What Is Compulsive Sexual Behavior Disorder?

Highlights

• Compulsive sexual behavior disorder (CSBD) is sometimes referred to as hypersexuality or sexual addiction.
• CSBD describes excessive sexual impulses and behaviors that you feel you can’t control and that cause distress and disruption to your daily life.
• The American Psychiatric Association doesn’t recognize hypersexuality as its own category within the DSM, but it’s now officially recognized by the World Health Organization within ICD-11.
• CSBD is categorized as a mental health disorder, not as a sexual disorder.
• Find the support you need to maintain healthy sexual relationships with eDrugstore.

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People fall across a broad spectrum of sexual behavior, sexual activity, and libido. However, if you’re unable to control your sexual impulses and find that your preoccupation with sex interferes with your daily life, you may meet the criteria for compulsive sexual behavior disorder (CSBD). Fortunately, there are resources to help you balance your sexual desires and maintain healthy sexual relationships. 

What is Compulsive Sexual Behavior Disorder?

Compulsive sexual behavior is sometimes referred to as hypersexuality. But having a high sex drive and engaging in frequent sexual activity doesn’t automatically categorize someone as having compulsive sexual behavior disorder (CSBD).

In early 2022, the World Health Organization (WHO) revised the International Classification of Diseases (ICD-11) to include compulsive sexual behavior disorder. The ICD-11 provides clear descriptions of the CSBD, stating it is “characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior.” Additionally, this repetitive sexual behavior causes distress or impairs your daily life and relationships. 

Symptoms and Behaviors

Common symptoms and behaviors of CSBD include:

• Having recurrent and intense sexual fantasies, urges, and behaviors that feel out of your control for a period of six months or longer
• Repetitive sexual behavior becomes a central focus of your life, to the point where you neglect your health, personal care, interests, or responsibilities
• Making multiple attempts to reduce repetitive sexual behavior without success
• Continuing to engage in repetitive sexual behavior, even when you derive little or no satisfaction from it
• Continuing to engage in repetitive sexual behavior, despite negative consequences, such as relationship, financial, health, or legal issues
• Feeling distress from engaging in repetitive sexual behavior
• Having difficulty maintaining healthy and stable relationships

Causes and Risk Factors

The exact cause of CSBD is unclear. Mental health and sexual behavior are complex processes that depend on a variety of factors. However, researchers have been able to identify a variety of potential causes and risk factors for the disorder. 

Potential causes and risk factors include:

• Imbalanced brain chemistry. An imbalance of neurotransmitters can significantly affect your mood or behavior. For example, dopamine has been linked to impulse control disorders, like gambling addiction. 
• Conditions affecting the brain. Traumatic brain injury, brain lesions, and neurological disorders can affect your personality and behavior. These conditions can also affect your impulse control. Research has linked frontal lobe injuries and tumors to compulsive sexual behavior. Conditions like dementia can also lead to compulsive sexual behavior.
• Emotional dysregulation. Emotional dysregulation has been linked to substance use disorder, mood disorders, and CSBD. Engaging in sexual behaviors can sometimes be used as a coping mechanism for being unable to regulate stress and emotion. 
• History of abuse and family dysfunction. Surviving abuse and family dysfunction places you at a greater risk for a variety of mental health disorders. Research suggests that adults who came from abusive or dysfunctional homes are at an increased risk for CSBD. Research has also linked childhood trauma with greater risk for engaging in high-risk sexual behaviors during adulthood.
• Other mental health conditions. Mental health disorders, like obsessive compulsive disorder (OCD), can place you at a greater risk for compulsive sexual behavior. Substance use disorders can also contribute to CSBD.

Sex Addition vs. Mental Health Disorder and Sexual Disorder

The WHO classifies CSBD under impulse control disorders within ICD-11. This places CSBD under the broader umbrella of mental health disorders. It isn’t classified as a sexual disorder.

Some providers use the terms compulsive sexual behavior, hypersexuality, and sex addition interchangeably. However, there’s ongoing debate within the scientific community about whether or not CBSD should be categorized as an addiction. Additional research is needed to support the categorization of compulsive sexual behavior as an addiction.

The WHO’s recognition of CSBD within ICD-11 allows providers to use common language to engage in meaningful conversations about compulsive sexual behavior. 

The American Psychological Association

The American Psychological Association (APA) decided against classifying hypersexuality as a mental health disorder in the most recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Providers can still make a diagnosis for hypersexuality or compulsive sexual behavior using the DSM-5 under a subcategory for another mental health condition. 

