Hypersexuality: Meaning, Symptoms, Causes and Treatment

Hypersexuality means sexual urges, fantasies or behavior that feel out of control and keep causing distress or harm. It isn’t the same as a high sex drive, and the closest formal diagnosis is compulsive sexual behaviour disorder in the World Health Organization’s ICD-11.

You may have heard the word from a partner, a therapist or a video. The term covers sexual behavior of any kind, including porn, masturbation and sex with partners, and it can be the main problem or a sign of another condition, such as bipolar disorder or a medication side effect. This guide covers what the research says about the meaning, symptoms, causes and treatment of hypersexuality, and what you can do next. If your concern is porn specifically, start with the porn addiction guide.

Hypersexuality at a Glance

Question	Short answer
What does it mean?	Sexual urges, fantasies or behavior that are hard to control and cause distress (Walton et al., 2017).
Is it a diagnosis?	The ICD-11 lists compulsive sexual behaviour disorder (Kraus et al., 2018). DSM-5 did not include the proposed criteria for hypersexual disorder (Kraus, Voon & Potenza, 2016).
Is it the same as a high sex drive?	No. In a Croatian survey of men, the hypersexuality group and the high-desire group overlapped in only four men (Štulhofer et al., 2016).
How common is it?	About 8.6% of US adults aged 18 to 50 scored at a clinical screening level for distress or impairment from difficulty controlling sexual urges (Dickenson et al., 2018).
Is trauma linked with it?	Most studies link child sexual abuse with compulsive sexual behavior, but much of the research is cross-sectional (Slavin et al., 2025).
Can it be a sign of another condition?	Sometimes. Dopamine agonist medicines have been linked with impulse control disorders in Parkinson’s disease (Weintraub et al., 2010), and risky sexual behavior has been found more often during manic episodes of bipolar disorder (Kopeykina et al., 2016).
Is treatment possible?	Yes. In a randomized trial of 137 men, group CBT had larger drops in symptoms than a waitlist (Hallberg et al., 2019).

What Does Hypersexuality Mean?

Hypersexuality is a label for sexual behavior that is hard to control and causes distress. Researchers still disagree about how to define it, and some question whether it’s a disorder at all.

In a critical review, Walton and colleagues describe hypersexuality as “the inability to regulate one’s sexual behavior that is a source of significant personal distress.” The review lists competing theories, including sexual compulsivity, sexual impulsivity, dual control and sex addiction, and it notes that the disagreement makes assessment and treatment harder. Some researchers question whether hypersexuality exists as a disorder, whether it’s simply normal behavior at the far end of sexual functioning, or whether it’s a problem that needs treatment rather than a diagnosis (Walton et al., 2017).

The diagnosis debate began with a proposal. Kafka proposed hypersexual disorder for the DSM-5 in 2010, describing it as “primarily a nonparaphilic sexual desire disorder with an impulsivity component” (Kafka, 2010). A DSM-5 field trial then tested the proposed criteria in 207 patients seeking treatment for hypersexual behavior, a general psychiatric condition or a substance-related disorder. Raters agreed with each other well, the criteria were stable over two weeks, and patients assessed for hypersexual disorder reported more consequences from their sexual behavior than the other two groups. The trial tested the criteria in clinics, so it doesn’t measure how common the condition is (Reid et al., 2012).

The DSM-5 did not include the proposed criteria for hypersexual disorder (Kraus, Voon & Potenza, 2016). The ICD-11, the World Health Organization’s classification, took a different route. It describes compulsive sexual behaviour disorder as “a persistent pattern of failure to control intense, repetitive sexual impulses or urges” over an extended period, such as six months or more, that causes marked distress or impairment in important areas of life. The diagnosis sits among impulse control disorders rather than addictions (Kraus et al., 2018).

In a nationally representative US survey run in November 2016 and published in 2018, 201 of 2,325 adults aged 18 to 50 (8.6%) scored at the clinical screening cut-off for distress or impairment from difficulty controlling sexual feelings, urges and behavior. The rate was 10.3% for men and 7.0% for women (Dickenson et al., 2018). Those are screening scores on a measure of distress, not diagnoses.

What Are the Symptoms of Hypersexuality?

