By Mark Ryan, BACP Accredited Psychotherapist and NCPS Accredited Relationship Therapist
You have promised yourself this will be the last time, and meant it. Or you are the partner who has just found out, and the ground has shifted under you. Either way, the words "sex addiction" may be the ones you have reached for, because they are the ones the internet offers. They can feel like a relief and a verdict at the same moment.
This article explains what the term means, how to tell a pattern that has slipped out of someone's control from a high sex drive, and what tends to help. It is written for the person whose sexual behaviour feels out of their hands and for the partner who is trying to understand what has happened. It is not a diagnostic test. It is a map, and a kind one, because shame has never helped anyone change.
I have written separately about porn use specifically, what the phrase porn addiction gets right and wrong, and what tends to help. This piece covers compulsive sexual behaviour that involves other people rather than solo content. That includes affairs, repeated encounters with new partners, paid sex and apps used compulsively. The underlying question is similar, but the relational stakes are often higher here. This version usually involves another real person, sometimes a betrayal of a specific partner, and sometimes a real risk to health or safety.
The two patterns are worth reading together where both apply. A behaviour that has stopped being fully within someone's control tends to work in much the same way whether it plays out through a screen or with other people. It is also common for the two to coexist or shift over time. Someone whose use began with pornography may move towards apps and encounters, and someone stepping back from encounters may find the same pattern reasserting itself through content. Neither direction is unusual, and neither means earlier work failed. The behaviour tends to find whatever outlet is available, which is why the work usually addresses the pattern underneath and not each outlet in turn.
What the term means
"Sex addiction" is the popular name. The formal one is compulsive sexual behaviour disorder, which the World Health Organization's ICD 11 classifies as an impulse control disorder. In plain terms it describes a persistent difficulty controlling intense, repeated sexual urges, which leads to repeated sexual behaviour over a period of months and causes real distress or harm to a person's life. A German national survey of 4,633 people used that ICD 11 definition and found that 4.9 per cent of men and 3.0 per cent of women reported experiences consistent with it at some point in their lives. Over the previous twelve months the figures were 3.2 per cent and 1.8 per cent (Briken et al., 2022). So this is not a rare or exotic problem, and it is not only a male one.
Three things in that definition matter most. The first is loss of control, meaning the person has tried to stop or cut back and has not managed to. The second is time, because a pattern held over months is different from a rough few weeks. The third is consequence, because the behaviour is damaging relationships, work, health, money or the person's own sense of who they are. None of these is about how often someone has sex or how much they want it.
Some people prefer other words, such as compulsive sexual behaviour, out of control sexual behaviour or hypersexuality. In my experience the name matters less than whether it helps you understand what is happening and what to do next. Use whichever one lets you speak about it without flinching.
A high sex drive is not an addiction
This needs saying plainly, because it is one of the most common and damaging confusions in this territory. Wanting sex often, having a high libido, or having a stronger sex drive than a partner is not sex addiction. Treating it as though it were causes real harm, either to someone who starts pathologising an ordinary part of themselves, or to a partner made to feel like the problem for wanting more than the other person does.
The marker is not how often someone wants or has sex. It is whether they have lost the ability to control the behaviour despite ongoing distress or harm, and whether that has gone on for a sustained period. Someone with a high drive who is not distressed by it, is not harming a relationship and can still choose not to act on an urge does not fit this picture, however high the number looks from outside. Someone having far less sex but experiencing it as something they cannot stop, despite real consequences, might.
Couples sometimes arrive at therapy with one partner convinced the other has a sex addiction, based almost entirely on how often one wants sex compared with how often the couple has it. That comparison says very little about addiction and a lot about a mismatch in desire, which is common, workable and a completely different conversation. If that sounds like you, my articles on when your sex drives don't match and why desire fades in long term relationships may be a better place to start. Getting the framing right early tends to save a couple months of arguing about the wrong question.
Values come into this too. The German survey found that a strict religious upbringing was more common among people whose experiences met the criteria than among those who had compulsive urges without distress. In my experience shame about sex that has nothing to do with loss of control can look very similar from the inside, which is one reason a careful, unhurried conversation matters. Gay, bisexual, queer and trans people, and people in consensually non monogamous relationships, are often judged against assumptions that do not fit their lives. A good therapist asks what the behaviour means to you and what it costs you, and does not measure you against anyone's idea of a normal amount of sex or a correct relationship structure.
What to look at instead of frequency
If frequency is not the useful marker, the better picture comes from looking at the behaviour and what is happening around it. A few patterns tend to show up together, though rarely all at once.
