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Hypersexuality is extremely frequent or suddenly increased
libido Libido (; colloquial: sex drive) is a person's overall sexual drive or desire for sexual activity. Libido is influenced by biological, psychological, and social factors. Biologically, the sex hormones and associated neurotransmitters that act u ...
. It is controversial whether it should be included as a
clinical diagnosis Medical diagnosis (abbreviated Dx, Dx, or Ds) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as diagnosis with the medical context being implicit. The information req ...
used by
mental health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles Stress (biology), stress, interpersonal relationships, and decision-maki ...
care professionals. Nymphomania and satyriasis were terms previously used for the condition in women and men, respectively. Hypersexuality may be a primary condition, or the symptom of another medical disease or condition; for example,
Klüver–Bucy syndrome Klüver–Bucy syndrome is a syndrome resulting from bilateral lesions of the medial temporal lobe (including amygdaloid nucleus). Klüver–Bucy syndrome may present with compulsive eating, hypersexuality, insertion of inappropriate objects in ...
or
bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of Depression (mood), depression and periods of abnormally elevated Mood (psychology), mood that last from days to weeks each. If the elevat ...
. Hypersexuality may also present as a side effect of medication such as drugs used to treat
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms beco ...
. Clinicians have yet to reach a consensus over how best to describe hypersexuality as a primary condition, or to determine the appropriateness of describing such behaviors and impulses as a separate pathology. Hypersexual behaviors are viewed variously by clinicians and therapists as a type of obsessive-compulsive disorder (OCD) or "OCD-spectrum disorder", an addiction, or a disorder of impulsivity. A number of authors do not acknowledge such a pathology and instead assert that the condition merely reflects a cultural dislike of exceptional sexual behavior. Consistent with there not being any consensus over what causes hypersexuality, authors have used many different labels to refer to it, sometimes interchangeably, but often depending on which theory they favor or which specific behavior they were studying. Contemporary names include
compulsive masturbation Masturbation is the sexual stimulation of one's own genitals for sexual arousal or other sexual pleasure, usually to the point of orgasm. The stimulation may involve hands, fingers, everyday objects, sex toys such as vibrators, or combination ...
,
compulsive sexual behavior According to proponents of the concept, sexual addiction, also known as sex addiction, is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. The con ...
, cybersex addiction,
erotomania Erotomania, also known as de Clérambault's Syndrome, named after French psychiatrist Gaëtan Gatian de Clérambault, is listed in the DSM-5 as a subtype of a delusional disorder. It is a relatively uncommon paranoid condition that is character ...
, "excessive sexual drive", hyperphilia, hypersexuality, hypersexual disorder, problematic hypersexuality, sexual addiction, sexual compulsivity, sexual dependency, sexual impulsivity, "out of control sexual behavior", and
paraphilia Paraphilia (previously known as sexual perversion and sexual deviation) is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals. It has also been defined as sexual interest in anything ot ...
-related disorder.


Causes

There is little consensus among experts as to the causes of hypersexuality. Some research suggests that some cases can be linked to biochemical or physiological changes that accompany
dementia Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affe ...
, as dementia can lead to disinhibition. Psychological needs also complicate the biological explanation, which identifies the temporal/frontal lobe of the brain as the area for regulating libido. Injuries to this part of the brain increase the risk of aggressive behavior and other behavioral problems including personality changes and socially inappropriate sexual behavior such as hypersexuality. The same symptom can occur after unilateral temporal
lobotomy A lobotomy, or leucotomy, is a form of neurosurgical treatment for psychiatric disorder or neurological disorder (e.g. epilepsy) that involves severing connections in the brain's prefrontal cortex. The surgery causes most of the connections t ...
. There are other biological factors that are associated with hypersexuality such as premenstrual changes, and the exposure to virilising hormones in childhood or in utero.


