Is sex addiction real? How to know if you have compulsive sexual behavior and when it may be problematic

• Sex addiction is not a real addiction in the way drug and alcohol addictions are. 
• Compulsive sexual behavior is a preoccupation with sexual thoughts, urges, and behaviors that disrupt daily life. 
• To address sex addiction, experts may recommend medications, therapy, and support groups. 

"Sex addiction" is more of a media buzzword than a medical term. This behavior is not technically an addiction in the same way as drug or alcohol addiction.

However, the compulsive sexual urges that come with self-proclaimed sex addicts are a subject of scientific research and can be medically treated when necessary. 

Even though sexual addiction is not necessarily a mental disorder, it can be an indicator of a more serious underlying condition. Here's what you need to know. 

Is sex addiction real?

Sex addiction isn't a real addiction in the way that drugs or alcohol are. The body does not physiologically crave sex. 

However, the release of dopamine and the feelings that a person associates with sexual activity can cause a person to crave sex. This is known as compulsive sexual behavior. 

What is compulsive sexual behavior?

Compulsive sexual behavior is when someone has an excessive amount of sexual fantasies, urges, and behaviors. 

These thoughts and behaviors are difficult to control, can cause a person distress, interfere with their family, friends, and work, and have a negative impact on their health. 

Compulsive sexual behavior isn't the same as an addiction

Engaging in sexual behaviors triggers dopamine, a hormone that activates the brain's "neurocircuit of reward," says Gail Saltz, an associate professor of psychiatry at the New York Presbyterian Hospital Weill-Cornell School of Medicine. 

In short: When some people stop having sex, they want more because it's gratifying. 

But, according to Saltz, that feeling is normal. Similarly, self-identifying sex addicts may yearn for certain consensual sexual behaviors when they stop engaging in them, but those feelings are not the same as a physiological addiction to substances like drugs and alcohol. 

Addiction to drugs and alcohol happens because these substances alter brain function to the point where the brain goes from wanting the substance to needing it. Therefore, drug and alcohol addiction are classified as mental health disorders by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

However, the DSM-5 does not classify sex addiction as a mental health disorder. Because, unlike drug addicts, those engaging in compulsive sex behaviors don't physically need sex, and won't experience withdrawal symptoms like jitters, elevated blood pressure, and malaise if they don't have it, says David Ley, Ph.D., a clinical psychologist in Albuquerque, New Mexico. 

Many sex addicts don't have abnormal amounts of sex

It's important to note that many self-labeled sex addicts do not have abnormal levels of consensual sexual activity, says Ley. Instead, these are often people coming from religious or culturally-conservative backgrounds who struggle with their sexuality. 

A 2020 study surveyed 3,500 people and found that religious and moral factors often increase a person's worry over porn addiction. This holds true even if they watch it at the same rate as non-religious people. Porn addiction isn't the same as sex addiction, but the guilt and shame likely stem from a similar source.

"The higher levels of internal shame and conflict you have over your sexual desires, the more likely you are to report struggles with controlling your sexual behavior," says Ley. "Even though these people don't actually have more sex or engage in more masturbation than anyone else."

When compulsive sexual behavior is problematic

The World Health Organization's International Classification of Diseases (ICD) recognizes multiple sexual behavior disorders, including excessive sexual drive and compulsive sexual behavior disorder. However, there is a fine line between being highly sexually active and having a sexual disorder.

For example, if a person is having a lot of consensual sex and it isn't affecting their job or relationship, then their behavior isn't considered a dysfunction, says Saltz. Compulsive sexual behavior becomes a disorder when it impairs a person's functioning and keeps them from living the life they want. 

Sexual behavior disorder symptoms

Saltz says that symptoms of compulsive sexual behavior disorder include:

• Thinking about sex nonstop. 
• Engaging in risky sexual behaviors, leaving them at risk of pregnancy and sexually transmitted infections (STIs.)
• Engaging in sexual behaviors at work.
• Loss of interest in other hobbies.
• Spending money in excess to have sex.
• Difficulty establishing and maintaining healthy relationships. 
• Compulsive sexual behavior used to escape issues such as stress, anxiety, and depression. 
• An inability to control sexual urges, fantasies, and behavior.
• A drive to complete certain sexual behaviors that relieve tension but also leads to guilt.

A scientific review estimated that roughly 3% to 6% of the population might struggle with hypersexual behaviors like watching porn for hours on end to satisfy intense sexual urges. 

Is there a sex addiction test?

There are quite a few sex addiction tests online. However, keep in mind that sex addiction is not a real mental disorder and that the results of these tests are not definitive. If you are interested in taking a test, you can find a few of them below.

• Sexual Addiction Screening Test
• Sex Addiction Test (Self-Assessment)
• Mind Diagnostics Sex Addiction Test

How many people are addicted to sex?

There is no way to know how many people around the world consider themselves to be sex addicts. However, in one 2018 study, 7% of women and 10% of men reported that their sexual thoughts and behaviors caused them significant sexual dysfunction. 

Sex addiction treatment

While a person may identify as a sex addict, their behaviors are often part of a larger group of issues.  A 2013 study published in Sexual Addiction & Compulsivity indicated more than 90% of those being treated for "sex addiction" had an underlying mental health disorder. 

Common mental health conditions associated with compulsive sex behaviors include borderline personality disorder, depression, anxiety disorders, and obsessive-compulsive disorder, says both Saltz and Ley. 

A possible explanation could be that these mental health conditions all share a common trait: issues with regulating the nervous system, from which sexual gratification might provide temporary relief.

"A lot of clinicians, who are poorly trained around sexuality, perceive these sexual behavior problems as the problem," Ley explains. "They are treating the symptom rather than the cause." 

It's also possible that there is no mental health issue occurring, and instead, a person is grappling with desires and behaviors that are outside of their values, community norms, or religious ideals.

Dealing with the underlying issue, whether it's a mental health disorder or otherwise, can help treat compulsive sexual behaviors, says Ley. If you're looking for sex addiction therapy, there are a few options. Treatments that have proven effective include: 

• Cognitive-behavioral therapy (CBT) 
• Mindfulness practices such as meditation
• Acceptance and commitment therapy (ACT) 
• Dialectical behavior therapy (DBT) 
• Medication meant to treat impulse control issues like mood stabilizers or naltrexone
• Antidepressants 

Getting help for sex addiction

If you believe that you are experiencing compulsive sexual behavior and you are finding it distressing, there are more ways to find help. Check out the following resources:  

• Sex Addicts Anonymous
• American Addiction Center
• The Sexual Recover Institute (Now called Relativity)

Insider's takeaway

Ultimately, treatment for compulsive sexual behaviors will vary from person to person depending on underlying cultural norms, values, relationship dynamics, and mental health conditions, says Saltz. That's why it's best to speak to a psychiatrist or therapist to determine an individualized treatment plan. 

And don't forget that sex, masturbation, and viewing pornography is often part of a completely healthy sexuality. The majority of people who enjoy sex, masturbation, and pornography do so without any harm to themselves or others.