The core signs are losing control over sexual urges, failing to cut back, and continuing despite harm. The criteria cover sexual fantasies, urges and behavior of any kind, not only porn.

The signs below draw on the two sets of criteria that Gola and colleagues compared side by side (Gola et al., 2022). They are plain-language versions, not a checklist for diagnosis:

• Losing time to it. Sexual urges, fantasies or behavior repeatedly get in the way of other goals, activities and obligations.
• Failed attempts to cut back. You try repeatedly to control or reduce it, without success.
• Continuing despite consequences. You keep going even though it brings negative consequences.
• Ignoring risk. You keep engaging in sexual behavior while disregarding the risk of physical or emotional harm to yourself or others.
• Using sex to cope with mood. You act on urges in response to anxiety, depression, boredom or irritability.
• Using sex to cope with stress. You act on urges in response to stressful life events.
• Getting little satisfaction. You keep going even though you get little or no satisfaction from it.
• Distress or impairment. The pattern causes marked distress, or impairment in relationships, work or other important areas of life.

The two sets differ on a few points. Using sex to cope with mood and stress appears only in the proposed DSM-5 criteria, while getting little or no satisfaction from it appears only in ICD-11 (Gola et al., 2022).

The ICD-11 also says the diagnosis shouldn’t rest on distress that comes only from moral judgments or disapproval, and that shame and guilt about sexual behavior are not reliably signs of an underlying disorder (Kraus et al., 2018).

For the signs that are specific to porn, see the porn addiction symptoms guide.

Hypersexuality vs. a High Sex Drive

Wanting a lot of sex isn’t the same as hypersexuality. Two Croatian studies found the two to be distinct, and the problem appears to be lack of control and distress rather than desire alone.

In an online survey of 1,998 Croatian men aged 18 to 60, run in 2014 and published in 2016, 57 men were classed as hypersexual on two questionnaires, and 70 were in a high-desire group. Only four men were in both groups. The high-desire group differed from the rest of the sample only in holding more positive attitudes toward porn (Štulhofer et al., 2016).

A 2015 analysis of a community online survey run in Croatia in 2014 found two clusters: one defined by a lack of control over sexuality and negative consequences, and one defined by high desire and frequent sex. The authors wrote that problematic sexuality “might be more associated with the perceived lack of personal control over sexuality and moralistic attitudes than with high levels of sexual desire and activity” (Carvalho et al., 2015).

Frequency alone doesn’t settle it. The daily masturbation guide explains how the research draws the line on masturbation specifically.

Wanting sexual variety is common, and the Coolidge effect guide covers the research on why novelty can feel so compelling.

What Causes Hypersexuality?

Several factors have been linked with hypersexuality, including coping with emotions, attachment, trauma, ADHD, and some medical conditions and medications. These are links found in studies, not proof that any one factor causes it.

Gola and colleagues note that compulsive sexual behavior is often associated with using sex to cope with difficult emotions, such as sadness, shame, loneliness, boredom or anger, as well as with stress or painful experiences (Gola et al., 2022).

A 2025 study of a small online convenience sample in Germany, with 154 people of whom 73.4% were women, found that attachment anxiety and attachment avoidance went with more compulsive sexual behavior symptoms in both men and women. Because the design was cross-sectional, it captures one point in time and can’t show which came first (Kürbitz et al., 2025).

Attention-deficit/hyperactivity disorder (ADHD) involves inattention, hyperactivity and impulsivity. The evidence on ADHD points in two directions. A 2022 meta-analysis of seven studies found a pooled 22.6% ADHD rate among patients with hypersexuality or paraphilic disorders. Its authors describe ADHD as “much more frequent” in those groups than in the general population, although the studies varied widely (Korchia et al., 2022). A 2021 systematic review, by contrast, found that some people with ADHD report hypersexuality, but no clear data showed that hypersexuality is more common in people with ADHD (Soldati et al., 2021). For comparison, a 2021 meta-analysis put persistent adult ADHD, which starts in childhood, at 2.58% of adults worldwide (Song et al., 2021). For more on ADHD specifically, see ADHD and porn addiction.

Trauma, medical conditions and medications each have their own section below.

Is Hypersexuality a Trauma Response?

