Compulsive sexual behavior: Signs and treatment options

Human sexual behavior is wonderfully nuanced and complex. So it’s generally unhelpful to treat specific forms of sexual expression as mental health conditions unless there are safety concerns involved. 

However, there can be times when a person has trouble controlling their sexual impulses in ways that negatively affect their mental health, relationships, and daily functioning. When this occurs, it could be a sign of something called compulsive sexual behavior. 

Signs of compulsive sexual behavior

Casually, some people refer to compulsive sexual behavior as “sex addiction” or “hypersexuality.” People often use these terms colloquially, but they’re not official diagnoses. If appropriate, a mental health provider may instead diagnose this behavior as an impulse control disorder or unspecified sexual dysfunction.

Regardless of the label, there are some common signs and symptoms that a person is having trouble controlling their sexual behavior. If you are repeatedly experiencing any of the following feelings or behaviors, don’t hesitate to ask for help.

• You spend hours each day thinking about sex or fantasies.
• You’ve tried to gain greater control of your sexual thoughts and behaviors, but you’ve been unsuccessful.
• You frequently feel the urge to engage in certain sexual behaviors and experience little to no satisfaction from it. 
• You feel distress after engaging in compulsive sexual behaviors.
• Your sexual behaviors have caused serious problems in important areas of your life, but you continue to engage in them anyway.
• Your important relationships have been harmed by your sexual behavior.

Impact of compulsive sexual behavior 

Compulsive sexual behavior can affect a person’s mental health, relationships, and ability to function in many ways. The following examples illustrate some of the complications that people living with compulsive sexual behavior can face:

• A loss of interest in activities you used to enjoy: For example, instead of going out with friends, you might choose to stay home and watch pornography.
• Feelings of guilt and shame: When you can’t seem to get your behavior under control, you start to feel ashamed and struggle with low self-esteem.
• Legal troubles: If your sexual behavior violates the law or rights of others, you may face legal consequences.
• Financial problems: Spending large amounts of money on things like sex workers or purchasing pornography can compromise your financial stability.
• Co-occurring health problems: Compulsive sexual behavior can increase your risk of depression, anxiety, sexually transmitted infections (STIs), and unhealthy substance use.
• Relationship issues: People who experience compulsive sexual behavior may attempt to conceal their behavior from loved ones to avoid scrutiny. This can lead to conflict and a loss of trust.
• Employment problems: If your compulsive sexual behavior affects your ability to focus on your responsibilities at work, you could risk losing your job.

A note on stigma: As you learn about compulsive sexual behavior, it’s important to keep in mind that there’s a difference between sexual behaviors that might be considered nonheteronormative or taboo versus those that may signal an underlying mental health concern. Highlighting this distinction can help combat the stigma that keeps people who experience compulsive sexual behavior from seeking the help they need. 

Causes of compulsive sexual behavior 

The medical and mental health communities are still working to understand the causes of compulsive sexual behavior. But some potential risk factors may include:

• Having an imbalance of brain chemicals or irregularities in the parts of the brain that control sexual desire and behavior
• Living with medical conditions that can damage the areas of the brain that control sexual behavior (like epilepsy, bipolar disorder, or dementia)
• Having a substance use disorder (SUD) involving cocaine, alcohol, or amphetamines
• Taking certain prescription medications, like those used to treat Parkinson’s disease

Six ways to manage compulsive sexual behavior 

If you think that you or someone you care about may be experiencing compulsive sexual behavior, there are effective treatments available. This typically includes a combination of individual or group therapy and medication.

1. Individual therapy: Cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) are both used to address compulsive sexual behavior. These types of therapy focus on increasing self-awareness and acceptance, interrupting unhelpful patterns, practicing mindfulness, and changing behaviors. 
2. Group therapy: Connecting with other people who know what you’re going through can reduce shame and help you feel less alone. It can also help you learn new skills and increase your accountability. 
3. Medication: Depending on the severity of your compulsive sexual behavior, your doctor may prescribe medication as part of your treatment plan.  

In addition to these treatment strategies, there are also some lifestyle changes that can help prevent compulsive sexual behavior.

1. Avoid triggers when possible. If you know your triggers, try to avoid them. For example, if you use apps to view pornography compulsively, delete them from your phone.
2. Don’t wait to seek help. Left untreated, compulsive behavior can get worse over time. 
3. Address all mental health concerns. Mental health challenges like depression, anxiety, or substance use disorders often occur alongside compulsive sexual behavior. So if you experience compulsive sexual behavior and also have a mental health condition, look for a therapist who has experience in treating co-occurring conditions and symptoms.

Find care with Rula

Human sexuality is complicated. Attraction and arousal can vary so much from person to person, and there’s nothing wrong with having a strong libido or enjoying sex. But if you’re having trouble controlling your sexual urges and they are negatively impacting your life, it could be a sign of compulsive sexual behavior. Fortunately, you can learn to manage your behavior and nurture healthy sexual expression with the right support. 

At Rula, we make it easy to meet with a behavioral therapist through our convenient online platform. When you need support for your mental health, we invite you to use our platform to find an in-network therapist and schedule your first appointment as soon as tomorrow.

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