MENTAL HEALTH Mental Disorders • Compulsive sexual behavior • Schizophrenia • Bipolar disorder • Borderline personality disorder • Compulsive gambling • Body dysmorphic disorder • Personality disorders • Dissociative disorders • Narcissistic personality disorder • Cyclothymia • Intermittent explosive disorder • Self-injury/cutting • Antisocial personality disorder • Schizotypal personality disorder

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Sexual expression is a natural part of a well-rounded life. But if you have an overwhelming need for sex and are so intensely preoccupied with this need that it interferes with your job and your relationships, you may have a problem called compulsive sexual behavior.

You may spend inordinate amounts of time in sexually related activities and neglect important aspects of your day-to-day life in social, occupational and recreational areas. You may find yourself failing repeatedly at attempts to reduce or control your sexual activities or desires.

Health experts use a number of labels for this potentially serious condition. Compulsive sexual behavior is sometimes called hypersexuality, nymphomania or erotomania. Others use the term "sexual addiction," comparing it with the uncontrolled use of a drug. Others argue that it's an issue of impulse control or obsessive-compulsive behavior.

No matter what name is attached to the behavior, compulsive sexual behavior is a very real affliction that interferes with everyday living. Current research indicates that compulsive sexual behavior is most common among men. Treatment may involve individual or group therapy and medications.

Sexual behavior becomes a problem and is considered compulsive when it's repeated often enough to interfere with your normal daily living and with your relationships. If your sexual behavior is compulsive, you may display it in a number of ways, including:

• Having multiple sexual partners or extramarital affairs
• Having sex with a succession of anonymous partners or prostitutes and treating them as objects to be used for sex
• Using commercial sexually explicit phone lines and Internet chat rooms
• Engaging in excessive masturbation
• Using pornographic materials frequently
• Engaging in masochistic or sadistic sex, such as experiencing sexual excitement by inflicting or receiving pain during sex
• Exposing yourself in public
• Often feeling compelled to engage in sexual activity when you're stressed, anxious or depressed

People who are sexually obsessed can be married and appear to live otherwise normal lives, though they may have difficulty establishing and maintaining emotional intimacy.

Sexually obsessive behavior tends to be chronic, intense and beyond your control. Although you may seek gratification through sexually compulsive behavior, you're unlikely to achieve fulfillment over the long term. In fact, you may feel that your life is becoming increasingly empty. People with compulsive sexual behavior often use sex as an escape from other problems, such as loneliness, depression, anxiety or stress.

Many experts believe that other psychological disorders underlie sexual obsessions and compulsions. Compulsive sexual behavior may be a maladaptive coping mechanism for other emotional problems, including mood and personality disorders.

For example, if you grew up in a dysfunctional family or were sexually, emotionally or physically abused as a child, you may have developed an unhealthy attitude toward sex. These early traumatic experiences may lead you to feel shameful and unworthy; these emotions can inhibit normal sexual expression and intimacy and can result in extremes in sexual activity. Many people who engage in compulsive sexual activity report a past history of sexual or physical abuse.

If you're feeling lonely and depressed, you may perceive your sexual compulsions as a way of filling the voids in your life. But even if compulsive sexual behavior brings you short-term relief, your negative feelings are likely to return, often at an intensified level.

In some cases, the cause of compulsive sexual behavior can be a neurological disorder, such as epilepsy or dementia.

Most people with compulsive sexual behavior need professional treatment. Attempts at self-care are usually unsuccessful because, by definition, a sexual compulsion tends to be beyond a person's control.

Some questions you can ask yourself are:

• Can I control my sexual behavior?
• Is my sexual behavior hurting my relationships with friends and family, affecting my ability to work, or resulting in negative consequences, such as getting arrested?
• Is sex constantly on my mind, even when I don't want to be thinking about it?

If you're concerned that you're obsessed with sex, look for a doctor who specializes in treating sexual behavior disorders. Your family doctor may be able to give you the name of such a specialist, or you can contact a nearby major medical center and ask for a referral.

If you experience sexual obsessions and compulsions, you run the risk of wide-ranging negative consequences. For example, you may:

• Neglect your partner or become deceitful in your marriage or other primary relationship. This can jeopardize or destroy the relationship.
• Accumulate large financial debts in pursuing your sexual impulses by spending money on prostitutes, pornography and phone-sex lines.
• Contract sexually transmitted diseases (STDs) and place other partners at risk.
• Be arrested for sexual offenses, such as exhibitionism or solicitation of prostitution.
• Lose your focus at work, risking your job.
• Cause an unwanted pregnancy.
• Engage in other high-risk behaviors, such as abuse of drugs or alcohol.
• Feel shame and guilt over your inability to control socially unacceptable behaviors that interfere with normal relationships.

Fear, shame or embarrassment may make it difficult for you to initially seek treatment for compulsive sexual behavior, but it's important for you to get help. Your doctor may suggest one, or a combination, of the following treatment options:

• Psychological treatment. Individual or group therapy helps many people manage their sexual obsessions. In therapy you can begin to acknowledge that sex should be part of a loving relationship. You can also start to deal effectively with developmental or interpersonal issues instead of acting out in a sexual manner. Doctors sometimes recommend inpatient treatment, but most people do well in outpatient settings.
• Marriage counseling. Marriage counseling is often necessary to help resolve the relationship problems that arise from sexual obsession.
• Self-help groups. Groups such as Sex Addicts Anonymous (SAA), Sex and Love Addicts Anonymous (SLAA) and Sexaholics Anonymous (SA) are modeled after the successful 12-step program of Alcoholics Anonymous (AA), and may be helpful for some people who engage in compulsive sexual behavior.
• Antidepressant medications. Your doctor may prescribe a drug such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft) to reduce the anxiety and depression that are often associated with sexual obsession. Additionally, a decreased libido is often a side effect of these medications.
• Naltrexone. This medication is used to help people addicted to drugs or alcohol. It blocks the pleasurable feeling or "high" associated with using these substances. There's some evidence that naltrexone (ReVia) may also be helpful for treating people obsessed with sex.