Overview
Compulsive sexual behavior is sometimes called hypersexuality, hypersexuality disorder or sexual addiction. It’s an excessive preoccupation with sexual fantasies, urges or behaviors that is difficult to control, causes you distress, or negatively affects your health, job, relationships or other parts of your life.
Compulsive sexual behavior may involve a variety of commonly enjoyable sexual experiences. Examples include masturbation, cybersex, multiple sexual partners, use of pornography or paying for sex. When these sexual behaviors become a major focus in your life, are difficult to control, and are disruptive or harmful to you or others, they may be considered compulsive sexual behavior.
No matter what it’s called or the exact nature of the behavior, untreated compulsive sexual behavior can damage your self-esteem, relationships, career, health and other people. But with treatment and self-help, you can learn to manage compulsive sexual behavior.
Symptoms
Some indications that you may be struggling with compulsive sexual behavior include:
- You have recurrent and intense sexual fantasies, urges and behaviors that take up a lot of your time and feel as if they’re beyond your control.
- You feel driven to do certain sexual behaviors, feel a release of the tension afterward, but also feel guilt or remorse.
- You’ve tried unsuccessfully to reduce or control your sexual fantasies, urges or behavior.
- You use compulsive sexual behavior as an escape from other problems, such as loneliness, depression, anxiety or stress.
- You continue to engage in sexual behaviors that have serious consequences, such as the potential for getting or giving someone else a sexually transmitted infection, the loss of important relationships, trouble at work, financial strain, or legal problems.
- You have trouble establishing and maintaining healthy and stable relationships.
When to see a doctor
Seek help if you feel you’ve lost control of your sexual behavior, especially if your behavior causes problems for you or other people. Compulsive sexual behavior tends to escalate over time, so get help when you first recognize there may be a problem.
As you decide whether to seek professional help, ask yourself:
- Can I manage my sexual impulses?
- Am I distressed by my sexual behaviors?
- Is my sexual behavior hurting my relationships, affecting my work or resulting in negative consequences, such as getting arrested?
- Do I try to hide my sexual behavior?
Seeking help for compulsive sexual behavior can be difficult because it’s such a deeply personal matter. Try to:
- Set aside any shame or embarrassment and focus on the benefits of getting treatment.
- Remember that you’re not alone — many people struggle with compulsive sexual behavior. Mental health professionals are trained to be understanding and discreet. But not all mental health professionals are experienced in treating compulsive sexual behavior, so make sure you find a therapist who is competent in this area.
- Keep in mind what you say to a doctor or mental health professional is kept confidential, except in cases where you report that you’re going to hurt yourself or someone else, you report sexual abuse of a child, or you report abuse or neglect of someone in a vulnerable population.
Seek treatment right away
Seek immediate treatment if:
- You think you may cause harm with uncontrolled sexual behavior
- You have other problems with impulse control, and you feel like your sexual behavior is slipping out of control
- You are suicidal — if you’re thinking of attempting suicide, call 911 or your local emergency number, or the National Suicide Prevention Lifeline (in the United States) at 1-800-273-TALK (1-800-273-8255)
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Causes
Although the causes of compulsive sexual behavior are unclear, they may include:
- An imbalance of natural brain chemicals. Certain chemicals in your brain (neurotransmitters) such as serotonin, dopamine and norepinephrine help regulate your mood. High levels may be related to compulsive sexual behavior.
- Changes in brain pathways. Compulsive sexual behavior may be an addiction that, over time, might cause changes in the brain’s neural circuits, especially in the reinforcement centers of the brain. Like other addictions, more-intensive sexual content and stimulation are typically required over time in order to gain satisfaction or relief.
- Conditions that affect the brain. Certain diseases or health problems, such as epilepsy and dementia, may cause damage to parts of the brain that affect sexual behavior. In addition, treatment of Parkinson’s disease with some dopamine agonist medications may cause compulsive sexual behavior.
Risk factors
Compulsive sexual behavior can occur in both men and women, though it may be more common in men. It can also affect anyone, regardless of sexual orientation. Factors that may increase risk of compulsive sexual behavior include:
- Ease of access to sexual content. Advances in technology and social media allow access to increasingly intensive sexual imagery and information.
- Privacy. Secrecy and privacy of compulsive sexual activities tend to allow these problems to worsen over time.