One is escalation into territory the person did not previously want or value. In practice this often looks like finding yourself drawn towards acts, partners or risks that sit outside what you would otherwise choose or feel comfortable with. Your preferences may not have changed. The behaviour has developed its own momentum, chasing novelty and intensity and no longer following what you want.
Another is a widening gap between intention and behaviour. Repeated promises to stop or cut back, made sincerely and then broken, are a more useful signal than frequency ever was. A single lapse does not indicate a pattern. A consistent cycle of resolving, breaking the resolution and feeling worse each time does.
A concrete version might look like this. Someone starts by using an app occasionally to meet people. Over time the arranging becomes more absorbing than the meeting, then the arrangements drift towards encounters they would have found uncomfortable a year earlier, with more partners in a shorter window, more risk and less connection to anything they would describe as wanting. None of that necessarily means something is clinically wrong. In my experience it is the trajectory, and the person's own growing discomfort with it, that matters more than any single point along the path.
A few questions can help you take stock.
Have I tried to stop or cut back and found I could not?
Do I hide what I do, and does the hiding take up more and more energy?
Am I taking risks with my health, safety, money, job or relationship that I would not choose on a calm day?
Do I feel worse afterwards, and does that feeling push me back towards the behaviour?
Is this about what I want, or about escaping something I cannot face?
If several of these land, that is information worth taking to someone safe, and it is not a judgement of your character.
When it involves another real person
This is where this piece diverges most from the porn specific one. When compulsive sexual behaviour plays out with other people, it often surfaces through infidelity. A study of 669 adults in relationships, all with childhood sexual abuse histories, found a graded pattern. Sexual compulsivity was higher among people with multiple partners outside the relationship than among those with one, and higher again among those with one than among those with none (Vaillancourt Morel et al., 2016).
That study looked at survivors of childhood sexual abuse, so it should not be read as a claim that every affair reflects compulsive sexual behaviour. Most do not, and infidelity has many more common explanations that have nothing to do with addiction. What the finding does show is that sexual compulsivity and a widening pattern of outside partners can go together, which is worth taking seriously without assuming compulsion whenever an affair involves more than one person.
Where infidelity is part of the picture, rebuilding trust afterwards follows much the same ground as any other betrayal. It involves disclosure, safety and a slow rebuild of confidence in a partner's account of themselves, with the added layer of understanding whether the behaviour was a one off decision or part of a harder to interrupt pattern.
That distinction matters for the couple's own understanding of what happened, whatever the clinical term ends up being. An affair that reflects a single poor decision under particular circumstances calls for a different conversation than a pattern of repeated, escalating encounters that the person felt unable to stop despite real attempts. Both are painful and both deserve to be taken seriously. Treating every affair as evidence of addiction, or dismissing a genuine pattern as just one mistake, tends to leave both people working from an inaccurate map of what needs to change.
If you are the partner, you may also be dealing with practical worries about sexual health. It is reasonable to ask for honesty about this and to get tested, and doing so is self care, not an accusation. Your hurt is real and deserves its own space, and you are allowed to take time before deciding anything about the relationship.
Wanting sex often, having a high libido, or simply having a stronger sex drive than a partner, is not the same thing as sex addiction.
Why this happens
For many people, compulsive sexual behaviour is a way of managing something else, such as anxiety, loneliness, low mood or a habit of reaching for intensity when distress has no other route out. The relief is real, which is exactly why the pattern is so hard to interrupt through willpower alone. Removing the behaviour without addressing what it was managing tends to leave the underlying feeling looking for somewhere else to go.
For some people the function is closer to distraction from a specific difficulty, such as a stalled career, an unprocessed grief or a marriage that has gone quiet in other ways. For others it connects to earlier experience, including trauma or early relational injury that made intensity feel more available or more trustworthy than closeness. None of this is a single explanation that fits everyone. The common thread is that the behaviour is doing a job, even while it causes harm, and understanding what that job is tends to matter more for lasting change than focusing on the behaviour alone.
Shame usually makes this worse. Most people caught in this pattern already know in detail everything that is wrong with what they are doing, and being told again rarely produces change. What tends to help is understanding the function the behaviour serves, which needs enough safety to look at it without getting defensive.
A partner's response matters more than most people expect going in. A partner who reacts to disclosure with total condemnation, understandable as that is, can unintentionally reinforce the shame cycle that has been driving the behaviour, making honesty feel more dangerous next time. This is not a reason to expect a hurt partner to manage their reaction for someone else's benefit. It is a reason both people usually need support, and not only the person whose behaviour needs to change.
