Hypersexuality is extremely frequent or suddenly increased libido. It is controversial whether it should be included as a clinical diagnosis used by mental healthcare professionals. Nymphomania and satyriasis were terms previously used for the condition in women and men, respectively.
Hypersexuality may be a primary condition, or the symptom of another medical disease or condition; for example, Klüver–Bucy syndrome or bipolar disorder. Hypersexuality may also present as a side effect of medication such as drugs used to treat Parkinson's disease. Clinicians have yet to reach a consensus over how best to describe hypersexuality as a primary condition, or to determine the appropriateness of describing such behaviors and impulses as a separate pathology.
Hypersexual behaviors are viewed variously by clinicians and therapists as a type of obsessive-compulsive disorder (OCD) or "OCD-spectrum disorder", an addiction, or a disorder of impulsivity. 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.
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 socially inappropriate sexual behavior such as hypersexuality. 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).
The American Association for Sex Addiction Therapy acknowledges biological factors as contributing causes of sex addiction. Other associated factors include psychological components (which affect mood and motivation as well as psychomotor and cognitive functions), spiritual control, mood disorders, sexual trauma, and intimacy anorexia as causes or type of sex addiction.
A positive link between the severity of dementia and occurrence of inappropriate behavior has also been found. Hypersexuality can be caused by dementia in a number of ways, including disinhibition due to organic disease, misreading of social cues, understimulation, the persistence of learned sexual behavior after other behaviours have been lost, and the side-effects of the drugs used to treat dementia. Other possible causes of dementia-related hypersexuality include an inappropriately expressed psychological need for intimacy and forgetfulness of the recent past. As this illness progresses, increasing hypersexuality has been theorized to sometimes compensate for declining self-esteem and cognitive function.
Symptoms of hypersexuality are also similar to those of sexual addiction in that they embody similar traits. These symptoms include the inability to be intimate (intimacy anorexia), depression and bipolar disorders. The resulting hypersexuality may have an impact in the person's social and occupational domains if the underlying symptoms have a large enough systemic influence.
In 1988, Levine and Troiden questioned whether it makes sense to discuss hypersexuality at all, arguing that labeling sexual urges "extreme" merely stigmatizes people who do not conform to the norms of their culture or peer group, and that sexual compulsivity be a myth. However, and in contrast to this view, 30 years later in 2018, the ICD-11 created a new condition classification, compulsive sexual behavior, to cover "a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behaviour". It classifies this "failure to control" as an abnormal mental health condition.
Hypersexuality may negatively impact an individual. The concept of hypersexuality as an addiction was started in the 1970s by former members of Alcoholics Anonymous who felt they experienced a similar lack of control and compulsivity with sexual behaviors as with alcohol.
The Merriam-Webster Dictionary defines hypersexual as "exhibiting unusual or excessive concern with or indulgence in sexual activity".Sexologists have been using the term hypersexuality since the late 1800s, when Krafft-Ebing described several cases of extreme sexual behaviours in his seminal 1886 book, Psychopathia Sexualis. The author used the term "hypersexuality" to describe conditions that would now be termed premature ejaculation. Terms to describe males with the condition include donjuanist,satyromaniac,satyriac and satyriasist, for women clitoromaniac,nympho and nymphomaniac, for teleiophilic (attracted to adults) heterosexual women andromaniac, while hypersexualist, sexaholic,onanist, hyperphiliac and erotomaniac are gender neutral terms.
^Quadland, Michael C. (1985). "Compulsive Sexual Behavior: Definition of a Problem and an Approach to Treatment". Journal of Sex & Marital Therapy. 11 (2): 121–132. doi:10.1080/00926238508406078. PMID4009729.
^Kingston, Drew A.; Firestone, Philip (2008). "Problematic Hypersexuality: A Review of Conceptualization and Diagnosis". Sexual Addiction & Compulsivity. 15 (4): 284–310. doi:10.1080/10720160802289249. S2CID53418034.
^Kafka, M. P. (2000). "The paraphilia-related disorders: Nonparaphilic hypersexuality and sexual compulsivity/addiction". In Leiblum, S. R.; Rosen, R. C. (eds.). Principles and practice of sex therapy (3rd ed.). New York: Guilford Press. pp. 471–503.