What Is Sexual Addiction (Nymphomania)? What Causes Sexual Addiction?
Sexual addiction, also called sexual dependency, hypersexuality, nymphomania, compulsive sexual behavior and sexual compulsivity, refers to the phenomenon in which individuals report being unable to manage their sexual behavior. People who are obsessed with sexual thoughts, feelings or behaviors that affect their health, job, relationships or other parts of their life, may have compulsive sexual behavior. Some experts believe that sexual addiction is actually a form of obsessive compulsive disorder.
Sexual addiction may involve a normally enjoyable sexual experience that becomes an obsession. Or compulsive sexual behavior may involve fantasies or activities outside the limits of culturally, legally or morally accepted sexual behavior.
According to Medilexicon's medical dictionary Nymphomania is "An insatiable impulse to engage in sexual behavior in a female; the counterpart of satyriasis in a male".
If untreated compulsive sexual behavior can damage self-esteem, relationships, career and other people. But with treatment and self-help, compulsive sexual behavior can be managed. The World Health Organization in the International Classification of Diseases (ICD) includes "excessive sexual drive" as a diagnosis of sexual addiction.
What are the signs and symptoms of sexual addiction?
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign. Compulsive sexual behavior symptoms vary in type and severity. Some compulsive sexual behaviors include:
* Sexual impulses are intense and feel as if they are beyond control.
* Even though the person feels driven to engage in certain sexual behavior, they may or may not find the activity a source of pleasure or satisfaction.
* Compulsive sexual behavior is used as an escape from other problems, such as loneliness, depression, anxiety or stress.
* Person continues to engage in risky sexual behavior despite serious consequences, such as potential transmission of a sexually transmitted disease, the loss of important relationships, trouble at work or legal problems.
* Trouble establishing and maintaining emotional closeness, even if married or in a committed relationship.
Broad range of sexual activities that can be warning signs of compulsive sexual behavior that can include:
* Avoiding emotional involvement in sexual relationships
* Engaging in excessive masturbation
* Engaging in masochistic or sadistic sex
* Exhibitionism
* Frequently using pornographic materials
* Having a fixation on an unattainable sex partner
* Having multiple sexual partners or extramarital affairs
* Having sex with anonymous partners or prostitutes
* Using commercial sexually explicit phone and Internet services (Cybersex)
If you feel like you have lost control of sexual behavior, get medical help. Compulsive sexual behavior tends to become more intense and difficult to control over time. It is essential to get help when the first signs are recognized. Efforts to use pure willpower to resist sexual compulsions may not succeed because the urges can be so powerful.
Some questions to ask when deciding whether to seek professional help:
* Can I control my sexual impulses?
* Do I try to hide my sexual behavior?
* Is my sexual behavior hurting my relationships, affecting my work or resulting in negative consequences, such as getting arrested?
* Is sex constantly on my mind, even when I don't want to think about it?
Seek immediate treatment if:
* You think you may cause harm with uncontrolled sexual behavior
* You have bipolar disorder or other problems with impulse control. You feel like your sexual behavior is slipping out of control
* You are suicidal
What are the causes of sexual addiction?
The exact causes of compulsive sexual behavior remain unclear. Causes may include:
* An imbalance of natural brain chemicals. High levels of certain chemicals in the brain (neurotransmitters) such as serotonin, dopamine and norepinephrine may be related to compulsive sexual behavior. These brain chemicals also help regulate mood.
* Sex hormone levels. Androgens are sex hormones that occur naturally in both men and women. Androgens also have a vital role in sexual desire. But it is not clear exactly how they are related to compulsive sexual behavior.
* Conditions that affect the brain. Certain diseases or health problems may cause damage to parts of the brain that affect sexual behavior. Multiple sclerosis, epilepsy, Huntington's disease and dementia have all been associated with compulsive sexual behavior. In addition, treatment of Parkinson's disease with some dopamine agonist medications may cause compulsive sexual behavior.
