Hypersexuality: What It Is (And Isn’t), Causes, Symptoms And Treatment

What Is Hypersexuality?

Hypersexuality, also known as compulsive sexual behavior disorder or less formally as “sex addiction,” is a condition characterized by an excessive preoccupation with sexual fantasies, urges, or behaviors that are difficult to control or negatively affect a person’s health, job, relationships or other parts of their life.

Hypersexuality is a proposed diagnosis for people who engage in sex, think about sex through fantasies, or experience sexual urges to the point of distress or impairment.

This distress and impairment is a key component of hypersexuality. 

If you’re okay with your frequency of sexual behaviors and fantasies and they’re not impacting your work, social life, or relationships, then it’s not a problem — and you don’t have hypersexuality.

On the other hand, if your behaviors, fantasies, or urges are negatively impacting your life or relationships — and you’re ignoring the consequences — that is a sign of hypersexuality.

People with hypersexuality may be more prone to risky sexual behaviors, such as unprotected sex, that put them at risk for sexually transmitted infections (STIs) and other health issues.

Hypersexuality Symptoms

Hypersexuality is a condition characterized by increased libido or intense sexual desire that leads to distress or impairment and can involve compulsive sexual behaviors, such as frequent masturbation or excessive pursuit of sexual partners.

Symptoms of hypersexuality may also include:

• Experiencing strong urges to watch pornographic material.
• Engaging in sex with multiple partners.
• Seeking out more and varied sexual experiences.
• Trying to reduce how much time you spend thinking about and engaging in sex, and not being successful.
• Turning to thoughts and fantasies about sex or engaging in sexual behavior as a way to deal with other problems, like stress and loneliness.

Additionally, hypersexuality can lead to compulsive thoughts about sex, an inability to reduce sexual thoughts or behaviors, and the disavowal of consequences of actions.

What Causes Hypersexuality?

It’s important to note that there’s a lot we don’t know about hypersexuality and research is ongoing, but known or suspected causes include:

• Mental health disorders
• Trauma or sexual abuse
• Brain injuries
• Hormonal imbalances
• Substance abuse
• Kleine-Levin syndrome
• Emotional disorders
• Medications, including SSRIs

Hypersexuality is often caused by underlying mental health issues, such as bipolar disorder, depression and anxiety, or PTSD.

Some research indicates that the risk of developing hypersexuality as a result of child sexual abuse is higher in males than it is in females.

Substance abuse, brain injury, and hormone imbalances can also cause hypersexuality.

In rare cases, it may be caused by a sleep disorder called Kleine-Levin Syndrome, which mainly affects teenage boys.

There are some studies that show that there may be a link between ADHD and hypersexuality, but the research on this is still in the early stages.

Other causes could include poor emotional regulation, poor self-esteem, difficulty dealing with stress and anxiety, or a need for emotional connection.

With that said, there seems to be some indication that certain medications can impact sex drive in this manner, as well.

There’s evidence that SSRIs (selective serotonin reuptake inhibitors), which are commonly used to treat depression, can reduce a person’s sex drive but there are stories surfacing that it can do the opposite for some people — and may cause hypersexuality as a side effect.

This study notes that “although limited to case reports, a growing body of evidence has suggested that hypersexuality is part of the side-effect profile of SSRIs and other serotonin-enhancing medications.”

Again, the information on this is limited and research is ongoing, but if you find that your sexual urges or behaviors have changed after recently starting any medications, it’s definitely worth talking to your healthcare provider.

How Is Hypersexuality Diagnosed?

Hypersexuality is typically diagnosed by mental health professionals based on a personal and family history, physical and lab tests, and an evaluation of current and past symptoms.

Clinicians may also use self-report questionnaires, psychological tests, and interviews to evaluate an individual’s level of hypersexuality.

They may also consider any reported risk factors, such as substance abuse or a history of trauma.

That said, it can be difficult for mental health care providers to diagnose hypersexuality — and I’ll explain why.

When working with patients, many practitioners use the DSM-5 to make a diagnosis, but hypersexuality does not exist as its own diagnosis in the DSM-5.

DSM stands for “Diagnostic and Statistical Manual of Mental Disorders,” with the DSM-5-TR being the fifth and most current version of the manual at the time of this writing.

Published by the American Psychiatric Association (APA), the DSM contains descriptions of mental disorders, including information on the symptoms of each.

Sometimes practitioners will use a portion of the DSM criteria for addiction, or compulsive behavior, as they apply to the situation.

That said, some mental health care providers may not be comfortable making a hypersexuality diagnosis without clear diagnostic criteria — and as I mentioned earlier, hypersexuality isn’t found in the DSM.

The DSM-5 is not the only way to diagnose a disorder, however.

There is a diagnosis for compulsive sexual behavior disorder (CSBD) in the International Classification of Diseases (ICD-11), which is published by the World Health Organization (WHO).

But it’s important to note that there are differences between hypersexuality and compulsive sexual behavior disorder as it is outlined in the ICD-11.

Some of these differences relate to the presence of other conditions.

For instance, a person who has a substance use disorder, or who is bipolar, would not be classified as having CSBD if “the pattern of failure to control intense, repetitive sexual impulses or urges and resulting repetitive sexual behaviour is not better accounted for by another mental disorder (e.g., Manic Episode) or other medical condition and is not due to the effects of a substance or medication.”

Another difference between hypersexuality and compulsive sexual behavior disorder is the role of pleasure when engaging in sexual activity.

A decrease in sexual pleasure is one of the things that is considered when determining if someone has compulsive sexual behavior disorder, as they will continue “to engage in repetitive sexual behaviour even when the individual derives little or no satisfaction from it.”

As I mentioned earlier, a hypersexuality diagnosis isn’t the easiest to make, and the process will vary based on the mental health care provider.

Hypersexuality Treatments

Hypersexuality is typically treated through psychotherapy, which may involve cognitive-behavioral therapy, dialectical-behavioral therapy, or psychoeducation.

Cognitive behavioral therapy (CBT) helps people learn coping skills to deal with the problems they may be facing. It’s a form of talk therapy and has been used for many different mental health issues over the years.

Dialectical-behavioral therapy (DBT) is more focused on mindfulness.

Patients learn how to cope with what is happening in the world around them, instead of trying to change the things that are happening.

Psychoeducation combines CBT with group therapy and with helping to educate the friends and loved ones of the patient.

The idea is that the more people can understand what is happening to their loved one, the more they can support them as they work through their problems.

Medication, such as antidepressants or hormonal birth control, may also be prescribed for the treatment of hypersexuality.

Support groups and educational resources can also help people to manage their hypersexuality.

For information about local and/or online support groups, try doing an internet search to see what’s available to you.

It’s important to note, however, that groups of this nature may sometimes be based on the same 12-step principles behind Alcoholics Anonymous.

Some people may find these steps helpful, while others do not.

Treatment programs may be an option for you as well. Keep in mind that these programs may cost thousands of dollars, and there is not a lot of evidence proving that they are successful.

Additionally, self-help strategies, such as developing better stress management techniques, mindfulness practices, and more meaningful relationships, may also be beneficial.