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Sex Addiction

By: GoodTherapy



Sex addiction is any compulsive, sexually motivated behavior that is acted out despite the negative consequences. It is also known as sexual compulsion or sexual dependency. Estimates suggest between 12 to 30 million Americans experience some kind of sexual compulsion.


Sex addiction can interfere with one’s social life, physical health, and emotional well-being. It generally does not improve until the person receives treatment. A compassionate therapist can help individuals develop a healthier relationship with sex and intimacy.



SIGNS OF SEX ADDICTION


Most people enjoy sex and seek it out from time to time. In sex addiction, however, this enjoyment becomes an obsession. An individual’s thoughts can be consumed by intense sexual fantasies. They may consistently prioritize sex over family, friends, and work. Over time, an individual may need to engage in increasing amounts of sex (or more unusual forms of sexual gratification) in order to get the same “high” as before.


Common signs of sex addiction include

  • Prolonged periods of promiscuity with multiple partners or one-night stands. 

  • Compulsive pornography.

  • Excessive masturbation (sometimes to the point of physical injury).

  • Excessive cybersex or sexting.

  • Prostitution or use of prostitutes.

  • Multiple acts of marital infidelity.

  • Frequent unsafe sex.

  • Exhibitionism.

  • Voyeurism.


Individuals with sex addiction can have different views on their behavior. Some people may be aware that their sexual compulsions are an issue yet feel unable to control it. They might make repeated attempts to reduce their sexual dependency but fail to make progress. Others may try to rationalize their actions. They may deny they have a sex addiction even when their behavior causes the loss of intimate relationships, family, or friends.



SEX ADDICTION AND GENDER


Sex addiction is often considered a men’s issue, but the condition can affect anyone. In a study of university students, around 3% of men had sexual compulsions, compared to 1.2% of women. A study of internet sexual addiction found a similar ratio: 5% of men and 2% of women.


Around 88% of people who seek sex addiction treatment are men. Some researchers believe women may be less likely to seek treatment due to stigma, leading prevalence rates to be skewed. There are no data on how gender affects treatment outcomes. However, since men and women manifest hyper-sexuality through the same symptoms, it is likely that treatment strategies would be the same for all genders.



WHAT CAUSES SEX ADDICTION?


There is no one trait known to cause sex addiction. However, research does point to several contributing factors.


Mood

Sexual compulsions may be a way to cope with emotional pain or stress. In one 1997 study, 96% of participants said specific moods triggered their sexual compulsions. The most common triggers were:

  • Sadness and depression (67%).

  • Happiness (54%).

  • Loneliness (46%).

Brain Chemistry

Research suggests people with sex addiction may have neurochemical differences in their brain’s reward center. Chemicals released during sex, such as dopamine and oxytocin, may create a "high" similar to that obtained from the use of drugs or alcohol. A person may develop an addiction to this pleasure, requiring more sex to get the same feeling. 


Hormones

Androgen is a sex hormone that affects libido. When the body makes too much androgen, it may increase a person’s risk of sex addiction.


History of abuse

A large majority of people with sex addiction report a history of abuse.

  • 72% report physical abuse.

  • 81% report sexual abuse.

  • 97% report emotional abuse.


In many cases, sex addiction is caused by multiple factors working in tandem.



SEXUAL ADDICTION AND MENTAL HEALTH


Most cases of sex addiction occur alongside other mental health issues. The most common comorbidities include:

  • Depression.

  • Anxiety.

  • ADHD.

  • Substance abuse.

  • Gambling addiction.

  • Compulsive shopping.

Additional mental health issues can make sex addiction more severe. In some cases, a person may be using sexual activities to cope with emotional distress or past trauma. Thus, therapy for sex addiction will often treat all of a person’s diagnoses, not just the sexual compulsion.



THE CONTROVERSY AROUND DIAGNOSING SEX ADDICTION


The scientific community has long debated whether sex addiction is a “real” diagnosis. The World Health Organization recognizes sex addiction as its own mental health condition, while the American Psychological Association does not. 


Some individuals claim that behaviors we classify as sex addiction are likely symptoms of other conditions. For example, people with bipolar can develop hypersexuality during a manic episode. They may have trouble controlling their sexual behaviors during this period. Others argue that sexual compulsions can and do occur independently of other diagnoses. 

Stigma is also large concern in the debate. In the past, women, people in the LGBTQ+ community, and other marginalized identities have been censured for displaying “too much” sexuality. Clinicians diagnosed overtly sexual women with nymphomania and “cured” the condition by removing the labia or cutting the clitoris. Some gay men, including the famous codebreaker Alan Turing, were chemically castrated to reduce their libidos. As such, many people are wary that a diagnosis of “sex addiction” will be used to pathologize marginalized communities or people with naturally high sex drives.


Proponents of the diagnosis believe sex addiction can be distinguished from cultural expectations. According to the current framework, sex addiction is characterized not by the amount or type of sex a person has, but by how these sexual activities affect a person’s well-being. Casual sexual encounters, consensual BDSM, or responsible pornography use do not indicate sexual addiction. It’s only when these behaviors grow out of the person’s control and sabotage their emotional health that they can be called sexual compulsions.

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