Hypersexuality is a clinical diagnosis used by mental healthcare professionals for extremely frequent or suddenly increased libido. 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, or through the administering of hormones such as testosterone and estrogen during hormone therapy.
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 behaviours 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.
Consistent with there not being any 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 were studying. Contemporary names 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, "out of control sexual behavior", and paraphilia-related disorder.
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 heterosexual women andromaniac, while hypersexualist, sexaholic,onanist, hyperphiliac and erotomaniac are gender neutral terms.
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. Psychological needs also complicate the biological explanation, which identifies the temporal/frontal lobe of the brain as the area for regulating libido. Persons suffering from injuries to this part of the brain are at increased risk for 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 use of antiandrogens to reduce undesirable sexual behaviour such as hypersexuality, testosterone has been found to be necessary, but not sufficient, for sexual drive. Other proposed factors include a lack of physical closeness, and forgetfulness of the recent past.
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 psychomotoric 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 behaviour 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.
Some authors have 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.
The ICD-11 has 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".
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