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Health condition

Compulsive Sexual Behaviour Disorder, an ICD-11 impulse-control condition, not a moral failing.

When repeated sexual urges and behaviours cause real distress or damage and you cannot control them, that is a clinical problem with a clinical answer.

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Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against ICD-11, WHO, RCPsych and peer-reviewed psychosexual sources listed at the end.

  • 03

    Current for 2026

    Reflects the ICD-11 6C72 impulse-control classification and modern UK psychosexual practice.

Key facts

CSBD at a glance.

The essentials, in plain English, what it is, what it is not, and how UK psychosexual services treat it in 2026.

  • What it is

    Compulsive Sexual Behaviour Disorder (CSBD) is an ICD-11 impulse-control disorder, code 6C72, marked by persistent, repetitive sexual urges or behaviours the person cannot control.

  • Not an addiction

    DSM-5 excluded hypersexual disorder, so CSBD is not classified as a behavioural addiction in the US system. ICD-11 recognises it as a distinct impulse-control disorder.

  • How common

    Community estimates suggest 2 to 6 per cent of adults meet criteria, with men more often affected than women.

  • Core feature

    Distress or impairment despite repeated efforts to control urges, not high libido or moral discomfort alone.

  • What it is not

    Not simply enjoying sex, not a non-problematic paraphilia, and not moral incongruence driven by religious or cultural values.

  • Treatment

    Specialist psychosexual therapy is first-line, with CBT, ACT, trauma-focused work and off-label pharmacotherapy where indicated.

Why this guide matters

A clinical problem, not a character flaw.

CSBD is treatable when it is named and assessed properly. The three principles below shape everything else on this page.

  • Distress and impairment define it

    The disorder is not defined by frequency, orientation or preference. It is defined by loss of control, distress and real-world harm.

  • Comorbidity is the rule

    Depression, anxiety, ADHD, trauma, substance misuse and other addictions travel with CSBD and need treating in parallel.

  • Care is stepped and specialist

    Psychosexual therapy leads, medication supports, and safeguarding, sexual health and relationship care all sit alongside.

How the assessment is done

From first conversation to a clear plan.

What a UK GP, psychiatrist or psychosexual specialist will normally cover, in order, so you know what to expect.

  1. 01

    Assessing

    Detailed sexual history

    Nature, frequency, control, distress and impact across relationships, work, finances and health, and any triggers or escalation over time.

  2. 02

    Assessing

    Screening questionnaires

    Compulsive Sexual Behaviour Inventory (CSBI), Hypersexual Behavior Inventory (HBI) and Sexual Addiction Screening Test (SAST) help quantify severity.

  3. 03

    Assessing

    Mental health and comorbidity scan

    Screen for depression, anxiety, ADHD, trauma or PTSD, bipolar, substance misuse, eating disorders and suicidality.

  4. 04

    Confirming

    Exclude other causes

    Rule out bipolar mania, frontal-lobe injury, dementia, dopamine agonists (as in Parkinson care) and paraphilic disorders that need a different pathway.

  5. 05

    Confirming

    Full sexual health screen

    HIV, syphilis, hepatitis B and C, chlamydia and gonorrhoea plus a partner-notification review, given the STI risk that comes with high-risk contact.

  6. 06

    Preparing

    Safeguarding review

    A mandatory screen for illegal behaviour, workplace concerns and child protection under Working Together to Safeguard Children, handled sensitively.

  7. 07

    Preparing

    Partner and family assessment

    Where appropriate, offer a specialist psychosexual and couple assessment so the impact on partners is heard and supported.

Typical timeline: first specialist appointment to a working plan in a few weeks.

Presentation

What CSBD actually looks like.

Persistent urges, failed control, preoccupation, harm and shame, plus the features that mean it is time to bring in specialist help.

  • Persistent, intrusive urges

    Intense sexual impulses that keep returning and dominate attention, even when the person wants them to stop.

  • Failed attempts at control

    Repeated promises to cut down, delete apps or stop behaviours, followed by relapse within days or weeks.

  • Preoccupation and neglect

    Hours lost to planning, seeking or recovering from sexual behaviour, with health, hygiene and responsibilities set aside.

  • Continued use despite harm

    Behaviour continues after relationship, work, financial, legal or health consequences have already appeared.

  • Shame, distress and low mood

    A heavy load of guilt, secrecy and self-criticism that often feeds the cycle and worsens comorbid depression.

  • Common behavioural patterns

    Compulsive masturbation, pornography use, cybersex, cruising, paid sex, affairs or high-risk anonymous encounters.

  • Escalation and diminishing satisfaction

    Needing more time, more novelty or riskier contact to reach the same relief, with satisfaction fading over time.

  • Red flag - safeguarding or self-harm

    Any concerns about child protection, illegal behaviour or suicidal thoughts need urgent specialist and safeguarding input.

Management

How CSBD is treated in the UK.

Specialist psychosexual therapy leads, with medication, sexual health care, peer support and, where needed, safeguarding sitting alongside.

  • Specialist psychosexual therapy

    A COSRT-accredited psychosexual therapist is the foundation, using CBT, ACT and mindfulness-based approaches tailored to CSBD.

  • Cognitive behavioural therapy

    First-line psychological work covering trigger identification, urge surfing, relapse prevention and value-led behaviour change.

  • Motivational interviewing

    Helps resolve ambivalence early in treatment and strengthens the person’s own reasons for change without moralising.

  • Trauma-focused therapy

    EMDR or cognitive processing therapy where childhood or adult trauma is driving the behaviour, delivered by a trauma-trained clinician.

  • Couple and relationship therapy

    Specialist Relate or psychosexual couple work supports partners, rebuilds trust and creates shared boundaries.