Also, an increased risk of compulsive sexual behavior may occur in people who have:
- Alcohol or drug abuse problems
- Another mental health condition, such as a mood disorder (such as depression or anxiety), or a gambling addiction
- Family conflicts or family members with problems such as addiction
- A history of physical or sexual abuse
Complications
Compulsive sexual behavior can have many negative consequences that affect both you and others. You may:
- Struggle with feelings of guilt, shame and low self-esteem
- Develop other mental health conditions, such as depression, suicide, severe distress and anxiety
- Neglect or lie to your partner and family, harming or destroying meaningful relationships
- Lose your focus or engage in sexual activity or search internet pornography at work, risking your job
- Accumulate financial debts buying pornography and sexual services
- Contract HIV, hepatitis or another sexually transmitted infection or pass a sexually transmitted infection to someone else
- Engage in unhealthy substance use, such as using recreational drugs or drinking excessive alcohol
- Be arrested for sexual offenses
Prevention
Because the cause of compulsive sexual behavior isn’t known, it’s not clear how it might be prevented, but a few things may help keep this type of behavior in check:
- Get help early for problems with sexual behavior. Identifying and treating early symptoms may help prevent compulsive sexual behavior from getting worse over time or escalating into a downward spiral of shame, relationship problems and harmful acts.
- Seek treatment early for mental health disorders. Compulsive sexual behavior may be worsened by depression or anxiety.
- Identify and seek help for alcohol and drug abuse problems. Substance abuse can cause a loss of control and unhappiness that can lead to poor judgment and may push you toward unhealthy sexual behaviors.
- Avoid risky situations. Don’t jeopardize your health or that of others by putting yourself into situations where you’ll be tempted to engage in risky sexual practices.
Hypersexuality describes a person’s inability to control their sexual behavior, impulses, or urges to the point of causing distress in their personal, work, or school life.
Healthcare professionals may also refer to hypersexuality as:
- compulsive sexual behavior disorder
- excessive sexual behavior
- sexual addiction
- hypersexuality disorder
The American Psychiatric Association’s Diagnostic and Statistical Manual, 5th Edition (DSM-5) does not recognize hypersexuality as an official disorder or diagnosis.
The DSM-5 omitted hypersexuality as a direct diagnosis due to a lack of clinical evidence and studies on people living with the condition. Another reason was the possible misuse of the diagnosis in forensic settings.
However, other organizations recognize it as an official diagnosable condition, such as the World Health Organization (WHO)’s International Classification of Diseases, 11th edition (ICD-11).
This article describes what hypersexuality is. It also looks at its characteristics, causes, treatments options, and more.
What is it?
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Hypersexuality is a condition in which a person experiences sexual impulses and urges that are persistent and uncontrollable.
This can lead to sexual behaviors that are repetitive and become the central focus of a person’s life. As a result, people may neglect other areas, such as their personal, family, work, or school life.
Several theoretical models exist to explain the behavior, including:
- Impulsivity model: This equates hypersexuality to an inability to delay sexual satisfaction. However, experts largely dispute this model.
- Compulsivity model: This model classifies hypersexuality as a type of obsessive-compulsive disorder (OCD), where sexual thoughts act as obsessions, and the acts or behaviors are the compulsions.
- Addiction model: This is often considered the most accurate parallel. It indicates that a person living with hypersexuality exhibits symptoms of addiction related to sexual behaviors and can experience symptoms of withdrawal when deprived of the sexual behavior.
How common is it?
The estimated prevalence of hypersexuality is between 2–6%, most commonly affecting males. However, estimates are difficult due to a lack of studies.
Characteristics
According to a 2017 article, hypersexuality can begin as excessive masturbation while watching pornography or generally wanting or needing sex.
However, this can develop into a constant need.
A person with hypersexuality may notice that sexual activities take precedence over everything else in their life. They may exhibit symptoms and behaviors such as:
- an inability to control or reduce sexual behaviors
- engaging in sexual behaviors despite adverse consequences, such as failed relationships and issues at work or school
- engaging in sexual behaviors despite experiencing little to no satisfaction from doing so
- experiencing increased tension or extreme arousal leading up to the sexual activity, followed by relief or a loss of tension afterward
According to the ICD-11, a person with hypersexuality may take part in various sexual behaviors, including:
- having sex with others
- compulsive masturbation
- consuming pornography
- participating in cybersex
- taking part in telephone sex
They may also attend strip clubs.