Should I See a Doctor for Compulsive Sexual Behavior Disorder?

Speak to your provider sooner rather than later if you’re concerned about compulsive sexual behavior. Seeking diagnosis and support can help you to achieve better treatment outcomes and to prevent further complications. 

Complications

Untreated CSBD can lead to serious complications for your health and personal life. 

Potential complications include:

• Relationship problems with your partner, family, or friends
• Feelings of guilt, shame, and low self-esteem
• New or worsened mental health conditions, such as depression and anxiety
• Contracting sexual transmitted infections (STIs)
• Financial risks or debt from buying sexual products, services, or pornography
• Disruption to career or work performance, due to intrusive sexual thoughts and impulses
• Increased risk for sexual dysfunction, such as erectile dysfunction (ED)

Diagnosis

Your doctor or mental health provider can perform a psychological evaluation to determine if you meet the criteria for CSBD. They will likely ask you questions related to your:

• Sexual thoughts, behaviors, and impulses
• Mental health and emotional well-being
• Physical health and sexual function
• Problems with or related to your sexual behavior
• Social and personal relationships, such as with your partner, friends, family, or coworkers
• Use of substances, such as recreational drugs and alcohol

If you’re experiencing complications that lead to sexual dysfunction, you may be referred to a urologist or a sex therapist for additional support. 

What Treatment is Available for Compulsive Sexual Behavior Disorder?

Providers often recommend a combined treatment approach for CSBD. This may include a variety of counseling or therapy approaches, medication, or treatment of other underlying conditions. The goal of treatment is to help you better manage your sexual impulses and behaviors so you can engage in healthier sexual activities and relationships.

Therapy

There are several types of therapy used to treat CSBD. These include:

• Psychotherapy. Psychotherapy encompasses most forms of talk therapy. During these sessions, you work with a provider to identify and manage your triggers for engaging in certain behaviors. There are a variety of methods that are effective for CSBD, such as cognitive behavioral therapy (CBT), motivational interviewing (MI), and acceptance and commitment therapy. 
• Couples therapy. During couples therapy or family counseling, you can work through relationship problems, practice effective communication strategies, and work toward relationship goals with an experienced provider.
• Sex therapy. You may need the specialized support of a sex therapist to better understand and manage your sexual impulses and behaviors.
• Support groups. Group therapy and self-help support groups can empower you to discuss your treatment and connect with a community of people who understand your condition.

Medication

Medication is typically used to treat underlying or related conditions but not CSBD itself. Your provider can help you to determine if medication is appropriate, based on your symptoms, risk factors, and related conditions.

Medications used to treat CSBD include:

• Anti-androgens. Anti-androgens reduce the effects of sex hormones in men. This can help to reduce sexual urges in severe cases of CSBD.
• Antidepressants. Sometimes antidepressants are prescribed to treat related anxiety, depression, or OCD in people with CSBD.
• Mood stabilizers. Certain mood stabilizers can help to reduce compulsive sexual urges. 
• Naltrexone (Vivitrol). Naltrexone is used to treat alcohol and opiate use disorder. It may also be helpful in managing behavioral addictions and CSBD.

Managing at Home

Managing CSBD can take time. For some people, CSBD treatment is a lifelong process. Making positive lifestyle changes can help you to better manage your symptoms.

You can improve your treatment outcomes by:

• Learning more about CSBD. Educate yourself about CSBD and healthy sexual practices. 
• Following your treatment plan. Have patience with your treatment plan and stick to it as closely as possible.
• Avoiding triggers. If you have specific triggers for sexual behaviors, such as alcohol or bars, then you may need to avoid triggers until you’ve made significant progress in your treatment.
• Treating substance use or mental health disorders. If you’re living with a mental health disorder or substance use disorder, you can prioritize managing the condition to prevent relapse.
• Practicing stress management. Practices like meditation, yoga, or tai-chi can help to reduce your stress and improve your mental health. 
• Leaning into hobbies and healthy outlets. Exercise, recreational activities, or relaxing hobbies can serve as healthier ways to cope with your emotions. 
• Tapping into your support network. Finding a support group or having a network of trusted loved ones can help you to feel connected and stay motivated throughout your treatment. 

Find Support with eDrugstore

If you’re struggling with sexual function issues, such as erectile dysfunction or premature ejaculation, we can help. Check out our medication guide or follow our blog for more information about sexual health and other men’s health issues.