Sex addiction is an emerging psychological condition that is gaining recognition within the field of addiction research and treatment. A growing body of evidence substantiates this condition, characterized by compulsive and problematic sexual behavior. An official diagnosis for this condition is imminent, but the details of what this disorder will be called and how it will be classified remain uncertain.
What Is Sexual Addiction?
Sex addiction is an unofficial term used to describe compulsive and problematic sexual fixations and behaviors. While there are several types of problematic sexual behavior, they all feature a loss of control over repetitive sexual fantasies, urges, and/or behaviors. It could be defined as a disorder characterized by compulsive sexual obsessions or behaviors that are continued even after causing harmful consequences and lasting changes in the brain.1
Is Sex Addiction Real?
Currently, sex addiction inhabits a gray area, lacking formal recognition from certain important institutions, such as the American Psychiatric Association, that would grant it complete legitimacy as a psychiatric disorder. Still, most experts agree that the disorder, or a similar disorder, exists. The World Health Organization (WHO) provided the first official recognition when it announced a new disorder called Compulsive Sexual Behavior Disorder (CBSD). CBSD, however, is being classified as an impulse control disorder instead of an addiction.
While this provides an official diagnosis for problematic sexual behaviors, it stops short of acknowledging it as an addiction. Another reason why the answer is unclear is that sex addiction isn’t included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5. The DSM-5 is the American Psychiatric Association’s diagnostic reference book. Another disorder called Hypersexual Disorder was considered for the last revision of the DSM-5 but ultimately was excluded, despite evidence supporting that the condition existed.2
In coming years, it is highly likely that there will be more formal acknowledgment for a disorder very similar to sex addiction, possibly with a different name.
Signs of a Sex Addict
A key sign of sex addiction is when someone’s sexual thoughts or behaviors become problematic in some way. Having obsessive sexual thoughts, spending excessive time on sex, and feeling shame or depression around sex are other indicators of a sex addict.
Some common warning signs for sex addiction include:
- Sexual behavior occurring in inappropriate places, times and situations
- Example: breaking professional boundaries by hitting on an employee you supervise
- A lack of sexual desire with real life partners or significant other
- Example: preferring to masturbate alone instead of having sex with your partner
- An inability to perform sexually with real life partners or significant other
- Example: unable to get or maintain an erection unless watching porn
- Being overly secretive about sexual behaviors or living a “double life”
- Example: Lying about working late but instead going to the strip club
- Developing sexual preferences that scare, upset, or disgust you
- Example: Needing extremely rough sex or violent porn to become aroused or to orgasm
- Lower relationship satisfaction, more infidelity, damage to committed relationships
- Example: Comparing partner’s attractiveness to adult film stars and being dissatisfied
- Direct sexual health consequences as a result of unsafe practices
- Example: Contracting STIs or unwanted pregnancies
- Using sexual behaviors as a way to cope with or escape stress or difficult emotions
- Example: Feeling a “need” for sex to stop feeling bad as opposed to wanting sex for pleasure
Does Female Sexual Addiction Look Different?
While sex addiction is much more common in men, women can also develop the condition. Women with sex addictions are more likely to arrange real-life sexual encounters, as opposed to virtual sex.3 Men with sexual addictions usually opt for more impersonal sexual encounters, which often occur online or through paid encounters.
Females with sex addictions may also have different motivations for their sexual behavior than men. Some research suggests that women are more likely to engage in sexual behaviors to reduce anxiety, as opposed to fulfilling a sexual desire.4 Men with sex addictions also use sex as a coping mechanism, but for a wider variety of issues, including stress, depression, loneliness, or even another addiction (called a cross addiction).5
Sex Addiction Symptoms
For now, the only available guides outlining the symptoms for sex addiction come from prior research on Hypersexual Disorder and the symptoms for the CSBD disorder.
Symptoms of Hypersexual Disorder
The symptoms of hypersexual disorder include:2
A. Over a period of at least 6 months, experiencing recurrent and intense sexual fantasies, sexual urges, or sexual behaviors in association with 3 or more of the following 5 criteria:
- Time consumed by sexual fantasies, urges or behaviors repetitively interferes with other important (non-sexual) goals, activities and obligations.
- Repetitively engaging in sexual fantasies, urges or behaviors in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability).
- Repetitively engaging in sexual fantasies, urges or behaviors in response to stressful life events.
- Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges or behaviors.
- Repetitively engaging in sexual behaviors while disregarding the risk for physical or emotional harm to self or others.
B. There is clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges or behaviors.
C. These sexual fantasies, urges or behaviors are not due to the direct physiological effect of a substance (e.g., a drug of abuse or a medication).
Hypersexual disorder also included an option to identify specific types of the disorder, including:
- Sexual Behavior with Consenting Adults
- Telephone Sex
- Strip Clubs
Symptoms of Compulsive Sexual Behavior Disorder
The symptoms used to diagnose compulsive sexual behavior disorder are:6
A. A persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior over an extended period (e.g., six months or more) that causes marked distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.
B. The pattern is manifested in one or more of the following:
- Engaging in repetitive sexual activities has become a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities and responsibilities;
- The person has made numerous unsuccessful efforts to control or significantly reduce repetitive sexual behavior;
- The person continues to engage in repetitive sexual behavior despite adverse consequences (e.g., repeated relationship disruption, occupational consequences, negative impact on health); or
- The person continues to engage in repetitive sexual behavior even when he/she derives little or no satisfaction from it.
What Causes Sex Addiction?
No single factor explains why some people develop an addiction and others do not. There are, however, several psychological, biological, social, and environmental factors that can heighten the risk for addiction.