  • Peer support groups

    Sex Addicts Anonymous (SAA), Sex and Love Addicts Anonymous (SLAA) and Sexual Compulsives Anonymous (SCA) offer step-based peer recovery.

  • Pharmacotherapy (off-label)

    SSRIs such as paroxetine, sertraline or citalopram can reduce urges; naltrexone shows emerging evidence for cravings; anti-androgens for severe or paraphilic cases only.

  • Sexual health and STI care

    Full screen plus treatment, condoms, safer-sex planning and HIV PrEP where appropriate through a specialist clinic.

What this guide is based on

The sources behind every claim on this page.

International classifications, UK specialist society standards and peer-reviewed psychosexual research, current at last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or psychosexual specialist knows your history and can say which parts apply to you. If you feel unsafe or overwhelmed, get support today.

  • World Health Organization. ICD-11 6C72 Compulsive Sexual Behaviour Disorder.

  • Royal College of Psychiatrists. Guidance on problematic sexual behaviour and impulse-control disorders.

  • College of Sexual and Relationship Therapists (COSRT). Ethical framework and practice standards.

  • Kraus SW et al. Compulsive sexual behaviour disorder in the ICD-11 - clinical features and evidence base.

  • BASHH. UK national guidelines on sexual health screening and PrEP.

Red flags

When CSBD needs urgent attention.

Most of CSBD is managed in planned specialist care. These are the situations that need faster action, safeguarding or an urgent specialist opinion.

  • Suicidal thoughts or self-harm

    Shame, secrecy and comorbid depression raise suicide risk. Any active thoughts need same-day GP, NHS 111 or crisis-team contact.

  • Safeguarding and child protection

    Any concerns involving children, non-consenting adults or vulnerable people must be reported per Working Together to Safeguard Children.

  • Illegal behaviour or workplace risk

    Behaviour that breaks the law, or breaches workplace policy, needs specialist psychosexual, legal and occupational-health input, not silence.

  • Sudden onset in mid or later life

    New hypersexual behaviour with mania, disinhibition or personality change can point to bipolar illness, dementia or frontal-lobe injury.

  • Dopamine agonist medication

    People taking dopamine agonists for Parkinson disease or restless legs can develop impulse-control disorders that need urgent prescriber review.

  • High-risk anonymous encounters

    Unprotected anonymous sex, chemsex or injecting drug use during sex needs urgent sexual health, HIV PrEP and specialist chemsex support.

  • Severe relationship or family crisis

    Disclosure, separation and family breakdown are common flashpoints and benefit from early couple and family support.

  • Rapid escalation of risk

    Escalating financial spend, riskier partners or more extreme content in a short window is a signal to bring the appointment forward.

  • Concerning paraphilic urges

    Urges involving children or non-consent need specialist forensic psychiatric assessment, not standard psychosexual therapy alone.

Living with it

A treatable condition, with a clear ladder.

Four things that make the biggest difference day to day: structure, honest support, whole-person health and compassion in place of shame.

A quiet reminder

Recovery is a practice, not a verdict.

Progress comes from consistent small steps, honest conversations and a team around you, not from a single dramatic decision.

  1. 01 Structure

    Reduce triggers, add friction

    Delete high-risk apps, use content blockers such as Covenant Eyes or Accountable2You, and rebuild routines that leave less unstructured time.

  2. 02 Support

    Do not do this alone

    A therapist, a peer group and one trusted accountability partner protect recovery better than willpower on its own.

  3. 03 Health

    Look after physical and mental health

    Regular STI screens, treat depression, anxiety, ADHD and substance misuse in parallel, and keep sleep, exercise and nutrition steady.

  4. 04 Compassion

    Judgment slows recovery

    Care that focuses on distress and impairment, not moral shame, works better long-term. Faith and culture matter and can be part of the plan.

Frequently asked

Everything we get asked about CSBD.

Quick answers on the diagnosis, therapy, medication, sexual health and partner support.

  • Is compulsive sexual behaviour the same as sex addiction?

    Not quite. ICD-11 classifies CSBD as an impulse-control disorder (code 6C72), and DSM-5 chose not to include hypersexual disorder as a formal addiction. The lived experience overlaps with addiction, and many people find 12-step language helpful, but the diagnostic label in UK practice is CSBD.

  • How do I know if I have CSBD rather than just a high sex drive?

    A high libido on its own is not a disorder. CSBD requires persistent, intense urges you repeatedly fail to control, preoccupation that displaces other parts of life, continued behaviour despite clear harm, and real distress or impairment lasting six months or more.

  • What if my distress is really about religious or moral conflict?

    ICD-11 is clear that moral incongruence, discomfort driven by personal, cultural or religious values, is not enough on its own to diagnose CSBD. A good assessment separates value-based distress from a genuine loss of control, so treatment fits the real problem.

  • What kind of therapy actually helps?

    Specialist psychosexual therapy is first-line, usually CBT-based with ACT and mindfulness techniques. Trauma-focused work is added where trauma is a driver. Peer groups such as SAA, SLAA or SCA can support therapy well. Couple work helps rebuild trust when a partner is affected.

  • Are there any medications for CSBD?

    All pharmacotherapy is off-label. SSRIs such as paroxetine, sertraline or citalopram can help by dampening urges. Naltrexone has emerging evidence for cravings. Anti-androgens are reserved for severe cases or paraphilic disorders and are prescribed only under specialist psychiatric care.

  • What about my sexual health and my partner?

    A full STI screen, including HIV, syphilis, hepatitis and chlamydia, should be part of any assessment, along with condoms, PrEP where appropriate and partner notification. Where a partner has been affected, specialist couple or psychosexual therapy helps process disclosure and rebuild the relationship.

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