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Compulsive Sexual Behavior


Disease: Compulsive Sexual Behavior Compulsive Sexual Behavior
Category: Psychiatric diseases
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Disease Definition:

Though sexual expression is a natural part of a well-rounded life, compulsive sexual behavior occurs when a person becomes obsessed with sexual thoughts, feelings or behaviors affecting their health, job, relationships or other parts of their life.

Compulsive sexual behavior, sometimes called hypersexuality, nymphomania or sexual addiction, might involve a naturally enjoyable sexual experience that becomes an obsession. This condition may also involve fantasies or activities outside the bound of culturally, legally or morally accepted sexual behavior.

Untreated compulsive sexual behavior could damage someone’s self-esteem, relationships, career and other people, regardless of what it is called or its exact nature. However, with self-help and treatment, the affected person can control compulsive sexual behavior and maintain their urges in check.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Mostly, compulsive sexual behavior consists of generally acceptable sexual acts taken to an extreme. These behaviors turn into problems when they become an obsession that is disruptive or harmful to the patient or others.
Other compulsive sexual behaviors are outside the bounds of normally accepted conduct. Called paraphilias, these behaviors rank from compulsive cross-dressing to having sexual desires toward children (pedophilia).

Symptoms for compulsive sexual behavior differ in type and severity. Some signs that a person might be struggling with compulsive sexual behavior include the followings:


  • The person uses compulsive sexual behavior as running away from other problems, like loneliness, anxiety, stress or depression.
  • The person’s sexual impulses are intense and feel as if they’re beyond their control.
  • The person has trouble establishing and keeping emotional closeness, even when they’re married or in a committed relationship.
  • A person keeps occupying in risky sexual behavior despite serious consequences, like the possibility of getting or giving someone else a sexually transmitted disease, the loss of essential relationships, trouble at work or legal problems.

Although someone feels driven to occupy in certain sexual behavior, they might or might not find the activity a source of pleasure or satisfaction.

There’s a wide range of sexual activities that could be warning signs of compulsive sexual behavior, such as:


  • Having sex with anonymous partners or prostitutes
  • Having multiple sexual partners or extramarital affairs
  • Exhibitionism
  • Having a obsession on a sex partner beyond one’s reach
  • Frequently using pornographic materials
  • Avoiding emotional involvement in sexual relationships
  • Engaging in masochistic or sadistic sex
  • Using commercial sexually explicit phone and Internet services
  • Engaging in excessive masturbation

Efforts to use absolute determination to resist sexual compulsions might not succeed for the urges could be so powerful. The affected person should get help when they’re feeling they are unable to control their sexual behavior, particularly when their behavior results in problems for them or for other people. Compulsive sexual behavior seems to become more intense and hard to manage with time, so they should get help when they first acknowledge there might be a problem.

Here is a list of questions for a person to ask themselves as they decide whether to seek professional help:



  • Is sex constantly on my mind, even when I don't want to think about it?
  • Can I control my sexual impulses?
  • Do I try to hide my sexual behavior?
  • Is my sexual behavior hurting my relationships, affecting my work or resulting in negative consequences, such as getting arrested?

One should seek immediate treatment if he or she:  


  • has bipolar disorder or other problems with impulse management, and they feel like they’re sexual behavior is getting out of control.
  • is suicidal
  • believes that he/she might cause harm with uncontrolled sexual behavior


What causes compulsive sexual behavior is uncertain. Causes might include:

An imbalance of natural brain chemicals. High doses of certain chemicals in the brain (neurotransmitters) that might be linked to compulsive sexual behavior include:


  • serotonin
  • dopamine
  • norepinephrine

These brain chemicals also help regulating a person’s mood.

Sex hormone levels. Androgens are sex hormones that normally take place in both men and women. Though androgens have a vital role in sexual desire as well, it is not clear exactly how they’re linked to compulsive sexual behavior.

Conditions affecting the brain. Certain diseases or health problems might result in damage to parts of the brain affecting sexual behavior. Epilepsy, multiple sclerosis, dementia and Huntington’s disease have all been related to compulsive sexual behavior. Moreover, treatment for Parkinson’s disease with some dopamine agonist medications might result in compulsive sexual behavior.

Changes in brain pathways. Compulsive sexual behavior is an addiction that with time might in fact result in changes in the brain’s neural circuits, the network of nerves permitting brain cells to communicate with one another. These changes might cause pleasant reactions by occupying in sexual behavior and unpleasant reactions when the behavior is stopped.



