be defined as a persistent inability to control intense sexual impulses or urges, leading to repetitive sexual behavior that causes significant impairment or distress in various areas of life for at least six months. Uncontrolled and excessive sexual urges, behaviors, and acts may negatively affect well-being, impair psychosocial functioning, and reduce quality of life. Some medical experts oppose the notion that sex can be addicting. Not all medical professionals agree with the term sexual addiction, and it is not generally considered a mental health disorder.This disparity and lack of clear consensus surrounding sexual addiction as a medical condition has made it difficult to accurately identify the symptoms and formally diagnose it.Sexual Addiction SymptomsSexual addiction is not the same as having a robust or high libido. With high libido, you experience a higher urge or desire for sex but still have control over that desire. A person with sexual addiction may become excessively preoccupied with sexual thoughts and behaviors and will want to engage in sex regardless of any negative consequences. They are unable to stop such sexual behaviors and thoughts, despite wanting to. This can disrupt their daily life as they put significant time and effort into fulfilling their sexual desires. Some signs and symptoms that may suggest sexual addiction include:Excessive sexual behaviorsRepetitive, intrusive sexual thoughts and fantasiesAn inability to control your sexual desireSexual behaviors that cause you distress and impair your relationship or your personal, professional, or social lifeSignificant time spent masturbating and watching pornographies (sexual videos)Eagerness to pay for sexFrequent cheating on a partnerDistress related to the adverse consequences of repetitive sexual behavior or the lack of satisfaction from the behaviorA perceived feeling of extreme guilt over sexual gratificationMood changes related to sexual activity, and neglect of social and occupational responsibilities or other activitiesWhat Causes Sexual Addiction?The exact reason why some people experience sexual addiction is not known. However, some risk factors have been linked to the condition, and experts have found several potential explanations through different psychological theories and models.Adverse Early Childhood ExperiencesExperts in psychodynamics (the influence of mental and emotional forces on a person's behavior) believe that people exhibit symptoms of sexual addiction as a result of past traumatic or adverse experiences. Childhood physical or sexual abuse can lead to the onset of sexual addiction in adulthood. These experts also link dysregulated sexual behaviors to self-destructive emotional needs or attachments stemming from childhood experiences.For instance, an affected individual may desire intimacy but have an intense fear of it, leading to a conflicting sexual interest. Some people with higher emotional needs may develop uncontrolled sexual behaviors and seek validation through multiple sexual partners.Neurochemical and Brain-Related MechanismsSexual behavior is partly regulated by excitatory (message-sending) and inhibitory (message-blocking) neurochemical mechanisms in the brain. Certain centers in the brain—like the hippocampus, amygdala, and hypothalamus—control memory, arousal, and brain reward. The dysfunction of these brain centers can cause sexual addiction manifestations.Dysfunction of the nerves or imbalance of brain chemicals (e.g., abnormal transmission of neurotransmitters like dopamine) may lead to addictive behaviors like sexual addiction.Unrealistic Expectations of LifeThe cognitive-behavioral model is a theory that an individual's beliefs and perceptions largely determine their feelings and behaviors. This model attributes sexual addiction to an irrational belief system and unrealistic expectations of life.For instance, if a person nurtures certain beliefs around sexual experiences, they can develop addictive sexual behaviors.Low Self-EsteemSelf-esteem is a reflection of how you perceive yourself. It refers to the extent to which you value, like, appreciate, or approve of yourself. An online survey study, which used the Sexual Addiction Screening Test (SAST) to assess sexual addiction, found that nearly 74% of the participants with sexual addiction had low self-esteem, while about 24% had very low self-esteem. This suggests a link between low self-esteem and sexual addiction.Dysfunctional CopingSome researchers consider sexual addiction to be a behavioral addiction that occurs in a pattern similar to substance use disorder (SUD). Initially, it induces a state of euphoria and pleasure and releases stress, which later leads to a constant craving for and dependence on it.Some people may use maladaptive sexual behaviors as coping mechanisms to mask or deal with their pain because the behaviors bring feelings of pleasure. However, this coping style is dysfunctional, eventually leading to a loss of control despite adverse consequences.Other Risk FactorsPeople are more likely to have sexual addiction disorder if they:Are assigned male at birthHave a substance use disorderHave a personality disorder, such as borderline or paranoid personality disorderHave other mental health conditions, like depression or anxiety disorderHow Is Sexual Addiction Diagnosed?There are no formal criteria for diagnosing sexual addiction. This may be because there is no extensive research on this topic, and the terminology is not generally accepted. Nonetheless, some diagnostic criteria are starting to become available. The 5th edition of the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not include “sexual addiction” as a mental health condition. The DSM-5 is a widely used reference book for medical professionals to classify and diagnose psychological conditions.The DSM-5 does have a category for “other specified sexual dysfunction," which may be helpful in diagnosing sexual addiction.The most recent revision of the International Classification of Diseases (ICD-11) includes compulsive sexual behavior disorder (CSBD) under “impulse control disorders,” now making it easier for healthcare providers to diagnose sexual addiction. According to the