It is common for substance use disorders and sex addiction to occur alongside one another. The same processes that make someone susceptible to substance use disorders can also increase the risk of addiction to sex. The loss of inhibitions that occur with the abuse of substances such as alcohol or other drugs can also lead to riskier sexual behavior. Treatment for co-occurring substance use disorders and sex addiction has been found to support recovery from addictions.
The misconception that women can’t have an addiction to sex is common but incorrect.
Psychiatrists don’t currently list sex addiction in the Diagnostic and Statistical Manual of Psychiatric Disorder (DSM-V). This is the major manual from which doctors diagnose psychiatric conditions like major depression or anxiety.
However, there are some standard criteria for addiction. The main criterion for sex addiction is sexual behavior that negatively impacts life or daily living.1 The four aspects of the addiction model are the same whether a person is addicted to alcohol, drugs, gambling, or sex. In addiction to sex these manifest as:
Compulsive behavior: Inability to control behavior even if efforts to stop have occurred.
Obsession: Spending a great deal of their time thinking about or engaging in sex or sexual behavior.
Continuation: Continuing to engage in a behavior, even when negative consequences from the behavior have occurred.
Tolerance: Escalating behaviors to experience the same "high." Examples may include engaging in progressively more dangerous sexual behaviors.
While sex isn’t the same as using an illegal drug or drinking alcohol to excess, it actually can have similar effects on the brain for some people. For example, sexual activity can cause the brain to release feel-good chemicals, including dopamine, adrenaline, and endorphins.1 A person’s brain and body can become addicted to the sensations these chemicals produce.
According to an article in Live Science, an estimated 8 to 12 percent of people seeking sexual addiction treatment are women.2 However, many other women may struggle with addiction to sex, yet are afraid to seek treatment for fear of being harshly labeled as “sluts” or “nymphos.”2
Sometimes it’s hard for a woman to know that her sexual behaviors classify as an addiction. Examples of behaviors that may be classified as sex addiction include the following:3
Frequently engaging in sex with strangers
Having affairs, especially those that are risky, such as with a partner's family members, or with close friends, co-workers, or neighbors
Only feeling pleasure through engaging in sadomasochism or other potentially dangerous sex acts
Feeling sad or depressed the morning after engaging in sex acts
Frequent use of pornography
Compulsive masturbation that is out of control or leads to the neglect of work, family, or friends
These are just some of the behaviors that a woman who struggles with addiction to sex may display. The symptoms can vary and range from mild to severe in how they affect a woman’s daily life.4
Sex addiction is a term that is rather like an umbrella – underneath the title are many different types. Examples of different types include:
Erotomania: This is a disorder where a person incorrectly believes that another person is obsessed or infatuated with them.
Hypersexuality: Doctors used to call this "nymphomania." Some people also call it satyriasis. It means a very heightened libido or sense of sexual desire that interferes with a person's daily life.
Paraphilia: A sexual response to objects, situations, or fantasies that are unusual or dangerous.
Sexual disinhibition: The absence of sexual inhibitions, often leading to inappropriate behavior such as public nudity or public sex acts.
Doctors usually divide sexual addiction types into paraphilic and non-paraphilic behaviors.5 Paraphilic behaviors are those that are outside most people’s sense of sexual normalcy. Examples include voyeurism, fetishism, and sexual masochism.5 According to an article in the journal Psychiatry, a woman’s paraphilias usually start when she is in her late teenage years and may be at their height when she is in her mid-20’s.5
Non-paraphilic behaviors are more inside the sexual norms, but also negatively affect a person’s life.5 Examples include going to strip clubs, engaging in affairs outside marriage or a monogamous relationship, or compulsive masturbation.
Biological addiction to sex occurs when a woman’s obsession with masturbation and pornography affects her ability to have a satisfying sexual relationship with another person.6 A woman may experience a significant rush of endorphins and feel-good chemicals from masturbation, yet be unable to achieve the same effects through sexual intercourse with another person.
A person who suffers from psychological addiction to sex uses sex as a way to try and repair wrongs from their past. This use of sex isn’t an effective “treatment” for their problems. People who struggle with psychological addiction often have experienced past trauma, neglect, or sexual abuse. They try to compensate for painful memories of their past through sex, in an attempt to feel better.
While in the moment the person may enjoy a high or feel comforted by sex, the emotion is often temporary. The person may ultimately feel sad or depressed. Women who struggle with psychological addiction often benefit from behavioral treatments to learn how to more effectively cope with past trauma in a way that doesn’t involve sex.
A woman with spiritual sexual addiction tries to reach spiritual fulfillment or connect with a higher power through sex. Some people who struggle with this addiction type may turn to cult-like organizations and behavior as a means to gain spiritual favor or enlightenment.
Spiritual addiction can be problematic because it can lead a person to engage in dangerous behaviors that are unrealistic and obsessive as a means to connect with a higher power.
