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Sexual addiction (hypersexuality): causes, symptoms, diagnosis and treatment

By Cristiano Antonino Last updated Jun 11, 2023

Sexual addiction (or sex addiction), also called hypersexuality, comprises a set of psychopathological conditions characterised by intrusive sexual thoughts and fantasies associated with a loss of control over sexual behaviour

This disorder is commonly referred to as ‘sexual addiction’, but also ‘hypersexuality’. In English ‘sex addiction’ or ‘sex dependence’.

What is sexual addiction

Sexual addiction falls into the category of ‘behavioural addictions’, i.e. pathological behaviour involving seemingly harmless objects or activities.

Such as food, gambling, work, shopping and sexuality.

Hypersexuality is defined as an addiction whose object is sex

It is characterised by recurring sexual fantasies, impulses and promiscuous behaviour not explained by substances, medical conditions or manic episodes.

Furthermore, sexual activity occurs as a response to unpleasant moods (e.g. depressed mood) or as a strategy to reduce stress.

Finally, such sexual behaviour creates discomfort to the point of interfering with social, work and/or relational functioning.

The subject enacts a series of behaviours in order to reduce sexual addiction but fails to do so, leading to strong feelings of guilt and shame as a result of losing control over them.

Symptoms and characteristics of hypersexuality

Just as with a drug addict, a person with a sex addiction problem also experiences craving (intense desire for the thing on which the individual depends), addiction, and withdrawal symptoms.

In this sense, the sex addict needs to increase sexual behaviour or its intensity in order to maintain the desired effect.

As time goes on, psycho-physiological changes occur (among them an increase in anxiety symptoms) and the sexual addiction behaviour itself is implemented to alleviate or avoid these withdrawal symptoms.

Sex addiction and normal sexuality

The notion of sexual addiction (or hypersexuality) is sometimes confused with the normal, positive, pleasurable and intense sexuality enjoyed by the normal population.

Or with the simple high frequency of sexual intercourse. Some people experience sexual excesses but are able to manage them.

Sex addicts, on the other hand, have lost control over their ability to say no and to choose.

Their sexual behaviour is part of a cycle of thoughts, feelings and actions that they can no longer control.

Despite the severe consequences of their acts and repeatedly promising themselves and others to stop, these individuals are unable to stop their self-destructive behaviour.

Sexual addiction has taken over their ability to choose.

Risk factors for sexual addiction

Abuse histories: early traumas such as physical, emotional and sexual abuse are associated with problems in sexual behaviour.

Insecure attachment: attachment characterised by poor care, reduced affectivity and rigid upbringing is often associated with sex addiction.

Attention-deficit/hyperactivity disorder (ADHD): The presence of untreated attention-deficit/hyperactivity disorder is often related to sex addiction.

Comorbidity with other psychological disorders: addiction to substances, shopping, work and gambling often coexist with sex addiction. Depression and anxiety are also often present in the sexually dependent population.

Physical, psychological and social repercussions

In hypersexuality, sex becomes a primary need for which everything else may be sacrificed, including health, family, friends, and work.

The behaviours that sexual addicts may engage in are wide-ranging and may include

sexual promiscuity
sex with prostitutes or personal prostitution
constant sexual fantasies
compulsive masturbation
exhibitionism
voyeurism
frotterism
sadomasochistic practices
addiction to pornographic materials or telephone lines
hypersexuality within a stable relationship to such an extent that it unbalances it

Due to sexual addiction, the person may suffer consequences on various levels: physical, economic, emotional, cognitive and social.

Physical consequences of sexual addiction

On a physical level, the person may develop traditional sexual dysfunctions (premature or delayed ejaculation, sexual desire disorder, etc.), venereal diseases or problems such as ulcers, high blood pressure, vulnerability to disease, nervous exhaustion or sleep disorders.

Economic consequences of sex addiction

On an economic level, sexual addiction can lead to expenses such as prostitution, pornography, sexual paraphernalia, erotic telephony, legal costs as a result of sex crimes or divorce. Not to mention losses in the employment sphere.

Psychological and relational consequences of hypersexuality

Sex addiction (or hypersexuality) has a profound impact on a person’s emotional life (depending on the case, one may experience increased anxiety, inadequacy, guilt, shame, depression and aggression).

It can also have profound effects on mental processes (the intrusion of unwanted thoughts and fantasies can prevent the person from working and concentrating on a normal occupation).

In addition, a good percentage of sexual addicts progressively deteriorate their emotional and relational relationships and have serious relationship problems.

Treatment of sexual addiction

For individuals suffering from sexual addiction, integrated treatment programmes including group therapy, individual psychotherapy and drug therapy have been proven to be effective.

Group interventions

Group therapies are helpful in alleviating the feelings of guilt, secrecy, and stigmatisation that are associated with hypersexual conduct.

They also provide important mutual support for motivation to pursue therapeutic goals.

Individual psychotherapy

Cognitive-behavioural-oriented psychotherapy remains the most structured intervention and, at present, the one offering the greatest potential for treating sexual addictions.

In particular, it aims at modifying dysfunctional negative thoughts that lead to addiction behaviour and learning functional strategies for managing the negative emotions that elicit sexual behaviour.

Currently, dialectical-behavioural therapy, mindfulness and metacognitive therapy have also proven to be effective for this type of addiction.