ICD-11, CSBD may be diagnosed when the following diagnostic symptoms are present:Failure to control intense, repetitive sexual desires and sexual behavior for up to six months or more, leading to significant impairment in personal, family, occupational, or educational lifeA focus on repetitive sexual behavior that results in neglect of health and personal care or other interests and responsibilitiesEngagement in repetitive sexual behavior, even when satisfaction from the behavior is lowContinuous engagement in sexual behavior despite negative consequences (e.g., harm to health, finances, or relationships)Inability to control or significantly reduce repetitive sexual behavior despite making several effortsThe absence of other mental disorders (e.g., manic episodes) or other medical conditions and no substance or medication use that might account for the sexually addictive behaviorThe ICD-11 also highlights the need for mental health professionals to carefully assess and examine the individuals they are treating. Some people may perceive themselves as “sex addicts” based on moral or religious judgments and personal disapproval.CSBD may be expressed in various forms, including masturbation, sex with others, pornography, telephone sex, and internet sex.Treatments for Sexual AddictionSexual addiction is a complex disorder that requires a multifaceted treatment approach. This may involve different healthcare providers, including a primary care physician, a psychiatrist, a psychologist, and a sex therapist. If you are concerned about your sexual behavior, consider consulting a healthcare provider. They will run a proper diagnosis to assess you, and if symptoms of sexual addiction are present, they may suggest treatments like:Cognitive behavioral therapy (CBT): CBT is a common form of treatment that will help you identify beliefs and thought patterns that are triggering your compulsive sexual behaviors and teach you healthier ways to cope with those thoughts.Psychodynamic therapy: During this therapy, your provider helps you explore events, past occurrences, and other underlying factors that are unconsciously causing your addiction. This practice enables you to develop new insights and better regulate your emotions.Motivational enhancement therapy (MET): This form of therapy doesn’t use a confrontational approach. Instead, it focuses on eliciting your own concerns and working with what you (not the provider) believe is the problem. It tries to use your motivation to elicit a change in negative behaviors. Couples therapy: This may be effective for people with sexual addiction who have partners, especially if the behavior is affecting the relationship. It helps address any issues of infidelity, teaches new intimacy skills, and helps rebuild relationships.Medications: No medication has been specifically approved for treating sexual addictions. However, your provider may prescribe certain medications to treat disruptive symptoms of the condition or to treat an underlying mental health condition causing the sexual behaviors. For example, selective serotonin reuptake inhibitors (SSRIs) can help treat compulsive behaviors in people with addictive behaviors. Hormonal medications and psychotropic drugs that affect neurotransmitters may also be useful.ComplicationsSexual addiction disorder can cause harmful psychosocial and health-related effects, such as:Failure to meet one’s responsibilities and commitments, such as reduced productivity at workIncreased risk of sexually transmitted infections (STIs)Porn-induced erectile dysfunction (PIED), or difficulty getting an erection due to pornography viewing habitsMarital and relationship issuesUnwanted pregnancies and abortions, which may lead to health complicationsFinancial problemsLow self-esteem and social isolationEmotional issues like feelings of shame, guilt, and depressionLiving With Sexual AddictionComplications related to sexual addiction can be challenging to deal with, especially feelings like shame and guilt. If you have concerns regarding your sexual behaviors or notice it has been causing you harm in various areas of your life, consider consulting a mental health professional.You may be unable to tell on your own if you have a compulsive sexual behavior disorder, but acknowledging that you have a concern is the first step. Your mental health provider will take it from there, assess you, and help you determine what you are dealing with.If their diagnosis indicates you have sexual addiction, they will recommend treatments. It’s important that you work with them to get the best result. Consider joining support groups like Sex Addicts Anonymous and involving your partner in your journey to self-recovery. Take steps to gradually eliminate your triggers, such as pornographic magazines. Also, consciously incorporate healthy distractions into your life, including exercising, outdoor activities with family, and meditation.Frequently Asked Questions

Is there such a thing as too much sex?

There is no standard indicator or way of measuring how much sex is too much. Sexual addiction is not necessarily about the number of times a person has sex but rather the emotional and psychological involvement.Sex becomes an issue when you have no control over it and you want to satisfy your urges at the expense of your responsibilities and despite negative consequences, as well as if it ends up causing you guilt and shame.

Can you control a sexual addiction?

Sexual addiction can be managed with the help of a mental health professional.Your provider will use different approaches, particularly talk therapy, to help you identify thoughts, negative beliefs, and triggers causing your sexual addiction. They will then help you develop coping mechanisms.

How can you cope with a hypersexual partner?

If your partner is hypersexual, you both may benefit from couples therapy and consultations with a sex therapist.Therapy can help you understand the nature of your partner's hypersexuality, the underlying causes and triggers, and how to help your partner deal with the triggers. It can also help you build trust and communication so you can have a healthier sexual life.

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