Compulsive Sexual Behavior

Compulsive sexual behavior, also called hypersexuality, hypersexual disorder, nymphomania or sexual addiction is an abnormal fetish for sex or sex-related activities, thoughts or behaviors.

The symptoms are severe enough to cause distress or deteriorate your health, job, relationships or other aspects of your life. Treatments and various self-help measures can help you manage your urges and minimize associated risks.

You may experience a wide range of compulsive sexual behavior symptoms depending upon which type of the disorder you have and how severe it is.

Here are some symptoms which may suggest you are going through some rough times with compulsive sexual behavior:

• Intense sexual impulses which you think are not in your control.
• Abnormal sexual behaviors may not certainly be making you happy or satisfied.
• You are accustomed to indulging in risky sexual behavior to run away from other problems, such as loneliness, depression, anxiety or stress.
• Your abnormal sexual behaviors could cost you a bunch of problems such as increased risk of acquiring or transmitting an STI (sexually transmitted infection), broken relationships, joblessness or legal troubles. You may know all about this but you still continue with the abnormal behavior.
• Marriage or a devoted relationship does not seem to bind you and you still remain detached.

When to see a doctor?

Ask for a medical help if your urges are causing troubles to you or those around you. Since the disorder only gets worse over time, seek help at the first appearance of any symptoms.

Here are some points to ponder before you think of getting a professional help:

• Are my sexual urges manageable with self-care measures?
• Do these symptoms put me in stress?
• Are my relationships affected by my behaviors?
• Can my sexual behavior increase risk of serious complications?
• Am I hiding my abnormal sexual behavior?

Feelings are always very personal and sexual feelings are the least exposed of all feelings. So talking about such problems can be very difficult, if not impossible.

To properly express yourself, take a deep breath and do these:

• Remember that the benefits of treatment weigh more than your feelings of embarrassment.
• Do not think that you are the only sufferer. There are many other people who are going through the same condition.

Not all mental health providers are qualified enough to provide help in such conditions. Therefore, your first job is to find the right person who can help you. Remember that a doctor or a mental health counselor you talk to, will not disclose your information or any part of the conversation except when you have committed a crime or are planning to do so.

Ask for immediate medical help if:

• You feel as if you are going to harm someone with your abnormal sexual behavior.
• You are diagnosed with bipolar disorder or other mental problems, and you think you are losing control over your sexual behavior.
• You are considering a suicide. Call 911 or your local emergency number, or the National Suicide Prevention Lifeline (in the United States) at 1-800-273-TALK (1-800-273-8255).

The causes of compulsive sexual behavior are still not well understood but some causative factors may include:

• Chemical imbalance in the brain: An elevated levels of brain chemicals (neurotransmitters) such as serotonin, dopamine and norepinephrine may have some links to compulsive sexual behavior.
• Certain brain disorders: Certain brain disorders such as epilepsy, Huntington’s disease and dementia may affect parts of the brain that control sexual behavior. Moreover, Parkinson’s treatments that increase level of dopamine in the brain may cause compulsive sexual behavior.
• Alteration of brain’s neural circuits: Similar to an addiction, compulsive sexual behavior may alter brain’s natural communication network establishing abnormal sexual behavior as a source of pleasure. Note that your brain loves to be happy.

Start the long diagnostic procedure for compulsive sexual behavior by talking to your family doctor. Your doctor may conduct a physical exam to rule out any health conditions that might affect your sexual behavior. S/he may refer you to a psychiatrist, psychologist or other mental health provider to further investigate the matter.

Finding a health professional experienced in problems of sexual behavior is a difficult task. Ask your doctor or search through reliable websites or a phone book to find the right professional who can help you. You may also go through government websites and local agencies such as the Department of Health and Human Services or the Department of Veterans Affairs. Also, consider contacting “The Society for the Advancement of Sexual Health, Sex Addicts Anonymous” and COSA, a program which helps victims of compulsive sexual behavior.

How to prepare yourself for the visit?

Getting prepared for the visit can optimize the therapy and help make the visit more fruitful.

• List out all the symptoms and mention their occurrence, frequency and triggers.
• Write down your key medical information including your diagnosis of anxiety or depression, if any.
• Write down the names of all your medications, vitamins or supplements.
• Ask a trusted friend or a family member to accompany you during the visit.
• Make a list of the questions to ask your doctor. Some typical questions can be:
  • Why am I obsessed to these activities even after knowing they cause me distress?
  • What are the treatment options and which one seems to best suit my condition?
  • Do you recommend joining a support group or a 12-step program?

What your doctor wants to know?

A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your doctor.

Your doctor might ask you typical questions like:

• When did you first notice these symptoms?
• Have you been into legal, relationship, employment or emotional troubles due to your sexual behavior?
• How often your behavior seems to be slipping out of control?
• Does any factor suppress or provoke your sexual urges?
• Have you been abused-physically, emotionally or psychologically?
• Does your behavior cause you shame, embarrassment or any other psychological trauma?
• Do you have other mental health conditions?
• Do you abuse alcohol or use other drugs?