Physiology

In research involving the use of
antiandrogen Antiandrogens, also known as androgen antagonists or testosterone blockers, are a class of drugs that prevent androgens like testosterone and dihydrotestosterone (DHT) from mediating their biological effects in the body. They act by blocking the ...
s to reduce undesirable sexual behaviour such as hypersexuality, testosterone has been found to be necessary, but not sufficient, for sexual drive. Other proposed factors include a lack of physical closeness and forgetfulness of the recent past. Pathogenic overactivity of the
dopaminergic Dopaminergic means "related to dopamine" (literally, "working on dopamine"), dopamine being a common neurotransmitter. Dopaminergic substances or actions increase dopamine-related activity in the brain. Dopaminergic brain pathways facilitate do ...
mesolimbic pathway The mesolimbic pathway, sometimes referred to as the reward pathway, is a dopaminergic pathway in the brain. The pathway connects the ventral tegmental area in the midbrain to the ventral striatum of the basal ganglia in the forebrain. The ven ...
in the brain—forming either psychiatrically, during
mania Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together wi ...
, or pharmacologically, as a side effect of dopamine agonists, specifically D3-preferring agonists—is associated with various
addiction Addiction is a neuropsychological disorder characterized by a persistent and intense urge to engage in certain behaviors, one of which is the usage of a drug, despite substantial harm and other negative consequences. Repetitive drug use o ...
s and has been shown to result among some in overindulgent, sometimes hypersexual, behavior. HPA axis dysregulation has been associated with hypersexual disorder. The American Association for Sex Addiction Therapy acknowledges biological factors as contributing causes of sex addiction. Other associated factors include psychological components (which affect mood and motivation as well as psychomotor and cognitive functions), spiritual control, mood disorders, sexual trauma, and
intimacy anorexia An intimate relationship is an interpersonal relationship that involves physical or emotional intimacy. Although an intimate relationship is commonly a sexual relationship, it may also be a non-sexual relationship involving family, friends, or ...
as causes or type of sex addiction.


As a symptom

Hypersexuality is known to present itself as a symptom in connection to a number of mental and neurological disorders. Some people with
borderline personality disorder Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong ...
(sometimes referred to as BPD) can be markedly impulsive, seductive, and extremely sexual.
Sexual promiscuity Promiscuity is the practice of engaging in sexual activity frequently with different partners or being indiscriminate in the choice of sexual partners. The term can carry a moral judgment. A common example of behavior viewed as promiscuous by ma ...
, sexual obsessions, and hypersexuality are very common symptoms for both men and women with BPD. On occasion for some there can be extreme forms of paraphilic drives and desires. "Borderline" patients, due in the opinion of some to the use of splitting, experience love and
sexuality Human sexuality is the way people experience and express themselves sexually. This involves biological, psychological, physical, erotic, emotional, social, or spiritual feelings and behaviors. Because it is a broad term, which has varied wit ...
in unstable ways. People with
bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of Depression (mood), depression and periods of abnormally elevated Mood (psychology), mood that last from days to weeks each. If the elevat ...
may often display tremendous swings in sex drive depending on their mood. As defined in the DSM-IV-TR, hypersexuality can be a symptom of
