However, this is not to imply your symptoms and concerns aren’t valid or real. This clarification refers to formal terminology only.
In this article, we use “sex addiction,” an expression written about, studied, and discussed in psychology and counseling groups and 12 step programs. Still, there is no empirical evidence to suggest that sex addiction exists, or that symptoms of compulsive sexual behavior may be explained as an addiction.
Regardless, if you’re experiencing compulsive and intrusive sexual behaviors, you may find improvement after seeking the support of a mental health professional.
Even then, not all experts agree these symptoms fit into one single mental health condition. This can sometimes make diagnosis challenging.
Although sex addiction is not a formal or recognized diagnosis, the phrase has often been used to describe symptoms associated with compulsive sexual behavior disorder (CSBD) .
Different factors and experiences may lead someone to develop sex addiction and other sex disorders.
Many people have intense sexual urges, fantasies, and behaviors. But what happens when these become intrusive and persistent?
It’s natural to wonder where your symptoms came from. However, the root causes of compulsive sexual behavior disorder, also known as hypersexuality, are not well understood.
Experts have identified a few factors that may be associated with what you or others may refer to as sex addiction.
However, whether they cause your symptoms, contribute to your symptoms, or are a result of your symptoms, has not been fully determined.
Potential causes and contributing factors of CSBD include:
- frontal lobe abnormalities
- neurotransmitters
- medications
- emotional dysregulation
- parental relationships
- childhood abuse
Frontal lobe abnormalities
There’s limited neuroimaging research on hypersexuality that would answer if and how different the brain is in people with compulsive sexual behavior.
However, some literature suggests that, in some cases, hypersexuality may be associated with frontal and temporal lobe injuries or tumors.
This review suggests hypersexuality is more likely to occur when there are previous psychosocial challenges or abnormalities on both temporal lobes.
Not all people with frontal or temporal lobe lesions experience compulsive sexual behaviors, though. In the same way, not every compulsive sexual behavior can be explained by a lesion in your brain.
Neurological conditions, such as dementia, have also been linked to sexual compulsions. A causality hasn’t been established yet, though.
Neurotransmitters
Imbalances in some neurotransmitters — such as the highly addictive dopamine — may contribute to compulsive sexual behavior disorder, though the exact mechanisms are unclear.
Neurotransmitters are an important part of your body’s sexual reaction, triggering responses of the central nervous system such as increased heart rate and regulating reactions to pleasure.
Significant changes in the levels of these neurotransmitters may impact your sexual behaviors.
Medications
Certain medications may trigger compulsive sexual behaviors, although experts have yet to understand the exact mechanisms.
For example, a 2010 study found that some treatments for Parkinson’s disease based on dopamine replacement have been associated with increased symptoms of compulsive sexual behavior and other impulse-control disorders.
More research on this topic is needed, however, to establish a cause and effect relationship.
Mood states and emotional dysregulation
Some experts have noted a relationship between mood states and emotional regulation with an increase in compulsive sexual behaviors.
A 2020 study, for example, found that emotional dysregulation can be both a symptom of and a contributing factor to the development of the condition.
Emotional dysregulation refers to a difficulty managing your emotions or regulating emotional reactions to a specific stimulus.
A 2020 review also found a link between feelings of boredom and hypersexuality, although more evidence is needed to establish a causal relationship.
In general, higher levels of both pleasant and unpleasant emotions have been linked to an increase in impulsive-compulsive behaviors.
Parental relationships
Family dysfunction may also contribute to symptoms of hypersexuality, although no cause and effect link has been established.
Older studies examined in a 2015 review found people from disengaged and rigid families experience more compulsive sexual behaviors than those from different family structures.
Childhood abuse
A 2020 study and a literature review from the same year indicated that childhood and adolescent sexual abuse is significantly associated with hypersexual behaviors.
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.
