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What is Sex Addiction

Maya Malchin, Clinical Social Worker, Psychotherapist, MSW, Director of Addiction
13 May 2026

Sex addiction (Compulsive Sexual Behavior Disorder – CSBD) is a condition characterized by a lack of control over sexual impulses and repetitive behaviors that impair functioning and quality of life. it is now understood to be a condition with a biological, neurological, and psychological basis.

Symptoms include compulsive preoccupation with sex, constant seeking of partners, excessive use of pornography, and behaviors that lead to harm in relationships, work, and health. According to the ICD-11, there are three main types: addiction to sexual intercourse, masturbation, and pornography.

Diagnosis is based on a persistent difficulty in controlling urges for at least six months, along with functional impairment and unsuccessful attempts to reduce the behavior.  

Risk factors include genetic predisposition, neurological changes, past trauma, and social influences. 

Important to know: there is a correlation between sex addiction and mental disorders such as depression, anxiety, PTSD and personality disorders.   The disorder can affect mental and physical health, relationships and daily function. 

Sexuality is a healthy part of life, and enthusiasm for sex can be positive when it serves as a source of creativity and self-expression. However, there are pathological situations in which this balance is disrupted. Sex addiction is a compulsive behavior that may harm self-image, functioning, and overall quality of life.

Sex addiction, or Compulsive Sexual Behavior Disorder (CSBD), is currently recognized as a behavioral condition involving loss of control over sexual impulses. It involves persistent preoccupation with sexual thoughts and a compulsive need to seek sexual gratification. In professional terms, it is defined as “impaired control over impulses.” In the past, it was often viewed as a personal weakness or inappropriate behavior, but today it is understood as a condition linked to neurobiological processes in the brain and may require both psychological and, in some cases, pharmacological treatment.

According to the 2024 Brookdale Institute study, conducted for the Addiction Treatment Department of the Ministry of Health, 9% of Jewish respondents were found to be at risk of sex addiction. Among Arab respondents, 18% were found to be at risk. The risk is higher among men, younger adults, non-religious men, and unmarried men.

Gender differences in sex addiction

Sex addiction is more common among men, who are more prone to pornography use and compulsive masturbation. Among women, it is sometimes more hidden and accompanied by greater shame. Women are more likely to develop compulsive sexual behavior in the context of emotional relationships and more frequently report feelings of self-harm or emotional distress resulting from the behavior.

Typical patterns of sex addiction

  • Persistent search for new sexual partners.
  • Uncontrolled purchase and use of erotic materials.
  • Hiding and hoarding of pornography.
  • Excessive use of the internet for sexual stimulation and finding partners, to the point of disrupting normal daily functioning.
  • Use of force or manipulation to obtain sex.
  • Constant demands for sex within a relationship.

Typical behavioral patterns

Sex addiction creates behavioral patterns in those affected that extend far beyond the sexual situation itself, and also impact those around them:

Many sex addicts are professionally successful but have real difficulty forming intimate relationships, which may manifest in different ways:

  • Difficulty forming and maintaining an intimate long-term relationship with one individual.
  • An uncontrollable need for conquests, excitement, and novelty.
  • A need for repeated validation of masculinity or femininity.
  • A deep fear of closeness, intimacy, relationships and sex as a core part of emotional connection.
  • A fear of heartbreak and an attempt to find relief through addiction to courtship and “fateful” sexual encounters.

People struggling with sex addiction may experience guilt and anxiety because they are unable to stop or reduce their sexual behavior, and sometimes even need to escalate it to achieve the same level of satisfaction.   They use sex to escape reality, and when they try to stop, they may experience emotional or physical distress. This can lead to neglect of important areas of life such as work, family or health.   They occasionally respond with anger or fear when their behavior is criticized, which damages relationships with those close to them, who may feel frustrated and disappointed. 

Types of sex addiction disorders

Sex addiction is not currently listed as an official disorder in the DSM-5 (the diagnostic manual of the American Psychiatric Association). It is, however, recognized in other frameworks, mainly under the term “Compulsive Sexual Behavior Disorder (CSBD),” which was included in the ICD-11 (the World Health Organization’s diagnostic manual) in 2018 under impulse control disorders. According to the ICD-11, the disorder includes three main types: addiction to sexual intercourse, addiction to masturbation and addiction to pornography:

  • Main characteristics: an uncontrollable urge to seek sexual contact with multiple and often changing partners, and indiscriminate sexual activity, including behaviors that may put oneself or others at risk.
  • Psychological motivation: in most cases, it involves an escape from emotional distress and feelings such as anxiety, loneliness, and depression, rather than sexual gratification alone.
  • Risks: sexually transmitted infections, harm to romantic relationships, impairment at work and involvement in prostitution or violence.

  • Main characteristics: extremely frequent masturbation, sometimes dozens of times per day, in a way that interferes with daily function, relationships, work or studies.
  • Emotional context: often accompanied by feelings of guilt, shame and poor self-esteem. The behavior is often carried out in response to stress or boredom, not necessarily sexual arousal.
  • Difference from a sex-with-partner addiction: there is not necessarily interaction with another person; the addiction is to the act itself and to the sense of escape it provides.

  • Main characteristics: compulsive consumption of pornography, sometimes for many hours a day, leading to impairment in personal, couples or occupational function.
  • Consequences: reduced arousal in partnered relationships, a need for increasingly extreme content over time (tolerance), and occasional difficulty in becoming sexually aroused outside of screen-based stimulation.
  • Difference from addiction to sex and masturbation: here, the addiction is primarily related to consuming content rather than engaging in direct sexual activity (alone or with others), and it is often accompanied by masturbation.