hypomania Hypomania (literally "under mania" or "less than mania") is a mental and behavioural disorder, characterised essentially by an apparently non-contextual elevation of mood (euphoria) that contributes to persistently disinhibited behaviour. Th ...
or
mania Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together wi ...
in
bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of Depression (mood), depression and periods of abnormally elevated Mood (psychology), mood that last from days to weeks each. If the elevat ...
or
schizoaffective disorder Schizoaffective disorder (SZA, SZD or SAD) is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis is made when the person has symptoms of both schizophrenia (usually psychosis) and a mood disorder: ...
.
Pick's disease Frontotemporal dementia (FTD), or frontotemporal degeneration disease, or frontotemporal neurocognitive disorder, encompasses several types of dementia involving the progressive degeneration of frontal and temporal lobes. FTDs broadly present a ...
causes damage to the temporal/frontal lobe of the brain; people with Pick's disease show a range of socially inappropriate behaviors. Several neurological conditions such as
Alzheimer's disease Alzheimer's disease (AD) is a neurodegenerative disease that usually starts slowly and progressively worsens. It is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As ...
,
autism The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...
,
ADHD Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inap ...
, various types of brain injury,
Klüver–Bucy syndrome Klüver–Bucy syndrome is a syndrome resulting from bilateral lesions of the medial temporal lobe (including amygdaloid nucleus). Klüver–Bucy syndrome may present with compulsive eating, hypersexuality, insertion of inappropriate objects in ...
, Kleine–Levin syndrome, and many more neurodegenerative diseases can cause hypersexual behavior. Sexually inappropriate behavior has been shown to occur in 7–8% of Alzheimer's patients living at home, at a care facility or in a hospital setting. Hypersexuality has also been reported to result as a side-effect of some medications used to treat
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms beco ...
. Some recreationally used drugs, such as
methamphetamine Methamphetamine (contracted from ) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Methamp ...
, may also contribute to hypersexual behavior. A positive link between the severity of dementia and occurrence of inappropriate behavior has also been found. Hypersexuality can be caused by dementia in a number of ways, including disinhibition due to organic disease, misreading of social cues, understimulation, the persistence of learned sexual behavior after other behaviours have been lost, and the side-effects of the drugs used to treat dementia. Other possible causes of dementia-related hypersexuality include an inappropriately expressed psychological need for
intimacy An intimate relationship is an interpersonal relationship that involves physical or emotional intimacy. Although an intimate relationship is commonly a sexual relationship, it may also be a non-sexual relationship involving family, friends, or ...
and forgetfulness of the recent past. As this illness progresses, increasing hypersexuality has been theorized to sometimes compensate for declining self-esteem and cognitive function. Symptoms of hypersexuality are also similar to those of sexual addiction in that they embody similar traits. These symptoms include the inability to be intimate (
intimacy anorexia An intimate relationship is an interpersonal relationship that involves physical or emotional intimacy. Although an intimate relationship is commonly a sexual relationship, it may also be a non-sexual relationship involving family, friends, or ...
), depression and bipolar disorders. The resulting hypersexuality may have an impact in the person's social and occupational domains if the underlying symptoms have a large enough systemic influence.