* Changes in brain pathways. Compulsive sexual behavior is an addiction that over time might actually cause changes in the brain's neural circuits which is the network of nerves that allows brain cells to communicate with one another. These changes may cause pleasant reactions by engaging in sexual behavior and unpleasant reactions when the behavior is stopped.
Neurochemical theories
Some experts argued that neurochemical changes, similar to an adrenaline rush in the brain, temporarily reduce the discomfort an individual experiences with urges and cravings for sexualized behaviors that can be achieved through obsessive, highly ritualized patterns of sexual behavior.
Psychological distress theories
Some experts argue that when children are growing up, they develop "core beliefs" through the way that their family functions and treats them. A child brought up with proper care has probabilities of growing up well, having faith in other people, and having self worth. On the other hand, a child who is neglected will develop unhealthy and negative core beliefs. They grow up to believe that people in the world do not care about them. Later in life, the person has trouble keeping stable relationships and feels isolated. Generally, addicts do not perceive themselves as worthwhile human beings. They cope with these feelings of isolation and weakness by engaging in excessive sex.
What are the risk factors of sexual addiction?
Compulsive sexual behavior can occur in both men and women however it is most common in men. It can also affect anyone regardless of sexual preference (heterosexual, homosexual or bisexual).
Compulsive sexual behavior often occurs in people who have:
* A history of physical or sexual abuse
* Alcohol or drug abuse problems
* Another psychological condition (mood disorder, impulse control disorder or other mental health problem)
People who suffer from bipolar disorder may often display tremendous swings in sex drive depending on their mood. Hypersexuality may be expressed during periods of mania or hypomania. Several neurological conditions such as Alzheimer's disease, various types of brain injury, Klüver-Bucy syndrome, Kleine-Levin syndrome, and many more neuro-degenerative diseases can cause hypersexual behavior. Importantly, at times, drugs can contribute to hypersexual behavior.
What are the complications of compulsive sexual behavior?
Compulsive sexual behavior can have numerous negative consequences that affect both the person suffering from the disorder and others.
* Accumulating financial debts by purchasing pornography and sexual services
* Being arrested for sexual offenses
* Contracting HIV, hepatitis or another sexually transmitted disease, or passing a sexually transmitted disease to someone else
* Developing other mental health conditions, such as depression, extreme stress and anxiety
* Engaging in unhealthy substance use, such as drug or alcohol abuse
* Facing an unwanted pregnancy and its consequences
* Losing focus or engaging in sexual activity at work, risking job
* Neglecting or lying to partner and family, challenging or destroying meaningful relationships
* Struggling with feelings of guilt, shame and low self-esteem
How is sexual addiction diagnosed?
To help the diagnosis, a medical examination with a thorough physical exam will assist in detecting whether there may be any underlying conditions linked to sexual feelings and behavior.
A psychological evaluation, may involve answering a number of questions about:
* Physical and mental health as well as overall emotional well-being
* Sexual thoughts, behaviors and compulsions
* Use of drugs and alcohol
* Family, relationships and social situation
Mental health provider may also request input from family and friends.
The diagnosis
Mental health providers refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnose mental health problems, including compulsive sexual behavior.
Sexual addiction is defined as a condition in which some form of sexual behavior is employed in a pattern that is characterized at least by two key features: recurrent failure to control the behavior and continuation of the behavior despite harmful consequences.
Compulsive sexual behavior does not have its own diagnostic category in the DSM. It is often diagnosed as a subcategory of another mental health condition. Diagnosis depends on the type and severity of the behavior.
Diagnosis of sexual behavior as a subcategory
In many cases, compulsive sexual behaviors are common and generally accepted sexual activities taken to an extreme. These may be diagnosed as a subcategory of another mental health condition, such as an impulse control disorder or an obsessive-compulsive disorder. Sexual addiction is considered to be (but is not always) associated with obsessive-compulsive disorder (OCD), narcissistic personality disorder, and manic-depression.