You need to go through a psychological evaluation and may have to answer the following questions: 

• Do you consider your physical and mental health normal?
• Are you emotionally stable?
• How are your sexual thoughts, behaviors and urges? Do you consider them normal?
• Do you use drugs or alcohol?
• How is your relation with family, friends and other persons in your community?

If you agree, your mental health provider may ask some questions to your family and friends.

Defining Compulsive sexual behavior

Defining compulsive sexual behavior is a debatable topic in psychiatric community and so is its diagnosis. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is commonly used for diagnosing mental health problems.

Many psychiatrists diagnose compulsive sexual behavior as a subcategory of impulse control disorder or other similar psychiatric problems while some consider compulsive sexual behaviors as pathologically extreme sexual activities.

The diagnosis can be confirmed if you have following characteristics:

• You spend significant time thinking about, planning or engaging in sexual behavior.
• You use abnormal sexual activities to escape from depressive moods or stress.
• You have been unsuccessful in reducing or controlling sexual thoughts or behavior in the past.
• You continue with your sexual behaviors even when realizing that they're harmful to you or those around you.
• Your sexual behavior causes you distress and negatively impacts your relationships, professional or social life, or daily functioning.

The only way to escape out of this quicksand is to ask for professional help no matter how embarrassing it can be. Right diagnosis can pave way for right treatment. So, leave behind your fear, anxiety and guilt, and move ahead to ask for help.

Several treatment methods are used for compulsive sexual behavior.

Psychotherapy combined with medications and self-help groups can help you reduce or control your urges. In some cases, treating the underlying mental health issues such as anxiety, depression or alcoholism and substance abuse can offer some degree of relief. Most often, following treatments are used:

• Psychotherapy: You may learn ways to control your abnormal sexual behaviors through various types of talk therapy which include:
  • Psychodynamic psychotherapy: This therapy can make you aware of your hidden thoughts and behaviors, and help you create motivations that sail you through the conflicts.
  • Cognitive behavioral therapy: This therapy helps you substitute your negative emotions with positive ones.

• Medications: Some medications that alter levels of brain chemicals can help you reduce your dependence on sexual behaviors as a source of pleasure or reward. You may need to try medication or medications to know what and which combination works for you.

  Some medications are:

  • Antidepressants: A class of depression treating medications called selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, paroxetine, sertraline are commonly used for this condition.
  • Mood stabilizers such as lithium, can be used to reduce excessive sexual urges.
  • Naltrexone: This alcoholism treating medication can reduce your sexual addiction by interfering with the brain’s pleasure centers.
  • Anti-androgens: Medications such as medroxyprogesterone can be given to reduce strong sexual urges.
  • Luteinizing hormone-releasing hormone: This hormone reduces testosterone production and hence obsessive sexual thoughts.
• Self-help groups and support groups: These groups provide help through internet or private meetings and may be helpful to you but remember that not all such groups match your taste or choice. So learn enough about the support group before joining.

Prevention of compulsive sexual behavior is not an option but you may reduce the risk with these tips:

• Start treatment as soon as the diagnosis is made.
• Get treatments for depression, anxiety or obsessive-compulsive behavior, if any.
• Resolve issues of alcohol and drug abuse.
• Avoid risky situations.

Here are some coping strategies for compulsive sexual behavior:

• Follow your doctor’s directions: Don’t skip medicines or miss therapy sessions.
• Learn more about your condition.
• Identify the triggers. Note your triggers and avoid them as far as possible.
• Don’t indulge in risky behaviors: Identify and avoid the risks that increase your likelihood of getting trapped again.
• Treat your other addiction or psychiatric conditions such as depression, anxiety and gambling addictions.
• Spend your energy or drive on other suitable and healthy options such as an exercise.
• Manage stress with simple techniques like meditation, yoga or tai chi.
• Do not lose sight of your goal: Don’t feel down by a few setbacks that come by your way during treatment. Stay motivated as you have got another chance to correct strained relationships, economic burden to name a few.

There are several risks and complications associated with compulsive sexual behavior.

Risks

Anyone can develop compulsive sexual behavior but it is more likely to occur in people with:

• Alcoholism or drug abuse
• Other mental disorders, such as a mood disorder (depression or bipolar disorder), or a gambling addiction
• A history of physical or sexual abuse

Complications

Compulsive sexual behavior causes a range of negative impacts to you or those around you.

Some problems that arise with such fetish include:

• Feelings of guilt, shame
• Low self-esteem
• Tarnished self-image
• Depression, extreme stress and anxiety
• Broken relationship
• Financial crisis
• Acquire or transmit HIV, hepatitis or another sexually transmitted infection
• Drug or alcohol abuse
• Arrest
• Loss of job