Sex Addiction: Signs, Causes and Treatment

For most people, sex is a healthy activity and enjoying it is normal. However, sex addicts have an excessive preoccupation with sexual fantasies, urges or behaviors despite negative repercussions.

This article looks at the signs, symptoms, causes and effects of sex addiction, and how to overcome it.

What is sex addiction?

Sex addiction – also known as sexual behavior disorder and hypersexual disorder – is “a compulsive, uncontrollable and continuous sexual behavior irrespective of its adverse effects or consequences.”

Sex addiction was considered for inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, it was excluded despite an in-depth review of scientific research by Dr Martin Kafka, Professor of Psychiatry at Harvard Medical School. This exclusion has hindered the prevention, research and treatment of sex addiction, and left clinicians without a formal diagnosis for the disorder.

Types of sex addiction

There are several different types of sex addiction including:

  • Anonymous sex – high-risk encounters with strangers
  • Paying for sex – buying sexually-related services
  • Fantasy sex – an obsessive preoccupation with sexual fantasies
  • Seductive role sex – the manipulation of others into sexual acts
  • Voyeuristic sex – watching others engage in sexual activity or having sex
  • Exhibitionistic sex – this includes exposing private parts in public
  • Trading sex – sex is bartered or sold to gain control over others
  • Exploitative sex using sex to gain power and dominance over a vulnerable person
  • Intrusive sex – violating someone’s boundaries, often without their knowledge
  • Pain exchange sex – inflicting or experiencing physical or emotional pain during sex**.**

The four stages of sex addiction

Dr Patrick Carnes, a leading expert on sex addiction, has identified four stages of sex addiction (known as the addiction cycle) that go on repeatedly:

  1. Preoccupation – The addict’s mind is consumed by obsessive thoughts of sex and sexual activities; they crave sexual stimulation.
  2. Ritualization – This involves special routines that heighten arousal and excitement. These rituals may include wearing certain clothes, playing particular music or cleaning the house to create the right “vibe”.
  3. Compulsive sexual behavior – The addict uncontrollably carries out the sexual activity. This can include anonymous sex, extra-marital affairs, compulsive masterbation, exhibitionism, voyeurism and indecent phone calls.
  4. Despair – They feels hopeless, desperate and powerless to curb or stop their behavior.

Prevalence of sex addiction

The National Survey of Sexual Health and Behavior, which questioned around 2,000 US adults, found that more than 8% of respondents described symptoms of sex addiction.

Researchers reported that 10% of men and 7% of women said they have “significant levels of stress and dysfunction because of their sexual thoughts or behaviors.”

The researchers concluded that compulsive sexual behavior problems appear to be more common than major depression, which affects around 5% of the US population.

Signs and symptoms of a sex addict

Many people with sex addiction try to hide their behavior from others. They lie about their activities or engage in them secretly to avoid being found out. However, sometimes the signs and symptoms are obvious and may include some or all of the following:

  • Preoccupation with sex, even when it interferes with daily life, relationships, career etc
  • Unable to stop or control the sexual behavior
  • Engaging in extramarital or extra relationship affairs
  • Self-prostitution or the use of prostitutes
  • Compulsive relations with multiple partners, including strangers
  • Frequent use of pornography, phone sex or internet sex
  • Unsafe sex practices including putting themselves or others in danger
  • Excessive masturbation
  • Obsessive sexual thoughts and fantasies
  • Lying to cover up sexual activities or behaviors
  • Neglecting other hobbies and activities
  • Using sex to escape from other problems such as depression, anxiety or stress
  • Committing criminal sexual offenses
  • Feeling shame, embarrassment and remorse after sex.

Causes of sex addiction

Although the causes of sex addiction are not entirely understood, they may include one or more of the factors outlined below.

Imbalance of brain chemicals

Certain chemicals in the brain, such as serotonin, dopamine and norepinephrine, help regulate our mood. High levels and an imbalance of these chemicals may be related to sex addiction.

Changes in brain pathways

Sex addiction may cause changes in the brain’s neural circuits. As with other addictions, more intensive sexual engagement is typically required over time to gain the same levels of satisfaction or relief.

Medical conditions that affect the brain

Certain medical conditions, such as epilepsy and dementia, may cause damage to parts of the brain that affect sexual behavior. Also, around one in six people taking medication used to treat Parkinson’s disease develop addictive behaviors, including sex addiction.

Family history

Sex addiction is more common in people where there is a family history of addiction. Research shows that only 13% of sex addicts report coming from families with no addiction disorders. Family environment is also a factor. In the same research, sex addicts described their families as rigid, dogmatic, inflexible and disengaged. They came from dysfunctional environments where failure to bond was the norm.


The majority of people with sex addiction have experienced some type of abuse in childhood or adolescence. According to research, sex addicts report suffering from physical abuse (72%), sexual abuse (81%) and emotional abuse (97%).


Research has shown that sex addiction can develop as a coping mechanism for trauma or extreme stress. Eight different trauma responses have been identified using the Post Traumatic Stress Index.

Negative effects of sex addiction

There are a multitude of negative consequences associated with sex addiction. The health risks include an increase in sexually transmitted diseases and unwanted pregnancies.

There can be legal ramifications of illicit sexual activities such as indecent exposure in public places and non-consensual sex. Addicts commonly experience relationship problems including a loss of trust, increased conflict, marital difficulties and divorce. Paying for sex and job loss through masturbating or viewing pornography at work can cause severe financial strain. A further negative effect is the development of other addictions, like drugs or alcohol, to numb the feelings of guilt and shame.

Treatment for sex addiction

Recognizing that you have sex addiction may be difficult but if your sexual habits are negatively affecting your life, it is important to seek professional help.

At Kindbridge, our fully-licenced counsellors are experienced at treating sex addiction and other co-occurring mental health disorders. We will work with you to develop a personalized treatment plan tailored to your needs. Our high-quality online therapy sessions will help you regain control and establish a healthy sex life.

Get in touch today to book your free 30-minute consultation.