Hypersexuality

Hypersexuality refers to a pattern of sexual thoughts, urges, or behaviors that are intense, frequent, or difficult to control and that cause distress or impairment in daily functioning. It is not uniformly recognized as a discrete clinical disorder in all diagnostic systems. In DSM-5, it was discussed as a proposed diagnosis but not adopted; in ICD-11, the term Compulsive Sexual Behavior Disorder is used to describe a persistent pattern of failing to control intense sexual impulses or urges, leading to distress or impairment.

Signs and symptoms commonly described include excessive preoccupation with sexual fantasies or activities, repeated attempts to reduce or control behavior that are unsuccessful, spending substantial time on sexual activities or porn, neglect of responsibilities or relationships, and engaging in sexual acts that are risky or illegal to obtain relief or gratification. The presentation can vary widely and may overlap with other conditions such as mood or anxiety disorders, obsessive–compulsive disorder, substance use disorders, or personality disorders.

Causes are multifactorial and not fully understood. Biological factors may involve dysregulated reward pathways and neurotransmitters; psychological factors include trauma, attachment issues, and coping strategies; social and cultural factors can influence attitudes toward sexuality. Comorbidity is common, and secondary causes should be evaluated, including medications or medical conditions that affect sexual function or behavior.

Assessment typically involves clinical interview, evaluation of distress and impairment, and consideration of differential diagnoses. Treatment often includes psychotherapy (such as cognitive-behavioral therapy or relapse-prevention approaches), psychoeducation, and addressing comorbid conditions. Pharmacological options—used cautiously and on a case-by-case basis—may include selective serotonin reuptake inhibitors or, in some severe cases, hormonal agents. Supportive resources and harm-reduction strategies can be beneficial.