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Compulsive sexual behavior: an uncontrolled sexual behavior

Reading time: 9 mins

Compulsive sexual behavior is defined as repetitive, compulsive sexual behavior, urges, or impulses that cause significant distress in a person’s life. In other words, compulsive sexual behavior is something a person can’t control, even if they want to.

The main symptoms of compulsive sexual behavior include recurrent and intense sexual fantasies, urges, and behaviors, feeling driven to engage in certain behaviors, and feeling guilt or shame afterward. A person with compulsive sexual behavior may attempt to stop and control their sexual behaviors or fantasies, but their efforts are unsuccessful. They tend to continue engaging in certain behaviors and activities despite the harmful effects and damage they cause.

Changes in brain chemicals and the presence of other mental health problems are the biggest causes of compulsive sexual behaviors. Easy exposure to sexual content is a common risk factor for this condition. 

Compulsive sexual behavior may occur in adolescence and peak in the mid-20s. The effects of this condition may include pronounced feelings of guilt and shame, relationship problems, financial and legal problems, and developing sexually transmitted diseases, just to name a few.

Treatment of compulsive sexual behavior usually includes medications, therapy, and support groups. Like patients with other disorders, men and women with compulsive sexual behavior need a strong support system.

What is Compulsive sexual behavior?

Compulsive sexual behavior is an excessive preoccupation with sexual urges, fantasies, and behaviors. These behaviors and urges are difficult to control, negatively affect a person’s health, relationships, and quality of life, and cause significant distress.

Compulsive sexual behaviors can be classified into two categories: paraphilic and non-paraphilic behaviors.

Paraphilic behaviors are that outside of the conventional range of sexual behaviors. These behaviors include exhibitionism, sexual masochism, voyeurism, pedophilia, sexual sadism, fetishism, frotteurism, and transvestic fetishism.

On the other hand, non-paraphilic behaviors are those that represent engagement in generally available practices. These include excessive exposure to pornography, compulsive masturbation, attending strip clubs, paying for sexual intercourse through prostitution, and extramarital affairs. 

Even though it’s difficult to compare potential historical notions of compulsive sexual behavior to what we currently think of as problematic behavior, some forms of this disorder date back to centuries ago. Keep in mind the characterizations and terminologies for sexual impulse control disorder changed over the years.

Back in 1775, D. T. de Bienville in his book Nymphomania or a Dissertation Concerning the Furor Uterinus described the over-stimulation of a woman’s nerves through too much chocolate and impure thoughts and reading novels can lead to excessive sexual desire.

In 1871, P. Henry Chavasse authored a book that claimed that extreme sexual restraint in men and women could result in satyriasis and nymphomania. 

As you can see; some theories about compulsive sexual behaviors existed a long time ago. It wasn’t until 1886 when Richard von Krafft-Ebbing wrote about sexual behaviors in males, that we got a description similar to the modern understanding of this behavior. German psychiatrist wrote that sexual instinct that preoccupies a person’s life resolves into insatiable and impulsive sexual enjoyment succession.

It will take a lot of years of research for scientists to understand how compulsive sexual behaviors work.

For many years sexual compulsive disorder wasn’t considered a specific mental health disorder. But, things changed a few years ago. In 2018, World Health Organization classified compulsive sexual behavior, for the first time, as a mental health disorder. WHO updated their 11th revision International Classification of Diseases (ICD-11) list and defined compulsive sexual behavior as a persistent pattern of failure to regulate repetitive, intense sexual urges or impulses resulting in repetitive sexual behaviors.

The ICD-11 goes into effect in 2022. At the same time, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) doesn’t include compulsive sexual behavior on the list of mental health disorders.

Numbers show about 3% to 6% of people in the U.S. have compulsive sexual behavior.

What are other words for Compulsive sexual behavior?

Other terms for compulsive sexual behavior are sexual addiction, hypersexuality, and hypersexuality disorder. Back in time, the term nymphomania was used to refer to compulsive sexual behaviors, but today that term is outdated.

When do you need to go to the doctor if you suspect you have Compulsive sexual behavior?

You need to go to the doctor if you start feeling like you have lost control of your sexual urges and behavior. Compulsive sexual behavior tends to develop gradually and escalate over time. That means it’s necessary to see a doctor as soon as you recognize the signs of the problem. 

Persons who suspect they have compulsive sexual behavior may want to ask themselves a couple of questions when trying to determine if they need professional help. For example, they can ask themselves whether they can manage sexual impulses or if their sexual behaviors cause distress in their lives. 

It also helps to ask oneself whether sexual behaviors are hurting relationships or whether they’re attempting to hide it.

Since getting help is a personal matter, Mayo Clinic, advises persons who suspect they have this disorder to remember they’re not alone. Many men and women struggle with compulsive sexual behavior. It’s also useful to remember conversations with a healthcare professional are confidential.