Diagnosis of sexual behavior as a paraphilia
In some cases, it is difficult to determine when normal sexual behavior crosses the line into problem sexual behavior. There are diagnostic criteria for clearly unhealthy sexual behaviors called paraphilias. They are behaviors that are generally considered harmful or socially unacceptable or are illegal. Diagnostic categories for paraphilias include:
* Exhibitionism, sexually arousing fantasies, sexual urges or behaviors involving the exposure of genitals to an unsuspecting stranger.
* Fetishism, sexually arousing fantasies, sexual urges or behaviors involving the use of objects.
* Frotteurism, sexual urges or behaviors involving touching and rubbing against a non-consenting person.
* Pedophilia, sexually arousing fantasies, sexual urges or behaviors involving sexual activity with a child or children.
* Sexual masochism, sexually arousing fantasies, urges, or behaviors involving being humiliated, beaten, bound or made to suffer.
* Sexual sadism, sexually arousing fantasies, sexual urges or behaviors involving acts in which the psychological or physical suffering, including humiliation, of the victim is sexually exciting.
* Transvestic fetishism, sexually arousing fantasies, sexual urges or behaviors involving cross-dressing in a heterosexual male. A person diagnosed with transvestic fetishism may also have gender dysphoria which is discomfort with gender role or identity.
* Voyeurism, sexually arousing fantasies, sexual urges or behaviors involving the act of observing unsuspecting persons who are naked or engaging in sexual activity.
* Paraphilia not otherwise specified, sexually arousing fantasies that do not meet the criteria for any of the specific categories. Examples include sexual behaviors involving obscene phone calls (telephone scatologia), obsession with dead bodies (necrophilia), exclusive focus on part of body (partialism), animals (zoophilia), feces (coprophilia), enemas ( klismaphilia) and urine (urophilia).
Whatever the nature of the compulsive sexual behavior, it is essential to seek a professional evaluation.
What is the treatment?
Help may be available through an out-patient or in-patient program or private counselor.
Treatment for compulsive sexual behavior typically involves psychotherapy, medications and self-help groups. A primary goal of treatment is to help the patient manage urges and reduce excessive behaviors while maintaining healthy sexual activities.
Patients with other addictions or severe mental health problems may benefit from inpatient treatment at first.
A mental health provider, such as a psychiatrist or psychologist, who has experience in treating sexual behavior disorders, will best assist in the treatment.
People who have compulsive sexual behavior may also need treatment for another mental health condition as well. Compulsive sexual behavior often comes with alcohol or drug abuse problems or other mental health problems that need treatment (obsessive-compulsive behaviors, anxiety or a mood disorder such as depression).
Seeking help for a sexual behavior can be difficult because it is a personal matter. Set aside any shame or embarrassment and focus on the benefits of getting treatment. Many people struggle with sexual urges that are extremely powerful and difficult to manage. Mental health providers are aware of this. They are trained to be understanding, discreet and helpful. What is discussed in sessions is kept confidential (except in cases where patient admits to planning or committing a crime or harming someone else).
Psychotherapy
Several forms of psychotherapy may help compulsive sexual behavior:
* Cognitive behavioral therapy. This form of therapy helps identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones.
* Family therapy or marriage counseling. Since compulsive sexual behavior affects the entire family, it is often helpful to involve partner or children in joint therapy sessions.
* Group therapy. It involves meeting regularly with a group, under guidance of a mental health professional, to explore emotions and relationships.
* Psychodynamic psychotherapy. It focuses on increasing awareness of unconscious thoughts and behaviors, developing new insights into motivations, and resolving conflicts.
Medications
Certain medications may be helpful. They act on brain chemicals linked to obsessive thoughts and behaviors. They reduce the chemical "rewards" these behaviors provide when acting on them. The type of medication depends on the overall situation and other mental health conditions or addictions that may exist.
