Sex addiction may be somewhat difficult to define simply because the range of what is “normal” sexually is quite broad. Hormonal levels that stimulate sexual desire are different in various individuals.
For one person, enjoying sex several times per week is perfectly normal while, for another, once a month might be quite satisfactory.
Sex addiction occurs when a person feels he has lost control over whether or not he engages in sexual behavior. He has likely attempted to stop the compulsive sexual behavior without success. The sex addict will continue to seek out sexual encounters in spite of negative or harmful consequences. Finally, the sex addict obsessively thinks about sex and spends inordinate amounts of time planning the next sexual encounter.
The unique patterns of behavior and brain activity found in addictions are true for substance and behavioral addictions alike. Sex addiction encompasses a variety of sexual behaviors including:
Having multiple affairs, either sequential or simultaneous
Having multiple or anonymous sexual partners and/or one-night stands
Having unsafe sex
Engaging in cybersex or phone sex
Using prostitutes or escort services
Visiting strip clubs and adult entertainment venues
Frequenting massage parlors
Having sexual paraphilias
Sexually addicted women are at particular risk for unplanned pregnancies, complications from abortions, and violence. Like men, sexually addicted women are also susceptible to sexually transmitted diseases.
More needs to be said about the sexual paraphilias. Sexual paraphilias are recurrent sexually arousing fantasies, sexual urges, or behaviors that are pathological in nature, and frequently illegal. Exhibitionism is the exposure of one's genitals to a stranger, sometimes masturbating as part of the experience. A fetish is the use of a nonliving object, such as women's undergarments, for sexual stimulation. Again, fetishism is frequently associated with masturbation.
Frotteurism is another type of sexual paraphilia and involves touching and rubbing against a nonconsenting person and often occurs in crowded places such as a mall, sports event, or public transportation. Pedophilia is sexual activity with a prepubescent child and is, of course, illegal. Sexual masochism is an act of being humiliated, beaten, bound, and so forth for sexual stimulation and arousal. Sexual sadism involves the infliction of psychological or physical suffering on another for the purpose of sexual excitement.
Transvestic fetishism is dressing in clothing of the opposite gender and masturbating while cross-dressed. Finally, voyeurism is the act of watching unsuspecting individuals disrobing or engaging in sexual activity. The voyeur achieves sexual excitement through watching and frequently simultaneously masturbates.
Paraphilias are overwhelmingly associated with men. Except for sexual masochism, other paraphilias are a rarity in women. Even in sexual masochism, the ratio is 20 men to one woman in terms of occurrence. However, the accuracy of statistics obtained from Internet sources is questionable because of the ability of respondents to disguise their gender and age.
What causes sex addiction? Psychological factors include fear of intimacy, a negative way of releasing anger, or guilt/shame, which may have stemmed from a history of sexual abuse, familial sexual secrets, or observing the sexual activity of one's parents. Sexually addictive behavior can also be a means of managing stress or numbing emotional pain. Environmental factors may include watching pornography or sexually explicit movies, listening to erotic music lyrics, or being influenced by friends involved in sex addictions.
Biologically, all of the chemistry described in love addiction applies here. Additionally, the desire for sexual release is associated with rising levels of testosterone in both sexes. Interesting to note, testosterone is highest in men early in the morning and in women around ovulation. Testosterone levels fall with the experience of sexual release and then build again to motivate further sexual activity.
Although sex addicts may become involved in illegal sexual activities, it is important to recognize that this is not inevitable. A sex addict is not doomed to become a sexual offender. Sex addiction is highly associated with risk-taking and then blaming others for the resulting problems.
The brain literally goes wild during an orgasm. The vagus nerves, the reticular formation, basal ganglia, anterior insular cortex, amygdala, cerebellum, and hypothalamus are all involved during the sexual stimulation of orgasm. Biologically and chemically speaking, sexual activity can be very reinforcing, and for the person who has crossed the line into sex addiction, recovery is possible but understandably difficult.
Treatment focuses on establishing behavioral control and helping the sex addict to develop a healthy perspective of sexuality through education and psychotherapy. Sex Addicts Anonymous is a twelve-step group specifically designed to address this addiction and offers group support. Medications such as Prozac, Anafranil, and others used to treat obsessive-compulsive symptoms may be helpful in managing the obsessive nature of this disorder.