Compulsive Sexual Behavior Disorder (Hypersexuality)

Compulsive sexual behavior disorder (CSBD), also called hypersexuality or sex addiction, involves strong sexual thoughts, urges or behaviors that feel hard to control. These happen a lot and can get in the way of your daily life. They may cause stress, shame or problems with relationships, work or finances.

You might use these behaviors to cope with anxiety, depression or past trauma. You may try to stop or cut back, but find it difficult. And you may keep doing them even if they cause guilt or regret.

Treatment often includes therapy to understand your patterns and triggers. Care may also focus on treating related mental health conditions and building healthier ways to handle stress and emotions.

Sex addiction signs and symptoms

There isn’t a list of symptoms all providers use to diagnose compulsive sexual behavior disorder. But there are common behavior patterns. These might include:

• Strong focus on sex: Sexual thoughts take up a lot of time and make it hard to focus.
• Loss of control: Sexual behaviors feel hard to stop, even when you want to change.
• Repetitive behaviors: Doing things like watching porn or masturbating happen over and over.
• Time and life impact: Sex takes up a lot of your time and may affect your work, health or relationships.
• Escalating behavior: Sexual activities become more frequent or intense over time.
• Continued behavior despite harm: Behaviors continue even when they cause problems like relationship conflicts, money issues, health risks or emotional pain.
• Emotional ups and downs: Feelings like guilt, shame or regret often follow the behavior, but the pattern continues.
• Less satisfaction: Sex may not feel as good as it used to, but the urge remains strong.
• Stress when stopping: Cutting back may cause restlessness, tension or irritability.

What causes hypersexuality?

Healthcare providers don’t know the exact cause of CSBD. It likely develops from a mix of brain changes and learned behavior patterns.

Possible factors include:

• Changes in brain chemicals: Higher activity in certain brain chemicals (neurotransmitters) — like dopamine, norepinephrine and serotonin — may increase sexual urges and behavior.
• Brain conditions or injuries: Conditions affecting brain areas involved in behavior control (like your frontal lobe, amygdala or prefrontal cortex) may play a role. These can include dementia, epilepsy or bipolar disorder.
• Habit formation over time: Repeated behaviors can turn into habits. The urge may feel automatic, even when the behavior no longer feels rewarding.
• Relief of tension: Sex may help you feel better for a short time. This can reinforce the behavior, even if stress follows later.
• Medication effects: Certain medications that affect brain chemicals, like dopamine, may trigger or worsen this behavior.

What are the triggers of hypersexuality?

Triggers are things that can set off symptoms. They vary from person to person. Common triggers may include:

• Strong emotions: Feelings like anxiety, depression, irritability, boredom or emotional emptiness
• Major life events: Big changes or upsetting experiences, like trauma
• Intrusive sexual thoughts: Continuous sexual thoughts or fantasies
• Ongoing stress: Stress related to work, money, relationships or daily responsibilities
• Rising urges: A buildup of craving or arousal that happens before a loss of control
• Sexual cues: Exposure to sexual content, like online pornography or sexualized media
• Lack of structure or isolation: Periods of social isolation or changes to daily routines

Risk factors

This condition can affect anyone. You may be at higher risk if you have one or more of the following:

• Difficulty managing emotions
• Early life stress or trauma
• Easy access to sexual content
• Impulsivity
• Negative self-beliefs

Complications

Compulsive sexual behavior disorder can affect many parts of your life. Possible complications include:

• Difficulty maintaining healthy relationships with partners or family members
• Feelings of guilt, shame or hopelessness
• Financial stress or problems related to paying for sexual activities or services
• Higher risk of anxiety, depression or thoughts of suicide
• Increased risk of pregnancy or sexually transmitted infections (STIs)
• Increased risk of substance use
• Possible legal consequences related to sexual behavior
• Trouble focusing at work or school, reduced performance or job loss

If you’re having thoughts of suicide or self-harm, seek help right away. You can call or text 988 (U.S.). This is the Suicide and Crisis Lifeline. Someone is available to talk to you 24/7.

How doctors diagnose compulsive sexual behavior disorder

There’s no single test for hypersexuality. A healthcare provider makes the diagnosis through conversation and evaluation.

Your provider will ask about sexual thoughts, urges and behaviors. They’ll focus on whether these feel hard to control and whether they affect daily life, relationships, work or emotional health. They’ll also ask how long you’ve had symptoms.

Just having a strong sex drive doesn’t mean you have CSBD. Providers look for loss of control and negative impact, not just how often sexual activity happens. They also consider your personal values and cultural background.

