Compulsive Sexual Behavior: Symptoms and Main Causes

Compulsive sexual behavior is characterized by having a behavior pattern that involves the inability to control sexual impulses.
Compulsive Sexual Behavior: Symptoms and Main Causes
Leticia Aguilar Iborra

Written and verified by la psicóloga Leticia Aguilar Iborra.

Last update: 11 April, 2023

Compulsive sexual behavior encompasses sexual behaviors that are difficult to control, despite the consequences that this may have for the person and for their family in the long term. They usually manifest in a similar way to other addictive behavior (pathological gambling or alcohol consumption, for example)

It has had different names, from nymphomania to hypersexuality, erotomania, or satyriasis, and it may be confused with some obsessive-compulsive disorder (OCD) behaviors. However, they are two very different things, as the main difference is based on impulsive actions, something contrary to OCD.

What is sexually compulsive behavior?

This term refers to a maladaptive pattern of sexual behaviors. It leads to significant stress and discomfort for the person who suffers from it, as certain behaviors deviate from the norm, generating dissatisfaction. Some of the parameters are usually the following:

  • Tolerance: Frequent increase in sexual behavior to reach the desired level of intensity
  • Withdrawal: Psychophysiological needs when sexual behavior is discontinued. Therefore, it occurs more and more over time and with greater intensity.
  • There are conscious attempts to avoid it, but other important activities for the person are left out, generating greater dissatisfaction.
  • Despite recognition of the problem, compulsive sexual behavior continues.

Is it a sexual dependency?

Coleman pointed to two dynamic factors in compulsive sexual behavior. The first of them predisposes the person to the compulsive use of substances or behaviors as a way of eliminating or reducing emotional discomfort. The second predisposes them to perform sexual behaviors as a key way to alleviate their discomfort.

Therefore, it’s understood that sexual behavior can resemble an addictive phenomenon, such as substance use. It’s used in order to eliminate discomfort. The problem is that, like other types of addictions, the person spends all their time eliminating their emotional pain.

The letters XXX on a computer screen.
Pornography is a means by which patients channel their compulsive sexual behavior.

Symptoms of compulsive sexual behavior

The symptoms of compulsive sexual behavior vary from one person to another, depending on the sexual fantasies, being difficult to control in many cases and generating intense anguish. Consequently, the person usually uses various activities to alleviate their discomfort.

The most frequent behaviors are the following:

  • Compulsive masturbation: This is the most common action inside and outside the marital context. In cases of compulsive sexual behavior, there may be damage associated with abrasions or even injuries in men.
  • Prolonged promiscuity: The search for sexual partners for sporadic sexual encounters. In cases of compulsive sexual behavior, there may be the spread of sexually transmitted diseases and a rupture in a couple’s sentimental bond.
  • Use of pornography: In some cases, it reaches the point of dependence on using magazines or videos with pornographic content. In cases of compulsive sexual behavior, the use of pornography is usually associated with masturbation and, in turn, losing sexual interest in one’s partner. If pornography is associated with prepubescent arousal, the need for an evaluation for pedophilia should be considered.
  • Dependence on phone sex and cybersex: A tendency to call erotic phone numbers and join online groups with sexual content. One of the consequences of this type of behavior is the possible financial indebtedness of the person.

The main causes of compulsive sexual behavior

The causes of compulsive sexual behavior aren’t entirely clear. The development of these types of impulsive behaviors and not others may be due to early childhood experiences. These experiences, if they’ve been constant over time, give rise to ineffective coping strategies, such as impulsivity.

A history of sexual abuse isn’t necessary. The presence of other experiences, such as the extreme inhibition and disinhibition of emotions from early childhood can also play a role. To this, we can add other forms of physical punishment in childhood.

Comorbidity with other psychological disorders

Compulsive sexual behavior is considered, in many cases, a comorbid disorder with others. These can be constituted, for example, within the context of OCD, requiring an exhaustive diagnosis to differentiate them.

Borderline personality disorder (BPD) is characterized by extreme impulsiveness caused by very intense emotions. There may be an increase in sexual behavior in these people that’s aimed at reducing the discomfort caused by the intensity of emotions. However, in BPD, problem behavior isn’t reduced to compulsive sexual behavior alone.

Compulsive sexual behavior may also show up in post-traumatic stress disorder (PTSD) and dissociation. In PTSD, emotion regulation is often poor. In addition, there are dissociative factors, with the possibility that the person isn’t aware of their use of sex to try to reduce suffering.

Group therapy for sex addiction.
Group therapy can be a support to provide an emotional network of patients.

The treatment of compulsive sexual behavior

Treatment for compulsive sexual behavior is often difficult for one reason: Many people with this type of disorder tend not to seek help, either because they don’t see it as a problem or because they’re embarrassed.

The consequences are quite evident, ranging from marital and family problems to economic or even legal issues. The latter are characterized by the performance of grotesque behaviors in public or the development of non-consensual sexual practices.

Psychopharmacology or psychological therapy?

Pharmacological treatment is usually combined with psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) have been the most widely used. Specifically, fluoxetine, sertraline, paroxetine, venlafaxine, fluvoxamine, mirtazapine, citalopram, and duloxetine.

Psychological treatment is also an important factor. Cognitive-behavioral therapies are often used for individual attention. However, couple’s therapy should also be considered.

Group therapy, made up of the same components of the 12-Step Alcoholics Anonymous program, is also an option for skill development and learning about the experience of other people with the same problem. With respect to the person’s relatives, systemic family therapy works on areas of deficit and somewhat reduces the person’s burden of discomfort.

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  • Romero, MARIA B. “Adicción sexual y trauma temprano.” Revista de Psicotrauma para Iberoamérica 4.1 (2005): 32-41.
  • Actis, Carlos Chiclana, et al. “Adicción al sexo:¿ patología independiente o síntoma comórbido?.” Cuadernos de medicina psicosomática y psiquiatria de enlace 115 (2015): 19-26.
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