Trauma may play a part for some people, but the research can’t show that hypersexuality is a trauma response. Most studies have found a link between child sexual abuse and compulsive sexual behavior, though not all, and most of that research is cross-sectional.

A 2020 systematic review of 21 studies found that most identified a link between child sexual abuse and compulsive sexual behavior. The review also flagged inconsistent measures and the need for longitudinal studies, which follow people over time (Slavin et al., 2020).

An updated review in 2025 found that 15 of 17 publications reported an association between child sexual abuse and compulsive sexual behavior. The authors describe the research as “Western-centric, cross-sectional, and inconsistent in measurement” (Slavin et al., 2025).

The author of a 2026 review of sex differences notes that childhood trauma and abuse are often reported by people seeking treatment for sex addiction, especially women. Those are people in treatment, so the finding doesn’t show how common trauma is among everyone with the pattern (Weinstein, 2026).

If you have a history of child sexual abuse, it may help to look for a therapist with trauma training. Slavin and colleagues write that people with compulsive sexual behavior who have experienced sexual abuse “may benefit from trauma-focused treatment” (Slavin et al., 2020).

Can a Medical Condition or Medication Cause Hypersexuality?

Sometimes. A sudden change in sexual behavior can be linked with another condition or a medication, so it’s worth a medical check, especially if it starts after a new prescription.

Bipolar disorder. Kopeykina and colleagues reviewed 27 articles and wrote that “change in sexual behavior is recognized as an integral part of bipolar disorder.” The literature points to more risky sexual behavior in people with bipolar disorder during manic episodes than in patients with other psychiatric diagnoses, although the studies lack a formal definition of hypersexuality (Kopeykina et al., 2016). Bipolar disorder is also found at higher rates in people with compulsive sexual behaviour disorder, and in the ICD-11 the sexual behavior has to occur outside manic or hypomanic episodes to count toward that diagnosis (Kraus et al., 2018).

Dopamine agonists. Dopamine agonists are medicines used to treat Parkinson’s disease and some pituitary tumors, called adenomas. In a cross-sectional study published in 2010 of 3,090 people with treated Parkinson’s disease at 46 movement disorder centers in the US and Canada, impulse control disorders were found in 17.1% of those taking a dopamine agonist and 6.9% of those who weren’t. Compulsive sexual behavior was found in 3.5% of all patients (Weintraub et al., 2010). A 2026 systematic review and meta-analysis of people with pituitary adenomas found that those taking a dopamine agonist had about three times the odds of hypersexuality, compared with people not taking one (Bilbao et al., 2026).

How it’s managed. A 2025 expert review of Parkinson’s care calls dopamine agonist tapering, which means gradually reducing the dose, “the primary therapeutic approach,” alongside psychotherapy and second-line medicines. It also stresses close monitoring and caregiver involvement (Rigon et al., 2025). Changes to a dopamine agonist should be made by the prescriber.

Dementia. A literature review by Cipriani and colleagues found that the most likely change in sexual behavior in dementia is indifference, not hypersexuality. Inappropriate sexual behavior comes in two types, intimacy-seeking and disinhibited. Most of it occurs in moderate to severe Alzheimer’s disease, though it can appear early in frontotemporal dementia because of disinhibition. These behaviors are often better managed without drugs, although those approaches don’t always stop them (Cipriani et al., 2016).

Brain injury and stroke. A 2026 critical narrative review of 13 case-based publications on traumatic brain injury and stroke found that sexual dysfunction is common after acquired brain injury, whereas dysregulated sexual behavior “is less frequent and poorly quantified.” The authors note that case-based evidence limits how far the findings generalize. They advise checking what changed and whether reversible factors explain the behavior before treating it as a lasting pattern (Calabrò et al., 2026).

The ICD-11 says compulsive sexual behaviour disorder shouldn’t be diagnosed when other medical conditions, such as dementia, or medications prescribed for conditions such as Parkinson’s disease, can explain the behavior (Kraus et al., 2018).

If a sudden change in sexual behavior started alongside a new medication, a shift in mood or energy, or memory problems in an older adult, see a doctor. Talk to the prescriber before changing any medication.

Hypersexuality in Women

Women experience hypersexuality too. Surveys find it less often in women than in men, and women have been studied much less, so how it differs in them is still unclear.