Your provider will check whether something else is causing it, like a medicine, substance use or a health issue.

Throughout the process, providers aim to be respectful and nonjudgmental. The goal is to learn what’s going on and find the right kind of help.

Is sex addiction considered a mental health disorder?

Compulsive sexual behavior disorder is recognized as a mental health condition by major health organizations. It involves ongoing sexual urges or behaviors that feel hard to control and cause problems in daily life. Not all medical systems use the same name, and experts still discuss how best to classify it.

It isn’t currently listed in the updated version of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition). Even so, healthcare providers widely agree that this is a real and treatable mental health condition. Many people find relief and stability with the right support and care.

Hypersexuality treatments

Treatment focuses on helping you feel more in control, reducing stress and improving daily life. The goal isn’t to take away your sex drive — just to help it feel more balanced.

Treatment often takes time. Your provider may adjust your care as symptoms change.

Therapy

Therapy is the main treatment for CSBD. In therapy, you may work on:

• Understanding triggers and patterns
• Learning skills to manage urges
• Handling stress and strong emotions in healthier ways
• Changing unhelpful thoughts about sex
• Building routines that support recovery

Therapy might be just you, with your partner or in a group — whatever works best for you.

Medications

You may benefit from medication. A medication is usually added to therapy, not used alone.

Medications may help:

• Reduce strong urges or cravings
• Improve impulse control
• Treat related conditions like anxiety or depression

There’s no single medication made just for this condition. Your provider will help decide if medication makes sense for you.

When should I see my healthcare provider?

You should talk to a healthcare provider if sexual thoughts or behaviors feel hard to control or start causing problems in your life.

It may be time to seek help if:

• Sexual behaviors interfere with work, school, relationships or your health
• You’ve tried to cut back or stop, but haven’t been able to
• The behavior continues even after negative consequences, like relationship conflict, health risks, legal or work issues
• You feel ongoing guilt, shame, anxiety or stress related to sexual behaviors
• The sexual behaviors become more frequent, more intense or riskier over time
• You’ve struggled with control for several months, and it’s affecting your daily life

You don’t need to wait for a crisis to reach out. If you’re worried about your sexual behavior, a provider can help you sort through what’s going on and discuss next steps.

What can I expect if I have compulsive sexual behavior disorder?

Living with CSBD may feel difficult, and it often takes ongoing effort to manage. There’s no cure for CSBD, but treatment may help you feel more in control.

With therapy and support, many people learn skills to manage triggers and respond to urges in healthier ways. Over time, sexual thoughts may feel less intense, and behaviors may happen less often.

Progress takes time. You may have days when urges get stronger, especially when you’re stressed. That doesn’t mean you failed. These moments are part of your journey.

You may feel better, think more clearly and have better relationships as you gain more stability. With continued support and self-care, managing CSBD often becomes a regular part of life, like managing any long-term health condition.

Can compulsive sexual behavior disorder be prevented?

This condition can have many causes. Some factors, like brain chemistry or other health conditions, aren’t something you can control. Because of this, prevention isn’t always possible.

But there are steps that may reduce triggers and support healthier patterns. These include:

• Learning more about the condition: Understanding your diagnosis may help you recognize patterns and triggers. A healthcare or mental health provider can explain what’s happening and answer your questions.
• Reducing known triggers: If certain situations or content increase urges, limiting access may help. This might include blocking websites or changing routines when possible.
• Getting help for substance use: Alcohol or substance use may make urges harder to manage. Support for substance use may also support your recovery.
• Managing other mental health conditions: Conditions like anxiety, depression and bipolar disorder may affect urges. It may help to follow your treatment plan and check in with your provider if symptoms change.
• Finding healthy outlets: Activities like exercise, hobbies, creative work or relaxation may release stress.
• Being patient with yourself: Managing CSBD often takes time. Progress can be gradual. Support from your care team can help you stay focused on what matters to you.

ADHD and compulsive sexual behavior disorder: Is there a connection?

Some studies suggest that attention-deficit/hyperactivity disorder (ADHD) and compulsive sexual behavior disorder may be related.

If you have ADHD, you may have a harder time pausing, slowing down or controlling impulses. This can make sexual urges feel stronger or harder to manage. Because of this, hypersexual behavior shows up more often in people with ADHD than in the general population.

Not everyone with ADHD has CSBD. And not everyone with CSBD has ADHD. But the two may occur together. When they do, treating ADHD can sometimes help with impulse control and reduce sexual behavior problems.

If you have ADHD and struggle with sexual urges, or if you have CSBD and trouble with focus or impulsivity, it may help to talk with a healthcare provider about both.