Compulsive sexual behaviour

December in Badda, wedding season, and Adnan’s mother calls from Rajshahi after Isha. “Baba, the girl’s family wants to see you on Friday. Wear the blue shirt, not that sad grey one.”

Adnan, 26, a site engineer on a flyover project, promises the blue shirt. Then he closes the door of his room in the bachelor flat he shares with two friends, opens the laptop, and it is three in the morning again. He deleted the apps last week. He has reinstalled them twice.

“Ki re, are you designing the flyover at night too?” asks his flatmate Babu at breakfast, as Adnan falls asleep over his paratha. Everyone laughs. Adnan laughs too, and goes to the site with a heavy head and the same promise he made the night before: this was the last time. It has been the last time for two years.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding compulsive sexual behaviour

Compulsive sexual behaviour disorder is a diagnosis in ICD-11. It describes a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repeated sexual behaviour, which for some people means online pornography. The pattern lasts over an extended period, such as six months or more, and causes marked distress or problems in daily life. It is classed among the impulse control disorders. Importantly, it should not be diagnosed on the basis of distress that comes only from moral or religious disapproval of sexual behaviour. Shame and faith both matter, and a good assessment takes them seriously without confusing them with the disorder.

How common is compulsive sexual behaviour?

There is no Bangladeshi figure. In a nationally representative survey of 2,325 American adults aged 18 to 50, 8.6% reported clinically relevant distress or impairment linked to difficulty controlling sexual feelings, urges and behaviour: 10.3% of men and 7.0% of women.

Signs and symptoms of compulsive sexual behaviour

• Repeated promises to stop, broken again and again
• Hours lost late at night, and tiredness at work
• Using sexual behaviour to escape stress, loneliness or low mood
• Secrecy that weighs on you, or worry about a future marriage
• Turning down friends, sleep or prayer times to make room for it

Treatment for compulsive sexual behaviour

A psychiatrist will ask about mood, anxiety, loneliness, ADHD, alcohol and drugs, and medicines, because some medicines, particularly dopamine-based treatment for Parkinson’s disease, can increase sexual urges. A 2025 meta-analysis of 20 studies with 2,021 participants found that psychotherapy, mostly cognitive behavioural therapy and acceptance and commitment therapy, reduced problematic pornography use and sexual compulsivity, with large effects, though many studies had a high risk of bias. Therapy works on triggers, urges and the shame cycle that keeps the behaviour going. What is said in the room is confidential, within the usual limits.

What getting better can look like

Adnan’s way back might be the laptop living in the drawing room, a few months of therapy, sleep before midnight, and a Friday in the blue shirt on which he can look the girl’s family in the eye without the weight of last night.

Common questions about compulsive sexual behaviour

Is porn addiction a real diagnosis?

ICD-11 includes compulsive sexual behaviour disorder, which covers persistent, out-of-control sexual behaviour such as pornography use that causes marked distress or harm over a long period. It is not diagnosed only because a person or their family morally disapproves of the behaviour. A doctor can assess which applies.

What is the treatment for compulsive sexual behaviour?

Psychological therapy, mainly cognitive behavioural therapy and acceptance and commitment therapy, is the main treatment studied, and studies show large reductions in problematic pornography use, though many had a high risk of bias. A psychiatrist also checks for depression, anxiety, ADHD and medicine side effects that may be contributing.

When to see a psychiatrist

If you have tried to stop and cannot, and it is costing you sleep, work, relationships or peace of mind, please book an appointment; it is confidential. If shame has left you with thoughts of harming yourself, call 999 or go to the nearest emergency department now.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

Sources

• Kraus et al., World Psychiatry, 2018 (PMID 29352554)
• Dickenson et al., JAMA Network Open, 2018 (PMID 30646355)
• López-Pinar et al., Journal of Behavioral Addictions, 2025 (PMID 40126561)
• Schincariol et al., Neuroscience and Biobehavioral Reviews, 2026 (PMID 42330690)