For some people, persistent sexual desires, thoughts, and behavior can become problematic. Such individuals may become preoccupied with sexual fantasies and urges, and a subset will act on these impulses while feeling that they have no control over their actions—repeatedly sending explicit texts and images, for example, or attempting to fondle others without consent. This pattern of behavior is often referred to as hypersexuality or sex addiction. "Compulsive sexual behavior disorder” was recently added to the World Health Organization’s International Classification of Diseases (ICD-11), but the decision was controversial, as many psychologists believe that concepts like hypersexuality are best regarded as shorthand for perceived problems in regulating thoughts and behaviors related to sex. There is wide debate over whether the problem stems from a lack of impulse control, a greater-than-average sex drive, some combination of the two, or a moral code that proscribes sexual activity. With no clear definition of sex addiction, or agreement on its validity as a diagnosis, it’s impossible to say how many people are affected, but some literature reviews have estimated the prevalence as between 3 and 6 percent of adults.
The problematic behavior seen as reflecting sexual addiction may mask a state of depression or anxiety, in which case the sexual activity could be an attempt to remedy that distress, although it tends to create its own array of negative consequences, from declining physical health and financial problems to the disruption of relationships and careers. The behavioral pattern is often accompanied by feelings of deep shame, with the belief that sexual thoughts or behavior of any kind are shameful or a moral violation as a contributing factor. Most scientifically trained experts believe that the best treatment is psychotherapy that explores an individual’s deeper feelings and his or her ability to regulate feelings, beliefs about self, past sexual experiences, and more.