In what circumstances do you need to see a doctor right away?

Emergencies are unpredictable; you should see a doctor immediately if you suspect you may cause harm with uncontrolled sexual behavior. Being suicidal and feeling like sexual behavior is getting out of control due to other impulse control problems are also major reasons to see a healthcare professional immediately.

What are the factors that may increase your chances of developing Compulsive sexual behavior?

Factors that increase your chances of developing compulsive sexual behavior are ease of access to sexual content and secrecy or privacy associated with sexual activities. 

Thanks to the evolution of the internet and technology, people have easy access to different sexual content that may contribute to their compulsive behavior. Sexual content and activities are relatively easy to hide. This increased secrecy worsens compulsive sexual behavior.

Besides the above-mentioned, other factors that increase the risk of compulsive sexual behavior include the history of physical or sexual abuse, alcohol or drug abuse problems, the presence of other mental health conditions such as depression, compulsive disorders like gambling addiction, and a history of addiction and conflicts in the family.

Imbalances of neurotransmitters in the brain could also contribute to the development of compulsive sexual behavior. Exposure to these behaviors or urges could increase levels of dopamine and serotonin, feel-good chemicals. As a result, a person experiences pleasure and satisfaction, which motivate them to engage in the same activity again. 

Repeated exposure to certain sexual behaviors or activities can decrease the sensitivity of dopamine receptors. That means the exposure has to increase in order to produce the same effects. Eventually, it can become difficult for a person to control their urges and sexual impulses. In other words, their disorder becomes compulsive.

Do Men have the highest risk of getting Compulsive sexual behavior?

Gender may affect the risk of developing compulsive sexual behavior. Evidence shows men are more likely to have compulsive sexual behavior than women. For example, a study from the Journal of Clinical Medicine found a lifetime prevalence of compulsive sexual behavior was 5.6% and 3.3% for current prevalence. Both lifetime and current compulsive sexual behavior were higher in men than women.

Men were also more likely to have sadism, exhibitionism, frotteurism, and voyeurism, among other compulsive sexual behaviors.

What are the possible complications you can suffer when you have Compulsive sexual behavior?

The possible complications you can experience when diagnosed with compulsive sexual behavior are low self-esteem, guilt, and shame. When left unresolved, the condition can worsen and cause complications such as other mental health conditions (anxiety, depression, and suicidal thoughts and tendencies).

Some people with overactive sexuality may develop financial problems and debts because they spend a lot of money on buying sexual services and pornography.

Compulsive sexual behavior can jeopardize and ruin relationships as it makes people neglect or lie to people in their lives. Engaging in other risky behaviors such as substance abuse, developing sexually transmitted diseases, and developing problems with the law, or work are also some of the many complications of compulsive sexual behavior. 

In a nutshell, untreated compulsive sexual behavior causes a wide range of problems that harm a person’s physical, mental, and social function and well-being.


What are the preventive measures you should take to avoid developing Compulsive sexual behavior?

The preventive measures you should take in order to avoid developing compulsive sexual behavior include getting help early and learning to recognize signs of the problem in the early stages. 

Identifying early symptoms and getting help on time prevents the worsening of compulsive sexual behavior. This also indicates the risk of complications lowers at the same time. 

Prevention of compulsive sexual behavior also requires seeking early treatment for mental health problems such as depression and anxiety. As seen above in this post, the presence of mental health problems can increase the risk of compulsive sexual behavior or can worsen the condition. Getting much-needed help and treatment for underlying mental health problems can reduce the risk of sexual obsession disorder.

Since substance use disorders can induce unhappiness and loss of control or poor judgment, it’s necessary to get help for these conditions in order to prevent compulsive sexual behavior. By treating addiction to drugs or alcohol, it becomes easier to improve the sense of control and judgment. 

Additionally, reducing exposure to risky behaviors and sexual practices can also aid in the prevention of compulsive sexual behavior. That way, a person is not tempted to engage in specific sexual behaviors and activities.

What are the possible treatments after being diagnosed with Compulsive sexual behavior?

Possible treatments you’ll need to encounter after being diagnosed with compulsive sexual behavior include psychotherapy like cognitive behavioral therapy and psychodynamic psychotherapy, medications such as antidepressants, and self-help groups. 

The latter is helpful for persons’ compulsive sexual behavior and for those who want to deal with issues this condition can cause. A vast majority of support groups are similar to Alcoholics Anonymous and other 12-step programs.

In other words, people with the same problem discuss their life with compulsive sexual behavior. They also share their experiences and provide support to others. Support groups are intended to enable patients to get support and help while supporting and helping others with sexual addiction diagnoses.

The support groups can help persons with compulsive sexual behavior to learn about their disorder, prevent relapse, find support and understanding, and identify additional hypersexuality treatments.

