What Compulsive Sexual Behavior Disorder Is—and What It Isn't
When sexual thoughts and behaviors start to interfere with daily life.
Posted August 26, 2025 | Reviewed by Devon Frye
Out-of-control sexual behaviors have existed throughout history, yet their official recognition only came much later. Some of the old terms you might have heard include satyriasis , nymphomania , and Don Juanism .
In modern medicine, out-of-control sexual behaviors were proposed for inclusion in the DSM-5 as hypersexual disorder (Kafka, 2010). However, this proposal was ultimately rejected due to the lack of sufficient scientific evidence and other concerns (Kafka, 2014; Reid & Kafka, 2014).
About a decade later, in 2019, as empirical evidence accumulated (Grubbs et al., 2020), compulsive sexual behavior disorder (CSBD) was proposed as a new diagnostic entity for the 11th edition of the International Classification of Diseases (ICD-11), an international manual published by the World Health Organization. Three years later, the ICD-11 was officially released, and CSBD became a recognized diagnostic category for the first time (World Health Organization, 2022).
But what exactly does CSBD cover? In brief, CSBD is a persistent pattern of failure to control intense, repetitive sexual impulses, urges, or behaviors, resulting in significant distress or impairment in daily life, such as neglecting one’s health or needs.
Importantly, when an individual's distress comes entirely from their moral judgements and disapproval of their sexual behaviors, it is not labeled CSBD (World Health Organization, 2022)—though of course, this can be an important issue in itself (Grubbs & Floyd, 2025). CSBD is also distinct from paraphilias, such as voyeurism or exhibitionism, though paraphilic interests or behaviors can co-occur with CSBD (Engel et al., 2025).
What CSBD Looks Like in Real Life
So, to better understand CSBD, let’s consider the case of Alex. For the past months, Alex’s sexual thoughts and behaviors have become increasingly difficult to manage.
Thinking back, it started with pornography and masturbation , which gradually took up more and more of Alex’s free time. Nowadays, simply being at home alone triggers thoughts of porn.
Over time, Alex’s focus shifted toward seeking casual sex with new partners. Alex spends hours on dating apps trying to arrange these casual dates. The goal is no longer genuine connection; quick and casual sex has become the main focus.
Whenever something stressful happens, like a tough day at work, Alex turns to dating apps to “let off steam.” If no partner is available, frustration builds, and the evening often ends with more porn. Even during sexual encounters, satisfaction is fleeting—Alex is already thinking about the next potential partner and planning the following date.
Before these changes, Alex sometimes enjoyed casual sex, but it was never the central goal when going out, meeting someone, or using dating apps. Now, these urges are persistent, difficult to control, and interfere with daily life. Despite repeated attempts to cut back, the behavior continues, causing tension at work and strain in personal relationships.
How to Tell When Sexual Behaviors Become Problematic
Based on Alex’s example, we can see that CSBD might involve many different sexual behaviors, including online or offline, partnered or solo ones (Grubbs et al., 2024). But importantly, CSBD is not simply about the behaviors someone engages in or how often someone has sex; indeed, a high level of sexual activity does not automatically indicate a problematic behavior or a disorder (Bőthe et al., 2020).
CSBD is primarily about the role that sexual behavior—such as sex, pornography, or masturbation—plays in a person’s life. Does it occupy a majority of their thoughts throughout the day? Is it used as a way to cope with negative emotions? Has it reached a point where engaging in these behaviors leads to negative consequences? And is the experience still enjoyable, or has it shifted toward frustration or distress when the behavior cannot be carried out?
Alex is not alone. Current evidence suggests that around 5 percent of people worldwide may experience CSBD, with significant differences across genders (Bőthe et al., 2023).
Men may be more likely to experience CSBD, but women and gender-diverse individuals (e.g., nonbinary , genderqueer, genderfluid ) are also affected (Bőthe et al., 2023). When they do experience it, they may face additional challenges in seeking help, including heightened stigma , shame , or lack of accessible resources (Dhuffar & Griffiths, 2016; Kowalewska et al., 2025).
Indeed, only 14 percent of people with a high risk of experiencing CSBD sought treatment for it in a recent global study, while more than 30 percent did not do so, due to factors such as unaffordability or stigma (Bőthe et al., 2023). Reducing stigma and shame around CSBD is essential, as moral judgment or societal misconceptions can prevent people from seeking help.
By relying on scientific evidence and accurate knowledge about CSBD, we can help individuals like Alex understand their behaviors, access effective treatments, and reduce the shame and isolation that often accompany the issue.
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Bőthe, B., Tóth-Király, I., Potenza, M. N., Orosz, G., & Demetrovics, Z. (2020). High-frequency pornography use may not always be problematic. Journal of Sexual Medicine, 17(4), 793–811. https://doi.org/10.1016/j.jsxm.2020.01.007
Dhuffar, M. K., & Griffiths, M. D. (2016). Barriers to female sex addiction treatment in the UK. Journal of Behavioral Addictions, 5(4), 562–567. https://doi.org/10.1556/2006.5.2016.072
Engel, J., Nagy, L., Dickhut, C., Veit, M., Kneer, J., & Kruger, T. H. C. (2025). Paraphilias and Sexual Offending in Compulsive Sexual Behavior in the Sex@Brain-Study. Sexual Health & Compulsivity, 32(1), 25–44. https://doi.org/10.1080/26929953.2024.2392204
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Grubbs, J. B., Lee, B., Floyd, C. G., Bőthe, B., Jennings, T., & Kraus, S. W. (2024). What is the “Sex” in sex addiction? Problem behaviors reported among those endorsing compulsive sexual behavior. Sexual Health & Compulsivity, 31(4), 351–367. https://doi.org/10.1080/26929953.2024.2386518
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Reid, R. C., & Kafka, M. P. (2014). Controversies about hypersexual disorder and the DSM-5. Current Sexual Health Reports, 6(4), 259-264.
World Health Organization. (2022). International Statistical Classification of Diseases and Related Health Problems (11th ed.). https://icd.who.int/
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Beata Bőthe, Ph.D., is an assistant professor at the Department of Psychology at the University of Montréal in Canada, and Mónika Koós, Ph.D., is a postdoctoral researcher at the Institute for Forensic Psychiatry and Sex Research in Essen, Germany.
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