Trauma-based sexual addiction occurs when a person has been abused as a child or adolescent.6 Sometimes, a person may experience fantasies that stem in some way from their history of trauma. Examples could include physical violence in sex or dominating the other person.
A person who struggles with trauma-based addiction is frozen in time. They can’t move forward from their early trauma; they continue to repeat some part of what they’ve gone through. They use sex to escape their problems instead of dealing with them.
Intimacy anorexia or sexual anorexia is a medical condition where a person avoids sexual contact and intimacy in a seemingly compulsive way.6
A person with intimacy anorexia may engage in the following behaviors:
Intimacy anorexia may be the opposite of most other sexual addiction types, such as hypersexuality, but is also a form of sexual dysfunction. It’s an addiction to not being intimate. A person with intimacy anorexia may fear being sexual with another person so much that they become filled with anxiety at the thought.
Some people who struggle with mood disorders engage in hypersexual behavior that may be a part of their illnesses or a way in which they try to self-medicate their feelings.4 Examples of these mood disorders include:
According to VeryWell Mind, some neurological disorders may also result in sex addiction-type behaviors. Examples of these include head trauma, dementia, and epilepsy.2
Unfortunately, there isn’t a tremendous amount of research to tell doctors why some people become addicted to sex while others don’t. They do know that a person who has a history of physical, sexual, or mental abuse may be more likely to experience addiction to sex. They also know that people who have a substance abuse addiction or a co-occurring disorder like a mental illness are more likely to experience problems with addiction to sex.
Because there isn’t an official entry in the DSM-V, it’s possible that doctors may use different criteria to diagnose sex addiction in women. They will start by listening to a woman describe her past and current sexual experiences and how they affect her. They will try to identify common patterns, such as thoughts dominated by sex, or engagement in risky sexual behaviors such as exhibitionism or sex with strangers or extramarital affairs. A person who struggles with addiction to sex often experiences great “highs” where they may feel temporary sexual ecstasy. However, this feeling is often followed by feelings of low self-esteem, including anxiety, shame, depression, guilt, and regret.4 These low feelings can affect a person’s overall well-being.
Untreated addiction to sex can lead to several unpleasant side effects. Examples include increased risks of:3
Sexually transmitted infections
Violence from a sexual partner
Breakup of marriage or parenting partnerships
In addition to these factors, women with untreated sex addiction also lose a significant amount of productivity and time.6 Women may spend a great deal of time and money engaging in sex acts or looking at sexual materials.
Addiction to sex affects a woman’s ability to have healthy relationships with others. She may face stigma or fear stigma in society as she struggles with her addiction, which may also affect her daily life and overall health.
Doctors have found several differences in how men and women experience addiction to sex. Typical causes differ by gender. For example, male sex addiction is commonly rooted in factors such as:2
Early emotional neglect
Early problems with attachment to parents and loved ones
Women often have different contributing factors to sex addiction. According to LiveScience, these include a history of:
Physical or sexual trauma
Often a history of trauma, neglect, and physical abuse can contribute to sex addiction. According to LiveScience, many women try to reclaim their control over sex by becoming sex workers.2 This includes women who become strippers, prostitutes, adult film actresses, or who work in similar fields.2 While certainly, not all women with a sex addiction have a history of working in the sex industry, it is another common contributing factor.
Men and women with sex addictions both show out-of-control behavior when it comes to sex. They both engage in sexual behaviors that put their health and well-being at risk.
Treating sex addiction often requires a combination approach to therapy. This includes therapy to help a person identify the potential underlying causes of their sex addiction.1 In addition to this approach, a person may also benefit from participating in behavioral therapy, which can help them to learn healthier ways to be in a relationship with another person.
One of the most significant challenges for women can be finding a support group they feel comfortable participating in. Because the majority of people with sex addiction are men, this can be challenging.1 Whenever possible, if a woman can find a support group composed only or mostly of women, she may find she is more comfortable participating without distraction. Examples of groups designed to help women struggling with sex addiction include Sex and Love Addicts Anonymous and Sex Addicts Anonymous.6
Doctors may also prescribe medications to treat underlying causes of sex addiction, including anxiety or depression. Examples of these medications include selective serotonin reuptake inhibitors such as fluoxetine (Prozac). However, these medicines don’t always work to reduce unwanted sexual urges and impulses.
Sex addiction can affect women, usually in smaller numbers than in men. Because doctors don’t study sex addiction in significant numbers, it’s hard to know how many people struggle with sex addiction. If a woman does have the condition, it’s important that she seek medical treatment to avoid the physical and mental health complications that can occur with sex addiction.
If a woman struggles with behaviors which she thinks may be symptoms of sex addiction, she should talk to her primary care provider or psychiatrist, if she has one. These doctors can refer her to specialists to help her get the treatments she needs. These treatments can range from talk to behavioral therapy as well as support groups and medication. With time and treatment, a woman can learn to have a healthy relationship and approach to sex that can keep her from feeling shame, anxiety, or sadness related to sexual activity.