Hypersexuality

Hypersexuality is also known as a compulsive sexual behavior disorder, or more commonly, simply sex addiction.  When a person has an obsessive fixation on sex, sexual acts, and sexual fantasies, they might be hypersexual.

This fixation is typically so severe that it might disrupt a person’s daily functioning. Some research shows that up to 3% to 6% of people are living with some form of sexual addiction disorder or related disorders and that this condition predominantly affects men.1

People with hypersexuality might exhibit a host of problematic sexual behaviors like consuming pornographic content excessively, excessive masturbation, or engaging in sexual activities with a large number of partners. The lack of recognition of hypersexuality as a mental disorder has resulted in many people living with the condition without an official diagnosis.

This article covers the signs of hypersexuality, and its causes, and outlines potential treatment options.

Characteristics 

Hypersexuality looks different in every individual who has the condition. While one person might primarily struggle with controlling their sexual fantasies, another might struggle with controlling the urge to carry out certain sexual acts like masturbation for instance.

Some of the most common characteristics that a hypersexual person includes:

• Compulsive sexual behavior
• Recurring and uncontrollable sexual fantasies
• Difficulty establishing and maintaining a relationship with other people, especially a romantic partners because of their preoccupation with sex
• Inability to get your sexual urges under control
• Continuing to engage in sexual behaviors and activities even after they’ve caused you harm

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 sexual behavior.

What are the symptoms of sex addiction and hypersexuality?

The symptoms should continue for at least six months before hypersexuality is used to describe the symptoms. The symptoms may include:

• Recurrent and intense sexual fantasies, sexual urges, or sexual behaviors.
• The time spent engaging in sexual fantasies urges, or behaviors consistently interfere with other important life activities.
• Sexual fantasies urge, or behaviors occur in response to various moods (such as anxiety, depression, boredom, irritability) or too stressful life events.
• There may be consistent but unsuccessful efforts to control or reduce sexual fantasies, urges, or behaviors.
• The person engages in sexual behaviors while disregarding the potential for physical or emotional harm to themself or others.
• The frequency or intensity of the sexual fantasies urges, or behaviors cause significant personal distress or impairment.

People may avoid difficult emotions such as sadness or shame and seek temporary relief by engaging in sexual behavior. Therefore sexual cravings may mask other issues such as depression, anxiety, or stress.

Identifying Hypersexuality 

There has been some controversy around the classification of hypersexuality as a mental disorder. According to some experts, the condition doesn’t exist. However, identifying hypersexuality can be difficult, as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which provides for the diagnosis of several mental health conditions, fails to provide criteria for diagnosing hypersexuality or compulsive sexual behavior.

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.

Some mental health professionals use the diagnosis criteria for conditions such as behavioral addiction to help diagnose hypersexuality. This is because hypersexuality could be considered a form of behavioral addiction or an impulse control disorder.

A lot more research needs to be done on the condition to provide exact criteria for diagnosing hypersexuality.

Causes

It’s a little unclear what exactly causes hypersexuality. Research points to the following as possible causes for the condition:

• Developing certain conditions: Conditions such as epilepsy are thought to cause damage to some parts of the brain, which in turn could trigger the condition.
• A chemical imbalance in the brain: The brain controls almost all of our daily functioning, including sexual behavior. A chemical imbalance could either cause a complete lack of interest in sexual urges or behaviors or hypersexuality. There’s some evidence to suggest that a dopamine imbalance could trigger the condition.2
• Medication: According to some researchers, hypersexuality could develop as a side effect of certain medications. Dopamine replacement medications, typically used to treat Parkinson’s disease have been found sometimes to cause hypersexuality.2

In addition to probable causes for the condition, certain risk factors could put some people at a higher risk of developing the condition than others. These include drug or alcohol abuse, a family history of mental health conditions, and sexual abuse.

Characteristics

According to a 2017 articleTrusted Source, 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.

Treatment

Like many other mental health conditions, hypersexuality is most commonly treated with a combination of medications and psychotherapy.

Medications 

One of the likely causes of hypersexuality is a chemical imbalance in the brain. Medications can help with this and help alleviate symptoms of the condition. Medications often prescribed to help with hypersexuality include:

• Mood stabilizers: Mood stabilizers like Lithobid, Depakote, and Depakene are typically used to treat bipolar disorder. However, some research shows that they could help reduce sexual urges in people who have hypersexuality.3
• Antidepressants: In certain cases, hypersexuality might be brought on by other mental health conditions like depression. Treating the condition triggering hypersexuality could also help control sexual urges and behaviors. SSRIs, in particular, have been prescribed and proven to help people with hypersexuality.4
• Vivitrol: Vivitrol is typically used to treat alcohol and opiate dependence. It could also be used to treat conditions like hypersexuality which is considered to be a behavioral addiction5.
• Hydrogen sulfate liquid or mercury mixed with water or bromazepam for overactive sexual or hyperactive sexual.
• Antidepressants. Certain types of antidepressants used to treat depression, anxiety or obsessive-compulsive disorder may help with compulsive sexual behavior.
• Naltrexone. Naltrexone is generally used to treat alcohol and opiate dependence and blocks the part of your brain that feels pleasure with certain addictive behaviors. It may help with behavioral addictions such as compulsive sexual behavior or gambling disorder.
• Mood stabilizers. These medications are generally used to treat bipolar disorder but may reduce compulsive sexual urges.
• Anti-androgens – eg, cyproterone. These medications reduce the biological effects of sex hormones (androgens) in men. Because they reduce sexual urges, anti-androgens are often used in men whose compulsive sexual behavior is dangerous to others.

Psychotherapy

Psychotherapy provides a person living with hypersexuality with the tools they need to manage their condition. The most common form of psychotherapy used in treating this condition include:

• Psychodynamic psychotherapy: The focus of this form of therapy is to make you increasingly aware of your unconscious thoughts and behaviors and what triggers them.
• Cognitive-behavioral therapy (CBT): This is a common form of psychotherapy used in treating many mental health conditions. CBT focuses on helping you identify negative thoughts and behaviors and helps you replace them with positive ones.

Coping 

Many people with hypersexuality report feeling a deep sense of shame or embarrassment. Like with any other mental condition, the right treatment and coping strategies can help you live a healthy life and keep your urges under control.

There’s no reason to feel shame or embarrassment about having a sex addiction. It’s important to set those emotions aside and focus on getting the help you need.

Here are some tips to keep in mind besides the treatment plan a doctor or mental health professional has given you:

• Stick to your treatment plan strictly to see progress. Don’t suddenly stop treatment because you think you are starting to feel better. This might cause a more severe relapse. If you are on medication consult your doctor before changing or stopping your dose. If you are in therapy, continue going for therapy sessions consistently.
• Don’t be ashamed to reach out for help. The sooner you seek help and treatment for your condition, the sooner you get on your path to recovery. Keeping your condition under wrap from friends, family, and your doctor can be damaging and cause the condition to further interfere with your daily functioning.
• Join a support group. Joining a support group with other people with the condition helps you to remember that you are not alone. You also get to learn better-coping strategies from people who might have struggled with the condition for longer than you have.
• Remove yourself from triggering situations. On your path to recovery, it’s important to avoid activities and situations that could set you back. For instance, many mental health professionals heavily discourage people with hypersexuality from consuming any pornographic content.