In an online survey of 988 women, high masturbation frequency, more sexual partners and more porn use went with more hypersexual behavior on the Hypersexual Behavior Inventory, a self-report measure. Scores were also linked with sexual risk behavior. The authors concluded that female hypersexuality “seems to be more characterized by impersonal sexual activity,” which doesn’t support earlier research suggesting that hypersexual women mostly engage in passive forms of sexual behavior (Klein et al., 2014).

In the national survey described above, women reported that kind of distress less often than men did, and the authors say gender differences were smaller than previously theorized (Dickenson et al., 2018).

A 2026 review of sex differences says compulsive sexual behavior disorder is more common in men, while neuroticism and stress vulnerability contribute importantly to symptoms in women. The author adds that little is known about sex differences in the disorder (Weinstein, 2026).

In the German study described in the causes section, women who reported more childhood traumatic experiences, especially physical neglect in childhood, also reported more severe symptoms. That link didn’t appear in men (Kürbitz et al., 2025).

For how these patterns show up with porn, see porn addiction in women.

How Is Hypersexuality Treated?

The first step is checking for an underlying cause, and one randomized trial found that group CBT had larger symptom drops than a waitlist in men. Any medication decision belongs with a doctor who can monitor it.

The first randomized trial of group CBT for hypersexual disorder enrolled 137 men, who were assigned to seven weeks of group CBT (70) or a waitlist (67). The CBT group had larger drops in symptoms and sexual compulsivity, and better psychological well-being, and those gains held at three and six months. The authors say the long-term results are “vague due to the low response rate on follow-up measurements,” and that the program’s efficacy for women “remains unknown” (Hallberg et al., 2019).

The porn addiction treatment guide covers treatment options and how to find a therapist, and how to stop porn addiction with CBT covers the techniques themselves.

Medication is another option that a doctor can weigh. Savard and colleagues gave four weeks of naltrexone to 20 men with compulsive sexual behavior disorder. Symptom scores fell during treatment, and some of the effect remained afterward, but scores had risen again by the follow-up four weeks later, which the authors read as worsening. The most reported side effects were fatigue (55%), nausea (30%), vertigo (30%) and abdominal pain (30%). The study had no control group, and the authors say studies focusing on pharmacological treatment are sparse (Savard et al., 2020).

What You Can Do Now

These are practical suggestions, not a treatment plan.

1. Notice what comes before the urge. For a week, write down what you were feeling, where you were and what time it was. If urges tend to come when you’re hungry, angry, lonely or tired, the HALT method gives you those four states to check before you act.
2. Look for a link with medication changes. If the pattern began after a new medication or a change in dose, tell the prescriber. Don’t stop or change the medication on your own.
3. Get tested if sex has been unprotected. Ask a doctor or clinic about testing for sexually transmitted infections.
4. Talk to a doctor or therapist. A doctor can check for mood, medication and medical causes. A therapist who works with sexual behavior concerns can help with urges, guilt and any trauma history.
5. If you’re a partner, look after yourself too. Your own safety and wellbeing come first, and a doctor or therapist is better placed than you to assess the behavior. If porn is part of the picture, how to help someone with porn addiction covers conversations, boundaries and support for yourself.

When to Get Help

See a doctor if a change in sexual behavior is sudden, risky, or harming your relationships, work or health, or if it comes with mood changes.

A sudden change, especially one that starts after a new medication, is worth a medical check, and a psychiatrist can assess for bipolar disorder if mood changes come with it. If sexual behavior feels out of control or is hurting your relationships, work or health, a therapist who works with sexual behavior concerns can help.

If you’re worried about a child’s or teen’s sexual behavior, talk to that child’s doctor.

If you’re having thoughts of harming yourself, or your mood is very low, call or text 988 (the Suicide & Crisis Lifeline in the US), or your local emergency number (988 Suicide & Crisis Lifeline, n.d.).

The Bottom Line

• It’s about control and distress. Hypersexuality describes sexual urges or behavior that feel out of control and keep causing distress or harm.
• A high sex drive isn’t the same as hypersexuality. In one Croatian survey of men, the high-desire group and the hypersexuality group overlapped in only four men.
• The links aren’t proof of cause. Trauma, ADHD, bipolar disorder and some medications have been linked with hypersexuality, but most of those studies can’t show that any one of them causes it.
• Treatment has evidence behind it. In a randomized trial of 137 men, group CBT had larger drops in symptoms than a waitlist, and any medication decision belongs with a doctor.
• A sudden change deserves a check. If it comes on quickly or starts after a new medication, see a doctor.

