In medical and research communities, there is an ongoing debate about whether there is such a condition as "sex addiction" and, if so, what collection of behaviors should be used to diagnose it. Importantly, however, gambling addiction was first formally recognized as an addiction in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which was published in 2013; yet gambling addiction plagued millions of Americans long before psychiatrists outlined its parameters. One related argument about sex addiction observes that it is "about sex" as much as gambling addiction is about money or eating disorders are about food; rather, sex addiction often co-occurs with problems like stress, shame, depression, anxiety and feelings of inadequacy or loss of control. In other words, these behaviors are clearly a problem, but they don't cause physical dependence and withdrawal in the same way that substances like heroin do.[i] However, despite this reality, gambling addiction was added to the DSM-5 because brain imaging studies revealed that gamblers' brains are activated by gambling in nearly the same way that the brains of drug addicts or alcoholics are.[ii] Proof of these physical changes in the brains of gambling addicts was a significant step forward for all behavioral addictions, and further study may show that, for example, sex addiction is actually the result of a physical process.

The fact that sex addiction still needs to be fleshed out in the medical literature does not change the reality that many Americans are caught in a cycle of sex-related behaviors that put their health, relationships, and careers in jeopardy. Although more research needs to be done to understand the full extent of the phenomenon, the following points give some perspective on it:

  • About 12 million Americans have a sex addiction.[iii]
  • Accessibility of sexual material – especially on the Internet
  • – has increased the prevalence of sex addiction.
  • Over half of convicted sex offenders are estimated to have a sex addiction.[iv]

Clearly, sex addiction is a problem that cannot be ignored.

Signs and Symptoms

Sexual desire is a normal part of being human so where is the line between healthy libido and addiction? The desire to have sex frequently may be appear in some sex addictions, but there are many other potential symptoms; in fact, "frequently" will be defined differently in many situations, and if there have been no adverse consequences for the individual, then they are unlikely to have crossed the addiction line. Sex addiction in particular is often marked by willingness to engage in excessive, illegal, and/or risky sexual behavior despite very real consequences. This might look like any of the following:

  • Having multiple partners, many of whom may be strangers
  • Employing prostitutes and/or escorts
  • Engaging in frequent masturbation, even in public
  • Demanding sex from partners
  • Visiting massage parlors, adult book stores, and strip clubs
  • Obsessing over pornography, which may involve increased time on the Internet; certain professionals argue that some people with Internet addiction may actually have sex addiction
  • Participating in illegal activities like obscene phone calls, voyeurism, or exhibitionism

Sex addiction can appear in many forms; if you suspect that you have or are developing a sex addiction, you should discuss your behaviors with your doctor.

Effects and Consequences

Researchers still have much to learn about the consequences of sex addiction, but some effects are clear. Depending on the specific behaviors involved, someone addicted to sex may experience some of the following:

  • Increased risk for sexually transmitted diseases (e.g., syphilis, HIV, and hepatitis B and C) from unprotected sex with partners whose health status is unknown.
  • Greater likelihood of unwanted pregnancies.
  • Physical exhaustion and more injuries.
  • Financial problems from spending money on prostitutes, phone sex, pornographic websites, etc.
  • Legal problems if caught engaging in illegal behaviors.
  • Damage to personal and professional reputation.
  • The possibility of job loss if engaging in inappropriate activities at work.
  • Strain on relationships with romantic partners.

These are some of the potential problems that may result from a sex addiction for the addict, but sex addiction is one of only a few addictions that can cause direct physical harm to others as well (smoking is another example). Spouses and partners have an increased risk of contracting venereal diseases if the person who has a sex addiction is having unprotected sex with others. In fact, many of the above effects will apply to the person's partner as well.

Causes and Risk Factors

Because sex addiction is not thoroughly understood by science, the causes remain unclear. One factor that seems to be common to all addictions is impulse control problems. An example in sex addiction would be unprotected sex with an unknown partner; the person likely knows the risks but is unable to stop themselves.[v] Other related factors[vi] are listed below.

  • Males seem to be more susceptible to sex addiction than are females.
  • Sex addiction may occur with other addictions (e.g., alcohol, smoking, etc.) or mental health problems including depression or ADHD.
  • A family history of addictions increases risk.
  • A childhood environment with exposure to inappropriate sexual behaviors can increase the person's chances of risky and/or excessive sexual activity as an adult; these include being shielded from sex education, a parent's affair or other secretive sexual behavior, incest or abuse, and double standards.

Additionally, hypersexual behaviors and disinhibition can be symptoms of an underlying neurological problem like dementia, seizure disorders, tumors, or Huntington's disease. Thus, it is crucial to discuss concerning sexual behaviors with your doctor.

Treatment

Current treatments for sex addiction primarily focus on individual therapy to target any underlying emotional difficulties that could be contributing. If the person is married, counseling with his or her spouse is also a priority. Joining a support group – like Sex and Love Addicts Anonymous or Sexual Compulsives Anonymous will help the individual meet others with a sex addiction who are also pursuing recovery; having like-minded friends can help keep the person accountable. Residential treatment programs are available; these allow the individual to remove many potential triggers and focus on recovery.

The Food and Drug Administration (FDA) has yet to approve a medication specifically for the treatment of sex addiction. Still, some research has been reported on pharmacological options. SSRIs, a type of antidepressant, have been shown to help some individuals with sex addiction although there is speculation that the compulsive sexual behaviors were then correlated with an untreated mental health problem that was alleviated by the medication. Mood-stabilizing prescriptions (e.g., lithium and valproic acid) show promise for individuals with bipolar disorder who are also engaging in hypersexual behaviors. naltrexone, which is used in replacement therapy for opiate and gambling addictions, could also be helpful for sex addicts. Finally, your doctor may run some blood tests to ensure that there are no hormonal abnormalities that are contributing; hormone therapy could offer a temporary solution for some.[vii]