27 July 2004
by Jennifer D.
Unquestionably, sex is an intricate and important part of life. Pick up a book or magazine, turn on the television or radio, log onto the internet, listen to the conversation of friends or lovers, and you will undoubtedly find sexual content. Think of a few adjectives, and at least one of them has probably been used to describe sex - hot, mad, wild, fun, domineering, beautiful, complicated, intense, unrestrained ... see? But since the means of sexual expression vary widely from culture to culture, men to women, individual to individual, an obvious question arises: just what comprises a sexual addiction?
Sexual expression is a natural part of a well-rounded life. But if you have an overwhelming need for sex and are so intensely preoccupied with this need that it interferes with your job and your relationships, you may be afflicted with a paraphilia. You may find yourself failing repeatedly at attempts to reduce or control your sexual activities or desires.
Health experts use a number of labels for this potentially serious condition. It's sometimes called hypersexuality, nymphomania, erotomania or perversion. Some doctors call it sexual obsession. Others use the term sexual addiction, comparing it with the uncontrolled use of a drug. Others argue that it's an issue of impulse control or obsessive-compulsive behavior.
No matter what name is attached to the behavior, compulsive sexual behavior is a very real affliction that interferes with everyday living. The disorder is most common among men, but studies have shown that a woman experiencing the disorder may not confront it because of the shame associated with such a person. While it's difficult to accurately assess the number of people with this disorder, experts estimate that as many as one in 20 people in the United States exhibits compulsive sexual behavior.
ymphomania is the name of what was believed to be a psychological disorder peculiar to women characterized by an overactive libido and an obsession with sex. In men the disorder was called satyriasis (for etymology of the words, see Nymph and Satyr). As with all psychological disorders, it is only considered an illness if it is sufficient to prevent the sufferer from living a normal life.
As with many other things, sex drive varies widely, and what one person would consider a normal sex drive would be considered excessive by some, and low by others. However, a sex drive so strong that it prevents one living a normal life is excessive by any standards.
Nymphomania is no longer listed as a specific disorder in the DSM-IV, although hypersexuality in either sex can be viewed as a symptom of other disorders, such as bipolar disorder.
Hypersexuality and Bipolar Disorder
Hypersexuality can be a symptom of bipolar disorder, and is generally associated with the manic phase of the disease. Although manic hypersexuality may sound like a boon to some people, it often results in behavior that the manic person later bitterly regrets.
Manic sypmtoms may include the following. Abnormally and persistently elevated (high) mood and/or irritability accompanied by at least three of the following symptoms (four if the mood is merely irritable): overly-inflated self-esteem; decreased need for sleep; increased talkativeness; racing thoughts; distractibility; increased goal-directed activity such as shopping; physical agitation; hypersexuality and excessive involvement in risky behaviors or activities.
Hypersexuality and Erotomania
Usually when one refers to erotomania, they are talking about an obsession with someone that is unattainable. But when discussed in terms of hypersexuality the term erotomania is used in a less specific clinical sense meaning excessive pursuit of or preoccupation with love or sex.
Hypersexuality and "sex addiction"
Some therapists consider there to be a phenomenon of sex addiction, consisting of hypersexuality with the attributes of addictive behavior. This is not the same as hypersexuality caused by bipolar disorder or neurological damage.
Hypersexuality as it pertains to women
Although there is a long history of medical concern about female sexuality going back as far as Galen's belief in the necessity of women having periodic orgasms, even self induced ones, or otherwise hysteria would result, the fear of "excessive" female sexuality seemed to have peaked in the nineteenth century. In a period in which a large segments of the medical community believed that masturbation and sexual excess caused insanity and disease, it probably seemed logical to many of them to label women with "excessive sexual desires," as nymphomaniacs, although it was never clear what excessive meant. Men with similar excessive desires were said to be have satyriasis, but it was women who came in for the most pointed comments in the medical literature, dominated by the writings of male physicians.
Nymphomaniacs did not have to have a partner to be labeled as such, and much of the nineteenth century history of nymphomania is concerned with masturbation.
The medical community, however, was divided over whether nymphomania was a problem of the genitals or of the brain. Autopsies gave them no guidance, but the fear of dangers of nymphomania and masturbation inculcated into the public mind was so great that many women desperately sought help with their sexual problems in order to avoid going insane.
Even though many of the ideas about masturbation were challenged and even modified by individuals such as Havelock Ellis and Sigmund Freud, it was still believed that women who refused to accept their innate feminine psyches which programmed them to be modest, maternal, and passive, were oversexed, potentially pathological, and sexually deviant. Excessive sexuality in women, for example, might lead to lesbianism. A contrasting current theory had a different explanation, namely that nymphomaniacs were frigid and it was lack of sexual satisfaction which led women to be oversexed. Tied in with this was a belief that women made up charges of rape since fantasies of rape were common to most women and it was the
unsatisfied sexual drive of females which led them to make such claims.
Almost any women who seemed to enjoy sex could be called a nymphomaniac by some medical specialist or other and especially if she had a sex drive stronger than that of her male companion. Nymphomania made its appearance as a sexual deviation in the first DSM which appeared in 1951, and this was changed to a psychosexual disorder in the DSM III in 1980. The diagnostic category in both cases was ambiguous and not helpful since there were no specific diagnostic criteria and no instructions to the mental health practitioners on how to recognize it. The DSM IIIR labeled it a sexual addiction, but this was dropped in DSM IV. At the beginning of the twenty first century nymphomania had finally disappeared as a medical diagnosis, although a popular image of such a woman still is retained.
What the author concludes is that as far as women are concerned there is no satisfactory answer to how much is too much and how much is enough. The obvious answer is that this varies among women just as it does among men, something that many cannot yet accept.