Sexual Addiction: Real or Invented?

"My husband spends time on the Internet looking at pornography. He has "objectified" me and I am a means to his orgasm, not a person with needs and feelings. I have fed his addiction for years, so I am a co-addict. Our therapist says that sexual addiction is probably the most shameful of all the addictions and the most difficult addiction to recover from.

I still have so far to go, and I believe that with someone else's understanding and support, I will be OK. I just don't have any support now. Sexual addiction isn't socially acceptable. It's not like talking about alcohol addiction, because it is personal and it is more than self-inflicted. Everyone in the relationship suffers.

What do you think about sexual addiction?"

I think you might be surprised by what I think. I believe there are people who become obsessive in their behavior and neglect their responsibilities. Do they deserve the special category of "sex addict"? Not in my opinion.

I hold the viewpoint that the concept of sexual addiction was created by factions of the mental health community who were personally uncomfortable with robust sexuality and who possibly also wanted to create a new way of attracting therapy clients. The problem is, those who "treat" sexual addiction, by their own admission, are treating something that is "untreatable." Read any of the literature from the sex addiction field and one finds that it cannot be "cured." That's a nice way to keep a full therapy practice.

In the 1950s, Alfred Kinsey, the lead author of the famous "Kinsey Report,"was credited with having said, "Someone is 'promiscuous' when they've had more sex partners than you have." Of course, he was speaking about the issues of perceptions and personal standards. The use of the Internet today for sexual purposes offers a current day sexual philosopher a similar opportunity to comment, "Someone is a 'sex addict' if he (the usual gender of the labeled party) spends more time online looking at sexual images than his mate does." In some cases, the "more time online" needs only to be greater than zero.

The issue of sex addiction didn't begin with the advent of the Internet, but it sure has been fueled by it. Prior to the Internet, people used magazines, books, and videos to create arousal when they didn't feel like resorting to their own minds. The ease with which a person can click from one image to the next does invite some people to spend a great deal of time looking. Prior to the Internet, it took more "dedication" to create a large collection, but that didn't mean that some people weren't spending a lot of time.

I think that the use of explicit images can be very beneficial to some people and to some relationships. Generally, when people see it somewhat similarly, that's when the benefit can occur. When there's a large discrepancy between the two viewpoints, that's when a relationship can get into some difficulties.

Next: The reason the 12-step model won't work

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Sexual Side Effects

I often am asked about the sexual side effects of medications. Here are some of the most common:

Effexor XR: This can cause delayed or absent orgasm.

Options for treatment: Wait for spontaneous ending of the symptoms or try to get used to it (an approach that many clinicians try and that most patients dislike);

Reduce the dose to the minimal effective dose (often, but not always, the dose that removes the sexual side effects fails to offer help for the issue for which it was prescribed);

Attempt to schedule sexual activity at the low ebb of the medication (this means have sex and take the medication right after the sex -- it works best for medications with short half-lives);

Try switching to another antidepressant with a lower frequency of sexual dysfunction (Bupropion is often tried for this purpose);

Take a drug holiday or partial drug holiday (The long term effect of this practice is not known and it may cause withdrawal effects at the end of the drug holiday);

Try using an antidote (There are many possibilities: Amantadine, Bethanechol, Bupropion, Buspirone, Cyproheptadine, Dextroamphetamine, Methyphenidate, Mirtazapine, Nefazodone, Neostigmine, Yohimbine. Results on each of these varies. A physician can check "Sexual Pharmacology: Fast Facts" by Robert Taylor Segraves, MD and Richard Balon, MD for dosage).

Klonopin: This is most problematic for sexuality when used with lithium (nearly half who take the two have problems), but alone pretty low reports of problems.

Seroquel: I do not yet have any research on its sexual effects on women, but it may have some ejaculatory delay in men.

Baclofen: There are only a few case reports of sexual problems with this. My hunch is that for those it does affect, it may affect the muscle tension that creates vasocongestion/blood flow to the genitals).

Nexium: I found no research that reported sexual problems from this nor its "sister" Prilosec.

Sanctura: I could not locate any research for sexual side effects of this, but most of the drugs that treat these types of bladder concerns are not yet generally have negative sexual side effects. We may learn otherwise later, but as it stands, it us unknown.

So, there you have the possible "offenders" when it comes to your sexuality. You may want to discuss these findings with your prescribing physician(s).

For more information about a specific medication , try looking it up on WebMD's drug database.


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