TrueAlly’s daily check-ins and intimacy and mood tracker can help you see which moods tend to come before urges.

---

Sources

• Bilbao, R., Serralunga, J., Loschiavo, N., Altuna, R., Manfre, J., Capani, F., Otero-Losada, M., Ponzo, O. J., & Perez-Lloret, S. (2026). A systematic review and meta-analysis on impulse-control disorders in patients with pituitary adenomas exposed to dopamine agonists. Frontiers in Endocrinology, 17, 1869083. https://doi.org/10.3389/fendo.2026.1869083
• Calabrò, R. S., De Luca, R., Ruberto, R. R., Calderone, A., Milardi, D., & Tomaiuolo, F. (2026). Sexual dysregulation after traumatic brain injury and stroke: A critical narrative review of neurobiology, clinical phenotypes, and management. Brain Sciences, 16(9), 995. https://doi.org/10.3390/brainsci16090995
• Carvalho, J., Štulhofer, A., Vieira, A. L., & Jurin, T. (2015). Hypersexuality and high sexual desire: Exploring the structure of problematic sexuality. The Journal of Sexual Medicine, 12(6), 1356–1367. https://doi.org/10.1111/jsm.12865
• Cipriani, G., Ulivi, M., Danti, S., Lucetti, C., & Nuti, A. (2016). Sexual disinhibition and dementia. Psychogeriatrics, 16(2), 145–153. https://doi.org/10.1111/psyg.12143
• Dickenson, J. A., Gleason, N., Coleman, E., & Miner, M. H. (2018). Prevalence of distress associated with difficulty controlling sexual urges, feelings, and behaviors in the United States. JAMA Network Open, 1(7), e184468. https://doi.org/10.1001/jamanetworkopen.2018.4468
• Gola, M., Lewczuk, K., Potenza, M. N., Kingston, D. A., Grubbs, J. B., Stark, R., & Reid, R. C. (2022). What should be included in the criteria for compulsive sexual behavior disorder? Journal of Behavioral Addictions, 11(2), 160–165. https://doi.org/10.1556/2006.2020.00090
• Hallberg, J., Kaldo, V., Arver, S., Dhejne, C., Jokinen, J., & Öberg, K. G. (2019). A randomized controlled study of group-administered cognitive behavioral therapy for hypersexual disorder in men. The Journal of Sexual Medicine, 16(5), 733–745. https://doi.org/10.1016/j.jsxm.2019.03.005
• Kafka, M. P. (2010). Hypersexual disorder: A proposed diagnosis for DSM-V. Archives of Sexual Behavior, 39(2), 377–400. https://doi.org/10.1007/s10508-009-9574-7
• Klein, V., Rettenberger, M., & Briken, P. (2014). Self-reported indicators of hypersexuality and its correlates in a female online sample. The Journal of Sexual Medicine, 11(8), 1974–1981. https://doi.org/10.1111/jsm.12602
• Kopeykina, I., Kim, H.-J., Khatun, T., Boland, J., Haeri, S., Cohen, L. J., & Galynker, I. I. (2016). Hypersexuality and couple relationships in bipolar disorder: A review. Journal of Affective Disorders, 195, 1–14. https://doi.org/10.1016/j.jad.2016.01.035
• Korchia, T., Boyer, L., Deneuville, M., Etchecopar-Etchart, D., Lancon, C., & Fond, G. (2022). ADHD prevalence in patients with hypersexuality and paraphilic disorders: A systematic review and meta-analysis. European Archives of Psychiatry and Clinical Neuroscience, 272(8), 1413–1420. https://doi.org/10.1007/s00406-022-01421-9
• Kraus, S. W., Krueger, R. B., Briken, P., First, M. B., Stein, D. J., Kaplan, M. S., Voon, V., Abdo, C. H. N., Grant, J. E., Atalla, E., & Reed, G. M. (2018). Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry, 17(1), 109–110. https://doi.org/10.1002/wps.20499
