Treatment for compulsive sexual behavior typically involves psychotherapy, medications and self-help groups. A primary goal of treatment is to help you manage urges and reduce excessive behaviors while maintaining healthy sexual activities.
If you have compulsive sexual behavior, you may also need treatment for another mental health condition. People with compulsive sexual behavior often have alcohol or drug abuse problems or other mental health problems that need treatment — such as obsessive-compulsive behaviors, anxiety, or a mood disorder such as depression.
People with other addictions or severe mental health problems or who pose a danger to others may benefit from inpatient treatment initially. Whether inpatient or outpatient, treatment may be intense at first. And you may find periodic, ongoing treatment through the years helpful to prevent relapses.
Certain forms of psychotherapy, also called talk therapy, may help you learn how to manage your compulsive sexual behavior. These include:
- Psychodynamic psychotherapy, which focuses on increasing your awareness of unconscious thoughts and behaviors, developing new insights into your motivations, and resolving conflicts
- Cognitive behavioral therapy, which helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones
These therapies can be provided in an individual, group, family or couples format.
Certain medications may be helpful because they act on brain chemicals linked to obsessive thoughts and behaviors and reduce the chemical "rewards" these behaviors provide when you act on them.
Which medication or medications are best for you depend on your situation and other mental health conditions or addictions you may have. You may have to try several medications, or a combination, to find what works best for you with the fewest side effects.
Medications used to treat compulsive sexual behavior are often prescribed primarily for other conditions. They include:
- 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.
- Mood stabilizers. These medications are generally used to treat bipolar disorder, formerly called manic depression, but may reduce uncontrolled sexual urges. An example is lithium (Lithobid).
- Naltrexone. Naltrexone (Revia, Vivitrol) is generally used to treat alcoholism and blocks the part of your brain that feels pleasure with certain addictive behaviors.
- Anti-androgens. These medications reduce the biological effects of sex hormones (androgens) in men. One example is medroxyprogesterone (mud-rok-see-pro-JES-tur-own). Because they reduce sexual urges, anti-androgens are often used in men whose compulsive sexual behavior is dangerous to others, such as pedophilia.
- Luteinizing hormone-releasing hormone. This medication may reduce obsessive sexual thoughts by reducing the production of testosterone.
Self-help and support groups can be helpful for people with compulsive sexual behavior and for dealing with all the issues it can cause. Many groups are modeled after the 12-step program of Alcoholics Anonymous (AA).
In addition to helping you make changes directly, these groups can help you:
- Learn about your disorder
- Find support and understanding of your condition
- Identify additional treatment options and resources
These groups may be Internet-based or have local in-person meetings, or both. If you're interested in a self-help group, look for one that has a good reputation and that makes you feel comfortable. Such groups don't suit everyone's taste, so ask your mental health provider about alternatives.
Sept. 13, 2014
- Reid RC, et al. Re: Report of findings in a DSM-5 field trial for hypersexual disorder. European Urology. 2013;64:685.
- Leeman RF, et al. A targeted review of the neurobiology and genetics of behavioral addictions: An emerging area of research. Canadian Journal of Psychiatry. 2013;58:260.
- Reid RC, et al. Report of findings in the DSM-5 field trial for hypersexual disorder. Journal of Sexual Medicine. 2012;9:2868.
- Dawson GN, et al. Evaluating and treating sexual addiction. American Family Physician. 2012;86:73.
- Karim R, et al. Behavioral addictions: An overview. Journal of Psychoactive Drugs. 2012;44:5.
- Estellon V, et al. Sexual addiction: Insights from psychoanalysis and functional neuroimaging. Socioaffective Neuroscience & Psychology. 2012;2:1.
- Garcia FD, et al. Sexual addictions. The American Journal of Drug and Alcohol Abuse. 2013;36:254.
- Kaplan MS, et al. Diagnosis, assessment, and treatment of hypersexuality. Journal of Sex Research. 2010;47:181.
- Paraphilic disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed July 26, 2014.
- Rosenberg KP, et al. Evaluation and treatment of sex addiction. Journal of Sex & Marital Therapy. 2014;7:77.
- Reininghaus E, et al. Sexual behavior, body image, and partnership in chronic illness: A comparison of Huntington's disease and multiple sclerosis. Journal of Nervous and Mental Disease. 2012;200:716.
- Bianchi-Demicheli F, et al. "Sleeping Beauty paraphilia": Deviant desire in the context of bodily self-image disturbance in a patient with fronto-parietal traumatic brain injury. Medical Science Monitor. 2010;16:15.
- Rullo J (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 12, 2014.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 14, 2014.