Patients may have to try several medications, or a combination of medications, to find what works best with the fewest side effects. Medications used to treat compulsive sexual behavior are often used primarily for other conditions. They include:
* Antidepressants. Most commonly used to treat compulsive sexual behavior are selective serotonin reuptake inhibitors (SSRIs). These include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft) and others.
* Mood stabilizers. Such as lithium (Eskalith, Lithobid).These medications are generally used to treat bipolar disorder (manic depression). They may reduce uncontrolled sexual urges.
* Naltrexone (ReVia). This medication is generally used to treat alcoholism. It blocks the part of the brain that feels pleasure with certain addictive behaviors.
* Anti-androgens. These medications reduce the biological effects of sex hormones (androgens) in men. One example is medroxyprogesterone. They reduce sexual urges. Anti-androgens are often used in men whose compulsive sexual behavior is dangerous to others, such as pedophilia.
* Luteinizing hormone-releasing hormone (LHRH). This medication may reduce obsessive sexual thoughts by reducing the production of testosterone.
* Anti-anxiety medications. Examples include clonazepam (Klonopin), lorazepam (Ativan), chlordiazepoxide (Librium), diazepam (Valium) and alprazolam (Xanax). These medications are used to reduce serious anxiety and aggression in emergency situations. They are generally avoided, as they may worsen compulsive behavior in the long run.
Self-help groups
Self-help and support groups can be effective for sexual addiction and dealing with all of the issues it can cause. Most are modeled after the 12-step program of Alcoholics Anonymous (AA). They help making changes directly. With these groups the patients can help learn about their disorder, find support and understanding in their condition. They help identify additional treatment options and resources. These groups may either be Internet based or have local in-person meetings or both. Find one where you are comfortable. Ask a mental health provider about alternatives.
* Codependents of Sex Addicts (COSA)
* S-Anon International Family Groups
* Sex Addicts Anonymous
* Sex and Love Addicts Anonymous
* Sexaholics Anonymous
* Sexual Compulsives Anonymous
* Sexual Recovery Anonymous
Coping
Some steps can be taken while getting professional treatment.
* Stick to the treatment plan. Take medications as directed and attend scheduled therapy sessions. It may be difficult and there may be occasional setbacks.
* Inform yourself. Learn about compulsive sexual behavior in order to better understand its causes and treatment.
* Identify what drives you. Recognize situations, thoughts and feelings that may trigger sexual compulsions in order to take steps to manage them.
* Avoid risky situations. Do not jeopardize your health or that of others. Avoid situations where you will be tempted to engage in risky sexual practices.
* Get treatment for substance abuse or other mental health problems. Addictions, depression, anxiety and stress can feed off each other. This leads to a cycle of unhealthy behavior.
* Find healthy activities. Explore healthy ways to re-channel sexual compulsions through exercise and recreational activities.
* Practice relaxation and stress management. Try stress-reduction techniques, such as meditation, yoga or tai chi.
* Focus on goals. Recovery from compulsive sexual behavior can take time. Keep motivated by keeping recovery goals in mind. Remember it is possible to repair damaged relationships, friendships and financial problems.
Prevention
A few recommendations:
* Get help as soon as possible. Identifying and treating early symptoms may help prevent compulsive sexual behavior from getting worse over time. This can stop the acceleration into a downward spiral of shame, self-esteem problems and harmful acts.
* Seek treatment early for mental health disorders. Compulsive sexual behavior may be worsened by depression, anxiety or obsessive-compulsive behavior.
* Identify and seek help for alcohol and drug abuse problems. Mental health disorders and substance abuse can cause a loss of control and unhappiness. It can impair judgment and may lead toward unhealthy sexual behaviors.
* Seek treatment for childhood sexual abuse. Many people with compulsive sexual behavior were sexually abused as children. Appropriate professional treatment may help heal those emotional scars. |
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