• Kraus, S. W., Voon, V., & Potenza, M. N. (2016). Should compulsive sexual behavior be considered an addiction? Addiction, 111(12), 2097–2106. https://doi.org/10.1111/add.13297
• Kürbitz, L. I., Schröder, J., & Briken, P. (2025). The role of attachment, childhood traumatic experiences and gender in men and women with compulsive sexual behavior symptoms. International Journal of Sexual Health, 37(4), 695–710. https://doi.org/10.1080/19317611.2025.2548010
• Reid, R. C., Carpenter, B. N., Hook, J. N., Garos, S., Manning, J. C., Gilliland, R., Cooper, E. B., McKittrick, H., Davtian, M., & Fong, T. (2012). Report of findings in a DSM-5 field trial for hypersexual disorder. The Journal of Sexual Medicine, 9(11), 2868–2877. https://doi.org/10.1111/j.1743-6109.2012.02936.x
• Rigon, L., Fogliano, C., Chaudhuri, K. R., Poplawska-Domaszewicz, K., Falup-Pecurariu, C., Murasan, I., Wolfschlag, M., Odin, P., & Antonini, A. (2025). Managing impulse control and related behavioral disorders in Parkinson’s disease: Where we are in 2025? Expert Review of Neurotherapeutics, 25(5), 537–554. https://doi.org/10.1080/14737175.2025.2485337
• Savard, J., Öberg, K. G., Chatzittofis, A., Dhejne, C., Arver, S., & Jokinen, J. (2020). Naltrexone in compulsive sexual behavior disorder: A feasibility study of twenty men. The Journal of Sexual Medicine, 17(8), 1544–1552. https://doi.org/10.1016/j.jsxm.2020.04.318
• Slavin, M. N., Hewage, S., Roy, S., & Kraus, S. W. (2025). Child sexual abuse and compulsive sexual behavior: An updated systematic review of key findings and moderators. Current Addiction Reports, 12(1), 52. https://doi.org/10.1007/s40429-025-00658-3
• Slavin, M. N., Scoglio, A. A. J., Blycker, G. R., Potenza, M. N., & Kraus, S. W. (2020). Child sexual abuse and compulsive sexual behavior: A systematic literature review. Current Addiction Reports, 7(1), 76–88. https://doi.org/10.1007/s40429-020-00298-9
• Soldati, L., Bianchi-Demicheli, F., Schockaert, P., Köhl, J., Bolmont, M., Hasler, R., & Perroud, N. (2021). Association of ADHD and hypersexuality and paraphilias. Psychiatry Research, 295, 113638. https://doi.org/10.1016/j.psychres.2020.113638
• Song, P., Zha, M., Yang, Q., Zhang, Y., Li, X., & Rudan, I. (2021). The prevalence of adult attention-deficit hyperactivity disorder: A global systematic review and meta-analysis. Journal of Global Health, 11, 04009. https://doi.org/10.7189/jogh.11.04009
• Štulhofer, A., Jurin, T., & Briken, P. (2016). Is high sexual desire a facet of male hypersexuality? Results from an online study. Journal of Sex & Marital Therapy, 42(8), 665–680. https://doi.org/10.1080/0092623x.2015.1113585
• 988 Suicide & Crisis Lifeline. (n.d.). 988 Lifeline. https://988lifeline.org/
• Walton, M. T., Cantor, J. M., Bhullar, N., & Lykins, A. D. (2017). Hypersexuality: A critical review and introduction to the “sexhavior cycle.” Archives of Sexual Behavior, 46(8), 2231–2251. https://doi.org/10.1007/s10508-017-0991-8
• Weinstein, A. M. (2026). Sex differences in compulsive sexual behavior disorder. Frontiers in Behavioral Neuroscience, 20, 1821534. https://doi.org/10.3389/fnbeh.2026.1821534
• Weintraub, D., Koester, J., Potenza, M. N., Siderowf, A. D., Stacy, M., Voon, V., Whetteckey, J., Wunderlich, G. R., & Lang, A. E. (2010). Impulse control disorders in Parkinson disease: A cross-sectional study of 3090 patients. Archives of Neurology, 67(5), 589–595. https://doi.org/10.1001/archneurol.2010.65