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Hypersexuality: what do we know by now?

Azevedo, PA1; Ferreira Carvalho, RFC2

1: Magalhães Lemos, Portugal; 2: SexED, Portugal

Objectives: to summarize the latest literature in this field in order to educate health professionals on this topic.

Materials and Methods: A brief review of the latest literature was performed, using PubMed and the keywords “hypersexuality”, “compulsive sexual behavior”, “impulsive sexual behavior” and “sexual addiction”.

Results: Hypersexuality Disorder (HD) has been a highly debated topic in sexology and sexual medicine, being empirically defined as an abnormally increased sexual activity. However, no diagnostic criteria have been established formally in DSM-5 and several terms have been applied for the same overall subset of symptoms and complaints, which complicates the study and the access to information regarding this phenomena: hyperphilia, compulsive sexual behavior, impulsive sexual behavior, sexual addiction, problematic hypersexuality, out-of-control sexual behavior, out-of-control sexual behavior, sexual desire dysregulation.

This non-paraphilic condition consists of "excessive" sexual behaviors and disorders accompanied by personal distress and social and medical morbidity. It is a very controversial and political topic in terms of how best to categorize it as similar or not similar to addictive behaviors including substance abuse. Epidemiologically, recent reviews report a prevalence of 3-6% in the general population; more frequently diagnosed in males in a 2-5:1 ratio. It appears to be more common in late adolescence and early adulthood. Pathophysiological perspectives include dysregulation of sexual arousal and desire, sexual impulsivity, and sexual compulsivity. The etiology may be framed in a biopsychosocial perspective; with neurobiological theories, psychological theories and always influenced by cultural and moral perspectives.

Conclusions: Hypersexual Disorder is meant to represent a neutral descriptor for those with increased sex drive due to a currently unknown primary process. It has been proposed as a new diagnosis for the DSM-5 and greater awareness of HD-like symptoms in both clinical and nonclinical populations has resulted in a dramatic increase in related research. HD criteria require more than simple manifestations of excessive sexual behavior including an expansive range of associated features such as whether sexual thoughts, urges, and behaviors arise from stress or dysphoric mood states, create difficulties leading to dysfunctional consequences, and lead to a perceived diminished of sense of control.


Work supported by industry: no.

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