What helps
Honesty tends to matter more than any specific strategy, and it usually needs to come before a behavioural plan and not alongside one. Trying to change the behaviour while hiding its full extent from a partner, or from yourself, tends to drive it further underground, and the same pattern resurfaces later in another form.
Treatment has been studied, and the results are encouraging. A systematic review of 24 treatment studies found that treatment seemed to improve symptoms of compulsive sexual behaviour, with the clearest evidence for cognitive behavioural therapy (Antons et al., 2022). In my experience the specific method matters less than a steady relationship with a therapist who is not shocked, who understands sexual behaviour and who can hold both the behaviour and the person. The reviewers also point out that more rigorous research is needed, so no single approach should be presented as the answer.
Where a relationship is involved, both people benefit from clear, explicit agreements about what is acceptable going forward, worked out together and not imposed by one partner on the other. Conversations about sex tend to go better with some structure than when they happen only in moments of crisis or discovery, and that matters even more here, given how much shame is already sitting underneath the conversation for both people.
Individual work on what the behaviour has been managing, whether anxiety, trauma, loneliness or something else, usually needs to run alongside couples work and not instead of it. Honest self examination with a hurt partner in the room is rarely realistic in the early stages, even though the couple's work matters too.
A realistic sense of the timeline helps. Stopping the specific acts tends to happen faster than the underlying work that makes the change last. Couples sometimes expect the crisis phase and the recovery phase to move at the same speed. One person may feel steadier well before the other can trust that steadiness. That mismatch is a common and predictable source of friction, and not a sign that something has gone wrong.
Some small practices between sessions can also help.
Notice the moment before the urge. What were you feeling, and what did you need?
Put one other thing into that gap, such as a walk, a call to a friend or ten minutes of slow breathing.
Tell one safe person what is going on, even in part. Secrecy keeps the cycle running.
Look after the basics of sleep, food and movement, since tiredness and isolation make urges harder to ride out.
Treat a lapse as information about what you needed, and not as proof that you have failed.
None of these will fix the pattern alone. They build the experience that an urge can be survived without acting on it, and that experience is what the rest of the work rests on.
How therapy can help
A first conversation is not about establishing whether you meet a diagnostic threshold. It is about understanding the actual pattern, what the behaviour has been doing, what tends to trigger it and what has been tried already, so the work starts from where you are and not from where you think a therapist expects you to be.
Where a partner is involved and willing, the work often moves faster with individual sessions running alongside couples work, each supporting the other. Where it is just the person affected, the work stands on its own and does not need a partner's involvement to be worthwhile.
You also do not need to have decided in advance what you want the outcome to be. Some people arrive certain they want to stop the behaviour entirely. Others want to understand it first before deciding what change looks like for them. Both are reasonable starting points, and neither commits you to a destination before the work has begun.
If now feels like the right time to talk this through with a therapist, I offer a free 30 minute consultation in person in London or online. Either partner is welcome to reach out first, and you do not need to have agreed between you what is happening before you do.
About the Author
Mark Ryan is a BACP Accredited Psychotherapist and NCPS Accredited Relationship Therapist working in person across central London, from rooms in Pimlico, Kensington, and Angel. He works with couples, individuals, and polycules on relationship issues including jealousy, affairs and betrayals, sex problems, and considered separation. His practice is integrative, sex-positive, and affirming of all relationship structures and identities.
References
Antons, S., Engel, J., Briken, P., Krueger, T. H. C., Brand, M., & Stark, R. (2022). Treatments and interventions for compulsive sexual behavior disorder with a focus on problematic pornography use: A preregistered systematic review. Journal of Behavioral Addictions, 11(3), 643 to 666. https://doi.org/10.1556/2006.2022.00061
Briken, P., Wiessner, C., Stulhofer, A., Klein, V., Fuss, J., Reed, G. M., & Dekker, A. (2022). Who feels affected by "out of control" sexual behavior? Prevalence and correlates of indicators for ICD 11 compulsive sexual behavior disorder in the German Health and Sexuality Survey (GeSiD). Journal of Behavioral Addictions, 11(3), 900 to 911. https://doi.org/10.1556/2006.2022.00060
Vaillancourt Morel, M. P., Dugal, C., Poirier Stewart, R., Godbout, N., Sabourin, S., Lussier, Y., & Briere, J. (2016). Extradyadic sexual involvement and sexual compulsivity in male and female sexual abuse survivors. The Journal of Sex Research, 53(4 to 5), 614 to 625. https://doi.org/10.1080/00224499.2015.1061633