They may engage in these activities as a result of:
- boredom
- anxiety
- depression
- loneliness
Vs. high libido
Everyone has different levels of libido, and many factors can cause it to fluctuate.
Having a high sex drive is not a concern unless it interferes with a person’s relationships and daily life or mental health.
Diagnosis criteria
A person should contact a mental health professional if they think they are experiencing hypersexuality.
Although it is not an official diagnosis according to the DSM-5, the WHO’s ICD-11 recognizes it as a compulsive sexual disorder. This means that psychologists can use the ICD-11, recognized in the United States, to diagnose hypersexuality.
A healthcare professional may diagnose hypersexuality if the person meets the following criteria:
- They experience a persistent inability to control repetitive sexual urges or impulses that lead to repetitive sexual behavior. A person may manifest this behavior in the following ways:
- engaging in sexual behaviors to the detriment of health, activities, responsibilities, or personal care
- being unable to control or reduce the sexual behavior despite numerous attempts
- engaging in sexual behavior despite negative consequences, such as marital conflict and legal or financial consequences
- engaging in these behaviors despite gaining no pleasure from them
- They have been unable to control these intense urges and impulses for over 6 months.
- There is no other medical condition to account for these behaviors.
- These behaviors cause significant distress or negatively affect a person’s educational, occupational, familial, or personal life.
Causes and risk factors
The exact cause of hypersexuality is not known. It may be related to a person’s mental and physical health.
Some risk factors may include living with another mental health condition, such as:
- bipolar disorder
- tumors and injuries to the frontal lobe of the brain
- substance use
- present or past eating disorder
- medications
A history of sexual abuse, particularly among females, may also contribute.
Treatment
According to Mental Health America, there is no current standard of care for hypersexuality. However, treatments may include a combination of medications, therapy, and support groups.
Medication
A doctor may recommend one or more medications depending on how they view the condition. A doctor may prescribe:
- mood stabilizers
- hormone therapies
- antidepressants
Psychotherapy
A doctor may recommend cognitive behavior therapy (CBT) or psychodynamic psychotherapy for a person living with hypersexuality.
CBT helps a person change their way of thinking and feeling to better control their behaviors.
Similarly, psychodynamic psychotherapy focuses on helping a person connect with their unconscious thoughts in an attempt to change their behavior.
Complications and impact on a person’s life
People can experience periods of heightened sexual desire and activity without it becoming an issue. However, when a person experiences hypersexuality, it can severely impact their life.
People with hypersexuality may:
- neglect their responsibilities
- develop unrealistic expectations of sex and relationships
- feel shame and experience a decrease in their self-esteem
It can also affect other areas of a person’s life, including their relationships and professional or educational lives. Additionally, it can also lead to an increase in engaging in high risk sexual behavior and sexually transmitted infections.
Coping and support
The following may help a person navigate hypersexuality:
- following the treatment plan
- identifying and avoiding triggers
- practicing stress management techniques
- finding support groups
Support groups may help a person living with hypersexuality achieve their treatment goals. A person’s doctor may be able to provide a list of local support groups that may help a person or their family.
A person who is having difficulty finding mental healthcare may want to use the Substance Abuse and Mental Health Services Administration (SAMHSA)’s treatment locator.
This tool helps a person locate local doctors and facilities that may be able to provide treatment.
Mental Health America notes that a person should contact a mental health professional if they experience the following:
- They have felt that their sexual urges and fantasies have caused distress or impacted their ability to function.
- They have wanted to stop and reduce their fantasies, but with no success.
- In times of stress, depression, boredom, or anxiety, they have turned to their sexual fantasies or urges.
- They have continued to engage in repetitive sexual behaviors despite negative effects.
A person who suspects they may have hypersexuality should consider talking with a doctor about their symptoms. This is particularly important for people who find that they are experiencing difficulty with:
- personal relationships
- work or school
- stress, self-esteem, or other mental health symptoms
Summary
A person with hypersexuality experiences persistent and repetitive sexual urges, fantasies, or behaviors. These can interfere with their health and personal and professional life.
While the DSM-5 does not have an official diagnosis for hypersexuality, doctors may diagnose the condition using diagnostic criteria from the WHO’s ICD-11.
Currently, no standard of care exists. However, a doctor may recommend medication, therapies, or support groups to treat hypersexuality.
