Is Hypersexuality An Effect Of PTSD?

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PTSD: symptoms & diagnosis 

Post-traumatic stress disorder (PTSD)¹ is a psychological condition prompted by one or more traumatic events. Such events include war, natural disasters, sexual violence, abuse, or witnessing death. 

A person with PTSD has difficulty recovering from such an event, dramatically reducing their quality of life. While each person experiences PTSD differently, common symptoms are grouped into four clusters, which include the following:

Re-experiencing/Intrusion

  • nightmares or flashbacks of the event

  • spontaneous memories or thoughts of the event

Avoidance

  • avoiding people, places, or things related to the trauma

  • pushing away memories surrounding the traumatic event

Negative cognitions/mood

  • guilt/blaming oneself

  • inability to remember the event

  • concentration issues

Arousal 

  • irritability

  • paranoia 

  • hypervigilance

  • impulsivity and recklessness

Such symptoms can occur in anyone acutely after a traumatic event. However, people diagnosed with PTSD experience these symptoms for at least a month after the event. 

They also suffer significant daily impairment and distress. These impairments can also damage their ability to maintain and form meaningful relationships. 

What is hypersexuality?

Hypersexuality² occurs when someone is completely consumed by thoughts of having sex. They’re obsessed with engaging in sexual acts, sexual fantasies, and, more often than not, pornography. 

To be considered as having the disorder, people with hypersexuality also experience significant distress or impairment regarding sex. This can occur in the form of unsafe and frequent sexual encounters, sexual feelings in inappropriate settings, and issues with intimate relationships. 

As the definition of hypersexuality is often debated among experts, the prevalence of this condition can be difficult to estimate. However, some studies have estimated anywhere from 1-3% to 3-6%³ of the adult population are hypersexual. Prevalence is often higher in men than women. 

While many believe that hypersexual people have more sex than the average person, this isn’t necessarily true. 

These people do have more motivation for sex and sexual behaviors. However, this doesn’t necessarily mean they act them out or are successful in finding a sexual partner. 

Sometimes referred to as sex addiction, this condition is included in the World Health Organization’s International Classification of Diseases (ICD). The ICD defines the disorder as compulsive sexual behavior⁴ (CSB). This diagnosis is commonly reserved for the adult population, but research⁵ is beginning to note increased and pathological sexual behavior in children as well. 

Some experts consider CSB to be an issue with impulse control, while others suggest it's an issue with behavioral addiction or depression and anxiety. However, more and more research⁶ indicates psychological trauma as a significant underpinning factor. 

Is hypersexuality a symptom of PTSD?

With many researchers⁶ indicating the role that psychological and emotional trauma may have in hypersexuality, it’s logical to consider a link between the two conditions. While hypersexuality isn’t an explicit symptom of PTSD, it may be related. 

One example is that many male military veterans have an increased prevalence of PTSD and hypersexuality. Researchers have also found a significant link between PTSD,⁷ childhood trauma, and the presence of CSB.⁸ 

Other researchers⁸ have demonstrated that for both men and women, childhood sexual abuse is associated with sexual avoidance and sexual compulsivity in adulthood, which can affect adult romantic relationships.

Why does a link between trauma and hypersexuality exist?

Research⁸ has suggested that the PTSD–hypersexuality link is mediated by shame, guilt, and depression. The link between PTSD and depression has been extensively demonstrated, and it has been found that individuals with both disorders often display behavioral dependencies, such as gambling addiction, substance use, or hypersexuality. 

People also often feel tremendous guilt or shame in line with their trauma, which can promote hypersexual behavior. Sex, in this case, can be seen as a coping mechanism used to manage the symptoms of PTSD. 

Due to the avoidance symptoms typical of PTSD, people who develop PTSD as a result of sexual violence sometimes avoid sex altogether. While hypersexuality can occur with PTSD, sexual avoidance is also a consequence in some cases. 

Many people feel hypersexual impulses as their brains are focused on the trauma. They can enter an unhealthy cycle where they seemingly reenact their trauma. As mentioned, this can be a coping mechanism for many.

Some researchers⁹ suggest that when trauma occurs at an early age, it can affect how the child bonds with their parents and others. 

As a result, these problems in early relationships can affect arousal and desire later in life. In simple terms, the attachments made at a young age can affect our intimacy as adults. Intimacy issues can appear in the form of hypersexuality.

Treatment

Despite the complexities of PTSD and CSD, many effective treatments are available. In terms of PTSD, many types of therapy, including cognitive behavioral therapy (CBT), prolonged exposure therapy, and eye movement desensitization and reprocessing, therapy can help. 

Medications such as sertraline, fluoxetine, venlafaxine, and paroxetine can help alleviate symptoms. (Note: conditional recommendations for PTSD.) 

Hypersexuality treatments vary slightly and often include some form of medication, group therapy, and individual therapy. If therapy is used as a treatment, this may include CBT, Sexual Addiction Anonymous (similar to Alcoholics Anonymous), and psychodynamic psychotherapy. 

These therapies aim to reduce compulsive behaviors and reshape the way people think about sex. 

Drugs prescribed for hypersexuality include antidepressants, mood stabilizers, and anti-androgens.

Naltrexone¹⁰ is a drug used for substance use disorders and has also been suggested as a possible hypersexuality treatment. However, it’s important to note that no FDA-approved medications for hypersexuality are currently available.

Consult a healthcare professional to find out which PTSD and hypersexuality treatments are best suited for you. 

The lowdown

Both PTSD and CSB are psychologically and physiologically challenging disorders. While not everyone with CSB has comorbid PTSD, it can occur in many cases. Factors such as guilt, shame, and depression mediate this relationship. 

Help is available for the treatment of both conditions. Consult a healthcare professional if you’re experiencing any of the symptoms and concerns associated with PTSD and hypersexuality

  1. What is posttraumatic stress disorder (PTSD)? | American Psychiatric Association

  2. Should compulsive sexual behavior be considered an addiction? (2016)

  3. Compulsive sexual behaviour disorder in the ICD‐11 (2018)

  4. The development of the compulsive sexual behavior disorder scale (CSBD-19): An ICD-11 based screening measure across three languages (2020)

  5. Adolescents’ compulsive sexual behavior: The role of parental competence, parents’ psychopathology, and quality of parent–child communication about sex (2019)

  6. Hypersexuality and trauma: A mediation and moderation model from psychopathology to problematic sexual behavior (2021)

  7. Sexual symptoms in post-traumatic stress disorder following childhood sexual abuse: A network analysis (2020)

  8. Child sexual abuse and compulsive sexual behavior: A systematic literature review (2020)

  9. Hyposexuality and hypersexuality secondary to childhood trauma and dissociation (2008)

  10. Naltrexone use in treating hypersexuality induced by dopamine replacement therapy: Impact of OPRM1 A/G polymorphism on its effectiveness (2020)

Other sources:

Have you considered clinical trials for Post-traumatic stress disorder (PTSD)?

We make it easy for you to participate in a clinical trial for Post-traumatic stress disorder (PTSD), and get access to the latest treatments not yet widely available - and be a part of finding a cure.

Joining community groups and exercise programs for my condition made me feel empowered – but I want to be part of finding a cure.
Peter, 64

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