As a disorder

, a proposal to add ''
Sexual Addiction According to proponents of the concept, sexual addiction, also known as sex addiction, is a state characterized by compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences. The c ...
'' to the
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...
(DSM) system has failed to get support of the
American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 37,000 members are invo ...
(APA). The DSM does include an entry called Sexual Disorder Not Otherwise Specified (Sexual Disorder NOS) to apply to, among other conditions, "distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used". The
International Statistical Classification of Diseases and Related Health Problems The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and coordinating ...
(ICD-10) of the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level o ...
(WHO), includes two relevant entries. One is "Excessive Sexual Drive" (coded F52.7), which is divided into satyriasis for males and nymphomania for females. The other is "Excessive Masturbation" or "Onanism (excessive)" (coded F98.8). In 1988, Levine and Troiden questioned whether it makes sense to discuss hypersexuality at all, arguing that labeling sexual urges "extreme" merely stigmatizes people who do not conform to the norms of their culture or peer group, and that sexual compulsivity be a myth. However, and in contrast to this view, 30 years later in 2018, the
ICD-11 The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...
created a new condition classification, compulsive sexual behavior, to cover "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour". It classifies this "failure to control" as an abnormal mental health condition.


Treatment

Hypersexuality may negatively impact an individual. The concept of hypersexuality as an addiction was started in the 1970s by former members of
Alcoholics Anonymous Alcoholics Anonymous (AA) is an international mutual aid fellowship of alcoholics dedicated to abstinence-based recovery from alcoholism through its spiritually-inclined Twelve Step program. Following its Twelve Traditions, AA is non-professi ...
who felt they experienced a similar lack of control and compulsivity with sexual behaviors as with alcohol. Multiple 12-step style self-help groups now exist for people who identify as sex addicts, including Sex Addicts Anonymous,
Sexaholics Anonymous Sexaholics Anonymous (SA) founded in 1979 is one of several twelve-step programs for compulsive sexual behavior based on the original twelve steps of Alcoholics Anonymous. SA takes its place among various twelve-step groups that seek recovery fr ...
,
Sex and Love Addicts Anonymous Sex and Love Addicts Anonymous (SLAA) is a twelve-step program for people recovering from sex addiction and love addiction. SLAA was founded in Boston, Massachusetts in 1976, by a member of Alcoholics Anonymous (AA). Though he had been a membe ...
, and
Sexual Compulsives Anonymous Sexual Compulsives Anonymous (SCA) is a twelve-step program for people who want to stop having compulsive sex. SCA founding is attributed variously to 1982 in New York City and to 1973 in Los Angeles. Although the fellowship originally sought to ...
. Some hypersexual men may treat their condition with the usage of medication (such as
Cyproterone acetate Cyproterone acetate (CPA), sold alone under the brand name Androcur or with ethinylestradiol under the brand names Diane or Diane-35 among others, is an antiandrogen and progestin medication used in the treatment of androgen-dependent condition ...
) or consuming foods considered to be
anaphrodisiac An anaphrodisiac (also antaphrodisiac or antiaphrodisiac) is a substance that quells or blunts the libido. It is the opposite of an aphrodisiac, something that enhances sexual appetite. The word ''anaphrodisiac'' comes from the Greek privative pr ...
s. Other hypersexuals may choose a route of consultation, such as psychotherapy, self-help groups or counselling.


Terminology

The ''
Merriam-Webster Dictionary ''Webster's Dictionary'' is any of the English language dictionaries edited in the early 19th century by American lexicographer Noah Webster (1758–1843), as well as numerous related or unrelated dictionaries that have adopted the Webster's ...
'' defines ''hypersexual'' as "exhibiting unusual or excessive concern with or indulgence in sexual activity".
Sexologists Sexology is the scientific study of human sexuality, including human sexual interests, behaviors, and functions. The term ''sexology'' does not generally refer to the non-scientific study of sexuality, such as social criticism. Sexologists ap ...
have been using the term ''hypersexuality'' since the late 1800s, when
Krafft-Ebing Richard Freiherr von Krafft-Ebing (full name Richard Fridolin Joseph Freiherr Krafft von Festenberg auf Frohnberg, genannt von Ebing; 14 August 1840 – 22 December 1902) was a German psychiatrist and author of the foundational work '' Psychopath ...
described several cases of extreme sexual behaviours in his seminal 1886 book, '' Psychopathia Sexualis.'' The author used the term "hypersexuality" to describe conditions that would now be termed premature ejaculation. Terms to describe males with the condition include ''donjuanist'', ''satyromaniac'', ''satyriac'' and ''satyriasist'', for women ''clitoromaniac'', ''nympho'' and ''nymphomaniac'', for teleiophilic (attracted to adults)
heterosexual Heterosexuality is romantic attraction, sexual attraction or sexual behavior between people of the opposite sex or gender. As a sexual orientation, heterosexuality is "an enduring pattern of emotional, romantic, and/or sexual attractions" ...
women ''andromaniac'', while ''hypersexualist'', ''sexaholic'', ''onanist'', ''hyperphiliac'' and ''erotomaniac'' are gender neutral terms. Other, mostly historical, names include
Don Juanism Don Juanism or Don Juan syndrome is a non-clinical term for the desire, in a man, to have sex with many different female partners. The name derives from the Don Juan of opera and fiction. The term satyriasis is sometimes used as a synonym for Don ...
, the
Messalina Valeria Messalina (; ) was the third wife of Roman emperor Claudius. She was a paternal cousin of Emperor Nero, a second cousin of Emperor Caligula, and a great-grandniece of Emperor Augustus. A powerful and influential woman with a reputation ...
complex, sexaholism, hyperlibido and furor uterinus.


See also

* Erotophilia * Persistent genital arousal disorder * Pornography addiction *
Sexual Compulsivity Scale The Sexual Compulsivity Scale (SCS) - Sexual Sensation Seeking and Sexual Compulsivity Scale - is a psychometric measure of a high libido, hypersexuality and sexual addiction According to proponents of the concept, sexual addiction, also known ...
* Hypersexual disorder


References


External links

* WikiSaurus:libidinist {{Authority control Sexual dysfunctions Casual sex Human sexuality Sexual addiction Sexual arousal Sexual health Sexuality