How is sex addiction diagnosed

Diagnostic criteria according to ICD-11:

  • Repeated and persistent failure to control sexual impulses: the person experiences intense or uncontrollable sexual urges that lead to repeated behaviors such as masturbation, casual sex, pornography use, or cybersex, despite negative consequences.
  • Duration of at least 6 months: the behavior persists over time and is not the result of a single event or a short-term period.
  • Significant functional impairment: the behavior causes marked distress or significant impairment in key areas of life, such as social, occupational, or personal functioning.
  • Repeated unsuccessful attempts to control or reduce the behavior: the person has tried multiple times to manage or reduce sexual behavior, but without success.
  • The behavior is not due to another medical condition: it is important to rule out that the behavior is caused by another condition, such as mania (in bipolar disorder), substance use, or a neurological disorder.

Important to know

Important to know

The definition of sex addiction is not based solely on the amount of sexual behavior, but rather on a lack of control, ongoing harm, and the fact that the behavior is used to avoid negative emotions or as a means of emotional regulation.

Possible causes behind sex addiction

Genetic predisposition

A genetic predisposition to impulsivity or sensation-seeking.

Neurological causes

  • Abnormal brain activity in areas related to impulse control, reward, and emotional regulation.
  • Patterns similar to addiction to substances in terms of heightened sensitivity to sexual stimuli.

Psychological causes

  • History of sexual or emotional trauma, or childhood neglect.
  • Early relational trauma (attachment difficulties), feelings of emptiness, anxiety, shame, or depression.
  • Use of compulsive sexual behavior as a means of emotional regulation and escape from distress.

Social-cultural causes

  • Early exposure to pornography and normalization of sex without emotional connection.
  • Loneliness, social alienation and poor body image/self-esteem.
  • Gender norms and cultural pressure related to sexual performance and sexual identity.

The link between sex addiction and other mental health conditions

  • People with sex addiction report higher rates of depression, feelings of emptiness and self-shame, and sometimes a sense of low self-worth that leads to sexual behavior as a way of emotional regulation.
  • In bipolar disorder, increased sexual behavior may sometimes appear during manic or hypomanic episodes, and this should be ruled out before diagnosing sex addiction.

  • Compulsive sexual behavior may be used as a way to temporarily relieve anxiety.
  • Studies show links between sex addiction and generalized anxiety disorder (GAD) and OCD (obsessive-compulsive disorder), mainly due to patterns of repetition, loss of control, and strong urges to act.

  • There is a high rate of co-occurring substance misuse, including alcohol, cocaine, amphetamines, or cannabis.
  • In some cases, substance use increases uncontrolled sexual behavior, and in some situations the behavior itself occurs under the influence of substances.

  • Especially borderline personality disorder (BPD) and narcissistic personality disorder, which are characterized by difficulties in emotional regulation, feelings of emptiness, and a need for external validation.
  • In some cases, sexual behavior is used as a way to build identity or to seek intense closeness with others.

  • A high proportion of people with sex addiction report childhood sexual abuse or early trauma, including emotional neglect.
  • Sexual behavior is sometimes used as a way to cope with difficult emotions, dissociation, or the unconscious reenactment of traumatic experiences.

The link between childhood sexual abuse and sex addiction

Many people with sex addiction have experienced childhood sexual abuse or adolescent sexual trauma. Such experiences can disrupt a person’s sense of personal boundaries and distort the connection between intimacy and sexuality. In treatment, it is important to identify and process early sexual trauma alongside addiction treatment.

Repercussions of sex addiction

  • Anxiety, depression and shame: repetitive and uncontrollable behavior can lead to strong feelings of regret, low self-esteem, shame and a sense of failure.
  • Feelings of isolation: the sex addict may withdraw from their social environment out of fear of being exposed or judged. 
  • Dependence on the behavior for emotional regulation: using sex as an escape from dealing with negative emotions instead of developing healthy coping strategies. 
  • Increased risk of suicide: especially when there is comorbidity with depression or a severe sense of loss of control.

  • Increased risk of sexually transmitted infections: due to unprotected sexual activity with multiple partners. 
  • Physical injuries: in cases of aggressive or unsafe sexual behavior. 
  • Physical fatigue: resulting from excessive engagement in sexual behavior that disrupts sleep, nutrition or daily routines. 

  • Reduced concentration and performance: compulsive preoccupation with sex consumes energy, time, and attention. 
  • Absences from work or studies: in order to engage in sexual behavior or due to feelings of mental exhaustion.
  • Risk of job loss: due to using a computer or phone for sexual purposes at work, or a significant decline in functioning.

  • Damage to trust and the relationship: lies, infidelity, or secrecy around the behavior create distance, anger, and sometimes separation. 
  • Sense of vulnerability and emotional betrayal: partners may experience significant emotional pain and sometimes feel inadequate or as if they are “competing” with the behavior. 
  • Impact on children: children may be exposed to inappropriate content or behaviors, or experience a lack of a stable, available, and emotionally present parent. 
  • Feelings of shame within the family: visible behavior or public exposure may lead to shame or social isolation. 

Compulsive sexual behavior is a cycle that is difficult to break alone, but effective treatment is available. A combination of psychological therapy, support groups and, in some cases, medication can help and improve quality of life.   How does one begin? Read here about treatment approaches and ways of coping with sex addiction.