Psychological risk factors for sex addiction include an existing mental health diagnosis, and people with depression, anxiety, OCD, personality disorders, or other addictions are especially susceptible.5 People with sex addictions also report low self esteem and lower overall life satisfaction. They also struggle more to regulate their emotions, and tend to score higher on impulsivity ratings.7
Research also suggests that certain neurological and biological factors can also heighten the risk for sex addiction. People with delays or abnormalities in certain regions of the brain are more likely to struggle with problem sexual behaviors, as are those with neurological conditions like dementia, epilepsy, and Huntington’s disease.5,7
Relationship Problems, Attachment, & Trauma
In some instances, sex addiction may be indicative of underlying social or relationship deficits. Research has found that sex addicts (especially males) are more likely to report difficulty forming close relationships and a fear of deeper intimacy, and as many as 95% have an insecure attachment style.3 Insecure attachment styles often stem from trauma, suggesting that sex addicts may be more likely to have been the victim of physical, emotional or sexual abuse.
Certain types of sexual behaviors may also present unique risks for addiction. There has been a marked rise in the use of pornography and the number of people self-reporting a porn addiction. Unlike real-life encounters, porn does not require a person to consider the needs, preferences, and boundaries of another person, and unlike real life, is accessible 24/7.
Some experts believe that these factors can result in people developing very specific sexual preferences and to form unrealistic expectations that are difficult to meet offline. This could lead to difficulty engaging in real-life sexual encounters and increased dependence on pornography.8
Sexual Addiction Treatment
In most major cities, there are treatment options for sex addiction available, including inpatient options, outpatient therapy, and support groups.
Some of the most common sex addiction treatment options are:
Sex Addiction Therapy
Individual therapy is typically provided by a licensed counselor, psychologist, or social worker in an office-based setting. Sessions are generally around an hour in length and occur once or twice per week, depending on the person’s needs.
Couples or Family Therapy
Because sex addiction often impacts relationships, couples counseling or family therapy is sometimes needed, and can be a standalone treatment or an addition to other treatment. Couples and family therapy generally occurs in office based settings for 1-2 hours per week, and is provided by a licensed counselor or family therapist.
Inpatient Treatment Programs
These are intensive programs that offer 24 hour treatment to people struggling with addiction, and may be appropriate for people with more intensive treatment needs or more severe addictions.
Self-Help or Support Groups
Support groups like Sexual Compulsives Anonymous are available in most communities, and are often free of charge. These groups can provide support and guidance for people in recovery. They are not considered treatment because they are usually peer-led, but can be a helpful resource, especially when combined with formal treatment.
Medication is a less common form of treatment for sex addiction, but may be a necessary component of treatment for some, especially those with other underlying mental health conditions. Medication is often prescribed by a doctor, psychiatrist, or other licensed medical professional.
How to Find Sex Addiction Therapy
Finding the right treatment option is important in providing the best opportunity for a successful recovery.
Those seeking treatment for themselves or a loved one struggling with sex addiction can begin the process by following these steps:
1. Find Available Treatment Options
Do research to find available treatments in the community where you live. In many cases, this can be done by searching on google for “sex addiction treatment near me,” or using an online therapist directory and searching for someone who specializes in addiction and sexuality.
2. Determine the Time & Money You Can Commit
Everyone’s circumstances are different, and some people might have financial or scheduling restrictions, or have other obligations that can be barriers to certain treatments. Evaluating which options are feasible often involves checking with your insurance provider about coverage and figuring out how much time you can commit to treatment.
3. Find an Experienced Provider
Finding a therapist who specializes in treating addiction is important, as is making sure they have experience working with people who have sex addiction. Often, therapists who are trained in addiction will have a secondary license as an addiction counselor, indicating they are extensively trained in this specialty.
4. Screen for the Best Fit
Once you have narrowed down the list, calling or even visiting different facilities can help determine which would be the best fit. Make sure to ask questions that will help you understand more about the facility, program, and the treatment being provided. If possible, ask to speak directly with one of the treatment providers to help you get a better sense of their personal style.
5. Schedule an Intake Appointment
The final step involves scheduling an initial appointment. Typically, the first appointment is reserved for completing intake forms and the diagnostic assessment. A diagnostic assessment is normally conducted by a licensed mental health or addiction specialist, and is designed to confirm a diagnosis and evaluate treatment options.
How to Overcome Sexual Addiction
Sexual addiction recovery tends to be more successful when people get professional help, and also when they have support from family, friends, or loved ones. In early treatment, many recovering addicts also find it helpful to put safeguards and accountability measures into place, like allowing a partner to access their phone or adding parental controls to internet-connected devices.
Because sex addiction is often driven by deeper underlying psychological issues, finding new, healthier ways of coping with stress and difficult emotions is often an essential part of the recovery process.
Sex Addiction Tests, Quizzes, and Self-Assessment Tools
There is no official diagnostic tool to determine if a person has a sex addiction because the condition is still in the process of being researched and defined. Existing “unspecified” sexual disorders are sometimes diagnosed instead, but only a licensed and trained clinician can confirm this diagnosis. There are, however, certain screening tools to identify problematic or compulsive sexual behaviors.
The most reliable screening tools are:
- Compulsive Sexual Behavior Inventory: A 13 question screening tool asking respondents to report the frequency of specific sexual thoughts, urges and behaviors.
- Hypersexual Behavior Inventory: A 19 question screening tool which asks respondents to describe the frequency of specific experiences.
- Sexual Compulsivity Scale: A 10 question screening tool asking respondents to rate how much specific statements apply to their experiences.
For Further Reading
- Best Addiction Recovery Apps
- American Association of Sexuality Educators, Counselors, and Therapists
- SexAddictHelp.com: Recommended reading on sex addiction
- SexAddiction.com: A website with information, articles, resources, and treatments for sex addiction
- Smart Recovery: Support group
- Sex Addicts Anonymous: Support group