Hypersexuality

Hypersexuality is a proposed medical condition said to cause unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity to a point of distress or impairment. Whether it should be a clinical diagnosis used by mental healthcare professionals is controversial. Nymphomania and satyriasis are terms previously used for the condition in women and men, respectively.

Hypersexuality may be a primary condition, or the symptom of other medical conditions or disorders such as Klüver–Bucy syndrome, bipolar disorder, brain injury, and dementia. Hypersexuality may also be a side effect of medication, such as dopaminergic drugs used to treat Parkinson's disease. Frontal lesions caused by brain injury, strokes, and frontal lobotomy are thought to cause hypersexuality in individuals who have suffered these events. Clinicians have yet to reach a consensus over how best to describe hypersexuality as a primary condition, or the suitability of describing such behaviors and impulses as a separate pathology.

Hypersexual behaviors are viewed by clinicians and therapists as a type of obsessive–compulsive disorder (OCD) or obsessive–compulsive spectrum disorder, an addiction, or an impulse-control disorder. A number of authors do not acknowledge such a pathology, and instead assert that the condition merely reflects a cultural dislike of exceptional sexual behavior.

Consistent with having no consensus over what causes hypersexuality, authors have used many different labels to refer to it, sometimes interchangeably, but often depending on which theory they favor or which specific behavior they have studied or researched; related or obsolete terms include compulsive masturbation, compulsive sexual behavior, cybersex addiction, erotomania, "excessive sexual drive", hyperphilia, hypersexuality, hypersexual disorder, problematic hypersexuality, sexual addiction, sexual compulsivity, sexual dependency, sexual impulsivity, and paraphilia-related disorder.

Due to the controversy surrounding the diagnosis of hypersexuality, there is no generally accepted definition and measurement for hypersexuality, making it difficult to determine its prevalence. Thus, prevalence can vary depending on how it is defined and measured. Overall, hypersexuality is estimated to affect 2–6% of the population, and may be higher in certain populations like men, those who have been traumatized, and sex offenders.

There is little consensus among experts as to the causes of hypersexuality. Some research suggests that some cases can be linked to biochemical or physiological changes that accompany dementia, as dementia can lead to disinhibition. Psychological needs also complicate the biological explanation, which identifies the temporal/frontal lobe of the brain as the area for regulating libido. Injuries to this part of the brain increase the risk of aggressive behavior and other behavioral problems including personality changes and sexual behavior such as hypersexuality or pedophilia. The same symptom can occur after unilateral temporal lobotomy. There are other biological factors that are associated with hypersexuality such as premenstrual changes, and the exposure to virilising hormones in childhood or in utero.

In research involving the use of antiandrogens to reduce undesirable sexual behaviour such as hypersexuality, testosterone has been found to be necessary, but not sufficient, for sexual drive. A lack of physical closeness and forgetfulness of the recent past were proposed as other potential factors (specifically in the context of hypersexual behavior exhibited by people suffering from dementia).

Pathogenic overactivity of the dopaminergic mesolimbic pathway in the brain—forming either psychiatrically, during mania, or pharmacologically, as a side effect of dopamine agonists, specifically D₃-preferring agonists—is associated with various addictions and has been shown to result among some in overindulgent, sometimes hypersexual, behavior. HPA axis dysregulation has been associated with hypersexual disorder.