Some support groups are classic i.e. patients meet at a specific address such as a local community center. Other groups are based online; a patient just needs an internet connection to participate. Since there are many support groups around, it’s useful to choose the one that is considered most reputable. It’s useful to consult a healthcare professional and see which support group they will recommend.

What are some of the different types of psychotherapy to help you deal with Compulsive sexual behavior?

Psychotherapy is the cornerstone of the treatment of compulsive mental health disorders, substance use disorders, and other problems. Different types of psychotherapy you might encounter when getting help for compulsive sexual behavior are cognitive-behavioral therapy (CBT), acceptance and commitment therapy, and psychodynamic psychotherapy.

Cognitive-behavioral therapy is a form of psychotherapy that helps patients identify unhealthy and negative patterns of thoughts and behaviors in order to replace them with more positive alternatives. The main goal of CBT is to reduce unwanted sexual urges and impulses.

Evidence confirms that CBT intervention can significantly reduce sexual behaviors and thereby aid the treatment of hypersexual disorder. This type of therapy for sex addiction works by providing additional structure and focus. It emphasizes improving self-management and promotes self-regulation of behavior.

In persons with compulsive sexual behavior, CBT can help identify triggers that encourage these risky behaviors and helps swap them for healthier attitudes and thought patterns. In other words, it teaches patients how to deal with hypersexuality and sexual compulsions.

Besides CBT, treatment of compulsive sexual behavior may also include acceptance and commitment therapy (ACT). As a type of CBT, acceptance and commitment therapy is action-oriented and teaches patients to stop denying, avoiding, and struggling with their inner emotions. Instead, ACT enables patients to acknowledge them in order to commit to making much-needed changes in their behaviors. More precisely, instead of denying the existence of a problem, with ACT patients learn to accept and acknowledge it and then commit to choosing actions that help combat these behaviors. 

And lastly, psychodynamic psychotherapy is a type of psychoanalysis that focuses on revealing the unconscious content of a patient’s psyche. This type of therapy increases a patient’s awareness of unconscious behaviors and thoughts in order to provide more insight into their motivations. This helps understand why a patient has compulsive sexual behaviors and contributes to efforts to resolve them.

What medications might you need to help you deal with Compulsive sexual behavior?

The medications that your doctor may prescribe to help you deal with compulsive sexual behavior may include antidepressants, naltrexone, anti-androgens, and mood stabilizers.

Pharmacotherapy in compulsive sexual behavior treatment helps because it acts on brain chemicals associated with rewards and obsessive thoughts and behaviors. At this point, there are no medications that are specifically formulated for hypersexual disorder treatment, 

A healthcare professional may prescribe medications for other conditions. The first pharmacological treatment for compulsive sexual behavior are selective serotonin reuptake inhibitors (SSRIs) i.e. common antidepressants, according to a study from the Current Psychiatry Reports. Antidepressants that treat depression, anxiety, and OCD could also help with compulsive sexual behavior.

Naltrexone is typically prescribed for patients with opiate and alcohol dependence. This medication works by blocking the area of the brain that feels pleasure from exposure to certain behaviors. For that reason, naltrexone could help patients with behavioral addictions such as compulsive sexual behavior.

Mood stabilizers are mainly used to treat bipolar disorder. These medications could also aid in treating hypersexuality by decreasing compulsive sexual urges and impulses.

Anti-androgens aren’t prescribed to all patients with compulsive sexual disorder. They are mainly recommended to males whose sexual behaviors could be dangerous to other people. The main mechanism of action of anti-androgens is to decrease the biological effects of androgens, which are known for influencing sexual function and behaviors.

Do people with Compulsive sexual behavior require social coping and emotional support?

Yes, people with compulsive sexual behavior need social coping and emotional support while they’re getting professional help for their disorder. 

Compulsive disorders and behavioral addictions have serious consequences. Since the nature of these disorders has a lot to do with the brain’s chemistry, compulsive behaviors can be tricky to overcome. Compulsive sexual behavior is not the exception.

A person with compulsive sexual behavior disorder needs a strong support system and emotional support in order to recover successfully. People with this disorder have strong feelings of shame and embarrassment. Their mental health and well-being could only aggravate if they are judged and shamed by other persons. 

Family and friends have an important role in hypersexuality treatment, besides professional help. This means the affected person doesn’t have to hide their problem. The more open they are about their problem and the sooner they reach out for help, the sooner they get on the road to recovery.

Overcoming compulsive sexual behavior requires hard work. Sometimes obstacles are possible here and there, but the patient can overcome them by sticking to the treatment. Support system helps with obstacles too.

Additionally, coping with compulsive sexual behavior also implies educating oneself to learn as much as possible about it and how to stop hypersexuality.

Identifying triggers of sexual compulsions and avoiding them or reducing exposure to them can also help cope with this disorder.

Treatment for underlying substance use disorders, mental health disorders, and other problems also helps with sexual addiction treatment. Stress management and relaxation techniques are also important here.