Compulsive sexual behavior

Overview

Compulsive sexual behavior is sometimes called hypersexuality or sexual addiction. It's an intense focus on sexual fantasies, urges or behaviors that can't be controlled. This causes distress and problems for your health, job, relationships or other parts of your life.

Compulsive sexual behavior may involve different kinds of commonly enjoyable sexual experiences. Examples include masturbation, sexual arousal by using a computer to communicate, multiple sexual partners, use of pornography or paying for sex. But when these sexual behaviors become a major, constant focus in your life, are difficult to control, cause problems in your life, or are harmful to you or others, that's likely compulsive sexual behavior.

No matter what it's called or the exact nature of the behavior, untreated compulsive sexual behavior can damage your self-esteem, relationships, career, health and other people. But with treatment and self-help, you can learn to manage compulsive sexual behavior.

Symptoms

Some signs that you may have compulsive sexual behavior include:

• You have repeated and intense sexual fantasies, urges, and behaviors that take up a lot of your time and feel as if they're beyond your control.
• You feel driven or have frequent urges to do certain sexual behaviors, feel a release of the tension afterward, but also feel guilt or deep regret.
• You've tried without success to reduce or control your sexual fantasies, urges or behavior.
• You use compulsive sexual behavior as an escape from other problems, such as loneliness, depression, anxiety or stress.
• You continue to engage in sexual behaviors in spite of them causing serious problems. These could include the possibility of getting or giving someone else a sexually transmitted infection, the loss of important relationships, trouble at work, financial issues, or legal problems.
• You have trouble making and keeping healthy and stable relationships.

When to see a doctor

Ask for help if you feel you've lost control of your sexual behavior, especially if your behavior causes problems for you or other people. Compulsive sexual behavior tends to get worse over time without treatment, so get help when you first notice a problem.

As you decide whether to seek professional help, ask yourself:

• Can I manage my sexual impulses?
• Am I distressed by my sexual behaviors?
• Is my sexual behavior hurting my relationships, affecting my work or causing serious problems, such as getting arrested?
• Do I try to hide my sexual behavior?

Getting help for compulsive sexual behavior can be difficult because it's such a deeply personal and private matter. Try to:

• Set aside any shame or embarrassment and focus on the benefits of getting treatment.
• Remember that you're not alone — many people struggle with compulsive sexual behavior. Mental health professionals are trained to be understanding and not judge people. But not all mental health providers are experienced in treating this condition. Look for a provider who has experience in diagnosing and treating compulsive sexual behavior.
• Keep in mind that what you say to a health care or mental health provider is private. But providers are required to make a report if you tell them that you're going to hurt yourself or someone else. They also are required to report if you give information about sexual abuse of a child or abuse or neglect of someone who is vulnerable, such as an elderly or disabled person.

Ask for help right away

Ask a health care provider for help right away if:

• You think you may hurt yourself or others because of uncontrolled sexual behavior.
• You feel like your sexual behavior is slipping out of control.
• You're thinking of taking your own life. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, every day. Or use the Lifeline Chat. Services are free and confidential.

Causes

Although the exact causes of compulsive sexual behavior are not clear, possible causes may include:

• Changes in brain pathways. Compulsive sexual behavior, over time, might cause changes in the brain's pathways, called neural circuits. This may happen especially in areas of the brain that are related to reinforcement. Over time, more-intense sexual content and stimulation are usually needed to get satisfaction or relief.
• An imbalance of natural brain chemicals. Certain chemicals in your brain called neurotransmitters — such as serotonin, dopamine and norepinephrine — help control your mood. When these are out of balance, your sexual desire and behavior could be affected.
• Conditions that affect the brain. Certain health conditions, such as dementia, may cause damage to parts of the brain that affect sexual behavior. Also, treatment of Parkinson's disease with certain medicines may cause compulsive sexual behavior.

Risk factors

Compulsive sexual behavior can happen in both men and women, though it may be more common in men. It can affect anyone, regardless of sexual orientation. Factors that may increase the risk of compulsive sexual behavior include:

• How easy it is to get sexual content. Advances in technology and social media give people easy access to intense sexual images and information.
• Privacy. The secret and private nature of compulsive sexual activities can allow these problems to worsen over time.

Also, the risk of compulsive sexual behavior may be higher in people who have:

• Problems with alcohol or drug use.
• Another mental health condition, such as depression, anxiety or a gambling addiction.
• Family conflicts or family members with problems such as addiction.
• A history of physical or sexual abuse.

Complications

Compulsive sexual behavior can cause many problems that affect both you and others. You may:

• Struggle with feelings of guilt, shame and low self-esteem.
• Develop other mental health conditions, such as depression, severe distress and anxiety. You also may think about or attempt suicide.
• Neglect or lie to your partner and family, harming or destroying important relationships.
• Lose your focus or engage in sexual activity or search internet pornography at work, risking your job.
• Have financial problems from buying pornography, internet or telephone sex, and sexual services.
• Get HIV, hepatitis or another sexually transmitted infection, or pass a sexually transmitted infection to someone else.
• Have problems with drugs and alcohol, such as using recreational drugs or drinking too much alcohol.
• Get arrested for sexual offenses.

Prevention

Because the cause of compulsive sexual behavior isn't known, it's not clear how to prevent it. But a few things may help you keep control of problem behavior:

• Get help early for problems with sexual behavior. Identifying and treating early problems may help prevent compulsive sexual behavior from getting worse over time. Getting help also may prevent shame, relationship problems and harmful acts from getting worse.
• Seek treatment early for mental health conditions. Depression, anxiety or other mental health conditions can make compulsive sexual behavior worse.
• Get help for problems with alcohol and drug use. These can cause a loss of control that leads to poor judgment and sexual behaviors that aren't healthy.
• Avoid risky situations. Don't risk your health or that of others by putting yourself into situations where you'll be tempted to engage in risky sexual activities.