Compulsive sexual behavior can involve several negative outcomes affecting both the affected person and others. The affected person might:


  • Develop other mental health conditions, like depression, anxiety and extreme stress
  • Struggle with feelings of guilt, shame and low self-esteem
  • Accumulate financial debts. Purchasing pornography and sexual services
  • Get arrested for sexual offenses
  • Occupy in unhealthy substance use, like drug or alcohol abuse
  • Contract HIV, hepatitis or another sexually transmitted disease, or pass a sexually transmitted disease to someone else
  • Neglect or lie to their partner and family, taxing or destroying meaningful relationships
  • Face an unwanted pregnancy and its outcomes
  • Lose their concentration or occupy in sexual activity at work, risking their job


Psychotherapy, medications and self-help groups are included in the treatment of this condition. One of the main aims of treatment is to help a person control urges and decrease excessive behaviors while keeping healthy sexual activities.
People with other addictions, severe mental health problems or who pose a danger to others might primarily benefit from inpatient treatment. Whether inpatient or outpatient, treatment might be intense at the beginning. And the patient might find periodic, ongoing treatment through the years helpful to prevent relapses.

Finding the right kind of help
In the case of having compulsive sexual behavior, the patient might need treatment for another mental health condition as well. People with compulsive sexual behavior usually have alcohol or drug abuse problems or other mental health problems that require treatment, particularly obsessive-compulsive behaviors, anxiety or a mood disorder like depression. The patient should seek a mental health provider, like psychiatrist or psychologist, who has experience in treating sexual behavior disorders. The family doctor, if available, might be able to give the patient the name of a specialist, or they could contact a medical center and ask for a referral.

Finding help for a sexual behavior could be tough for being such a deeply personal matter. The patient should try putting aside their shame and embarrassment and concentrate on the benefits of getting treatment. They should always be reminded that they’re not alone, several people are struggling with sexual urges that are extremely powerful and hard to control. Mental health providers understand this and are trained to be understanding, discreet and helpful. One should always keep in mind that what is said to a doctor or mental health counselor is kept confidential except in cases where a person admits to planning or committing a crime or harming themselves or others.


Numerous types of psychotherapy might help compulsive sexual behavior. Such as the followings:

Cognitive behavioral therapy. This type of therapy helps identifying unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.

Psychodynamic psychotherapy. This type of psychotherapy concentrates on increasing the patient’s awareness of unconscious thoughts and behaviors, developing new insights into their motivations, and resolving conflicts.

Family therapy or marriage counseling. Compulsive sexual behavior affects the whole family, which is why it is usually beneficial to involve the patient’s partner or children in joint therapy sessions.

Group therapy. The patient might meet with a group on regular basis, under guidance of a mental health professional, in order to explore emotions and relationships.


Certain medications might be beneficial since they act on brain chemicals related to obsessive thoughts and behaviors and decrease the chemical “rewards” these behaviors offer when the patient acts on them. Which medication or medications are best for the patient depends on their overall condition and other mental health conditions or addictions they might have. The patient might have to try many medications, or combination of medications, to figure out what suits their condition best with the least side effects. Medications used to treat compulsive sexual behavior are usually used initially for other conditions. Such as:

Mood stabilizers. Such as lithium (Eskalith, Lithobid). These medications are in general, used in bipolar disorder (manic depression) treatment, but might decrease unmanageable sexual urges.

Antidepressants. Those most commonly used to treat compulsive sexual behavior are selective serotonin reuptake inhibitors (SSRIs). These include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and others.

Anti-androgens. These medications decrease the biological effects of sex hormones (androgens) in men. One example is medroxyprogesterone (med-rok-see-pro-JES-tur-own) is one of them. Since they decrease sexual urges, anti-androgens are usually used in men whose compulsive sexual behavior is threatening to others, like pedophilia.

Anti-anxiety medications. Such as clonazepam (Klonopin), lorazepam (Ativan), chlordiazepoxide (Librium), diazepam (Valium) and alprazolam (Xanax). These medications are used to decrease serious anxiety and aggression in emergency cases, but in general, are avoided, as they might worsen compulsive behavior in the long term.

Luteinizing hormone-releasing hormone (LHRH). This medication might decrease obsessive sexual thoughts by reducing the production of testosterone.

Self-help groups

Self-help and support groups could be effective for sexual addiction and handling all of the issues it could result in. Most are modeled after the 12-step program of Alcoholics Anonymous (AA). In addition to helping the patient make changes directly, these groups can help the patient learn about their disorder, find support and understanding in their case, and identifying additional treatment alternatives and resources. These groups might either be internet based or have local in-person meetings or both. When someone’s interested in a self-help group, they should seek for one with a good reputation and that makes them feel comfortable. Such groups don’t suit everyone’s taste, so they should ask mental health provider about options.



  • Sex Addicts Anonymous
  • Codependents of Sex Addicts (COSA)
  • Sexaholics Anonymous
  • Sexual Recovery Anonymous
  • Sexual Compulsive Anonymous
  • S-Anon International Family Groups
  • Sex and Love Addicts Anonymous


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