Can you be a sex addict in a relationship?

I need to have sex every day, sometimes more than once. My girlfriend also has a high libido, but however much sex we have, it’s never enough.

It is, I feel, quite worrying that a monogamous male suffering from nothing more sinister than a healthy sexual appetite, could even begin to contemplate that he might be suffering from some sort of pathology.

Sex addiction is not a clinical term, but it is widely understood to mean sexual behaviour that is out of control, high-risk and self-destructive.

People who are addicted to sex suffer from a compulsion to engage in an escalating quantity, or variety, of sexual experiences to achieve a sexual high.

They do this regardless of the medical, relational, social, financial or legal consequences.

Although this interpretation of sex addiction sounds like unarguable fact, the American Psychiatric Association does not even recognise sex addiction as a mental illness and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not include a full entry on hypersexuality — the clinical term for sex addiction. Instead, it is listed among the conditions that require more research.

For good reason too. Most self-confessed sex addicts have multiple dependencies, and it is often their use of alcohol and drugs that forces them to seek help.

Recovering sex addicts are usually put on a 12-step programme, much like that of recovering alcoholics and drug addicts, but other psychological disturbances such as obsessive-compulsion, bipolarity, histrionic personality disorder, borderline personality disorder, and generalised anxiety can manifest sexually too, so there is a danger that the label “sex addict” channels people who need other kinds of mental help into inappropriate 12-step-based recovery programmes.

Your sexual behaviour doesn’t cause you distress. You are not looking for sex outside your relationship. And your girlfriend is a willing partner with an equally high libido.

Far from being dysfunctional, those are the hallmarks of a healthy sexual relationship, and that ‘never can get enough’ feeling simply reflects the intensity of the sexual chemistry between you.

Sex and orgasm feel good because they trigger the release of neurochemicals, which stimulate the brain’s reward circuit. This is the same circuit that is exploited by drugs such as cocaine and heroin.

In fact PET brain scans carried out by Dr Gert Holstege at the University of Groningen in the Netherlands show that the brain of a man taking heroin is 95% the same as the brain of a man having an orgasm.

During orgasm and ejaculation, surging dopamine is accompanied by a decrease in activity in the amygdala, the part of the brain that is involved in vigilance and fear. And postcoitally, beta-endorphins, prolactin, and oxytocin create feelings of satiety and relaxation.

The pleasure associated with sex and orgasm is basically Mother Nature’s way of thanking us for ensuring the survival of the species.

It is addictive, particularly at the beginning of a new relationship, but over time habituation dulls desire to more manageable levels and couples can begin to fit in a few hours of work between all the sex.

Given the rather obvious distinction between a sex life that either is, or isn’t, marked by distress, it seems strange that a normal sexual appetite could ever be confused with the horrors of addiction.

However, in the past 10 years, a whole industry has emerged that seems intent on blurring the boundaries of what constitutes normal or aberrant sexual behaviour. In the US, 16 million people now label themselves as “sex addicts”.

Undoubtedly, some of them need help, but one can’t help thinking that for others, the term might just be a convenient rationalisation for not being able to keep their pants on.

You are not a sex addict, and nor am I, but in the interests of research I took the diagnostic screening test ( www.recoveryzone.com ) developed by America’s leading authority on sex addiction, Dr Patrick J Carnes. This is what I was told.

“We have compared your answers with people who have been diagnosed with sex addiction. Your answers have met a score on a basis of six criteria that indicate sex addiction is present . . .

You’ve taken the test and it confirmed your fears. You’re probably frightened, confused, and overwhelmed. Where do you go? Whom can you trust?

We know how you feel — we’ve been helping people like yourself since 1983, and we regard your anonymity as sacred.”

Revise that figure to 16 million and one.

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