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.
The exact causes of overactive sex drive are unknown, but research shows there may be links between hypersexuality and other mental and physical health problems. Any of the following conditions could possibly lead to an overactive sex drive:
Bipolar disorder. This treatable mental illness is marked by extreme changes in mood — from the highs of mania to the lows of depression. Hypersexuality can be one of the symptoms of the mania phase. Once bipolar disorder is under control, hypersexuality symptoms should be, too.
Dementia. According to a report in the journal Advances in Psychiatric Treatment, it is quite common for people with dementia to exhibit sexually inappropriate behaviors, such as exposing themselves, using obscenities, masturbating, or propositioning other people. It affects men and women with dementia equally and is more common in people with severe dementia. Medications used to treat hypersexuality in people with dementia have had mixed results. Some therapy may help. Caregivers need to be educated about the disorder and understand that it is a symptom of the greater health issue.
Persistent genital arousal disorder. Women with this condition constantly feel sexually aroused and can’t rid themselves of their intense feelings — not even achieving orgasm helps. The intense feelings of arousal can last for days or weeks. Treatment often involves a combination of antidepressants, hormonal therapy, anaesthetizing gels, and behavioral therapy.
Rabies. A 28-year-old woman went to her doctor at the Sri Gokulam Hospital and Research Institute in Salem, Tamil Nadu, India, complaining of having an overactive sex drive. She died four days later, and an autopsy showed she had rabies. Doctors believe the virus inflamed her brain, which led to the hypersexuality. Seek medical treatment immediately if you are bitten by an animal and don’t know if it was vaccinated against rabies. By the time symptoms of rabies become obvious, it can be too late for successful treatment.
Klüver-Bucy syndrome. This rare neurobehavioral condition, stemming from brain damage, causes a variety of unusual symptoms, including inappropriate sexual behavior as well as putting unusual items in the mouth and not expressing typical responses to anger and fear. There’s no cure for the syndrome, and treatment involves therapy and medication.
Sexual addiction. A person with a sexual addiction has an overactive sex drive and is obsessed with sex. It may start innocently as an addiction to masturbation, pornography, or even a relationship, but it then progresses to increasingly dangerous behaviors, such as prostitution and sex in public places.
“Modern science can show quite conclusively that anything that increases dopamine production, which sex does, is potentially addictive,” says Ethlie Ann Vare, a film and TV writer, producer, and author of Love Addict: Sex, Romance and Other Dangerous Drugs. Dopamine, a brain chemical, helps regulate reward and pleasure, and Vare says that sex can be as addictive as gambling or alcohol.
Vondie Lozano, MFT, PhD, a licensed marriage and family therapist in the greater Los Angeles area, says that “sex becomes a way to deal with feelings, fears, painful emotions — just like alcoholics use alcohol or addicts use substances.”
The American Psychiatric Association is expected to add hypersexual disorder to its Diagnostic and Statistical Manual of Mental Disorders, the manual that mental health professionals use to classify mental disorders, when the latest revision is published next year.
Treatment for sexual addiction includes 12-step programs such as Sexaholics Anonymous, Sex Addicts Anonymous, and Sex and Love Addicts Anonymous. Talk therapy with a therapist specializing in sexual addictions also may be helpful.
Seeking Treatment for Hypersexuality
Sexual health problems may be more common than people realize or want to admit. If you think you have a sexual health problem, find the strength to seek treatment. With treatment, Vare says, you can modify your behavior and develop a new way of relating to people that isn’t sexual in nature.
