Dear Dr Milrod:

I have a sexual addiction I believe. I think constantly about sex. Do support groups actually work or not? I think my sexual addiction has gotten worse because of the fact I quit smoking a few months ago, and since then, my sexual appetite has increased.

Is this normal?

Horny Toad

Dear Horny Toad:

Please let’s not confuse thoughts of sex and sexual appetite with sex addiction. If you have quit smoking it is only natural that your sexual appetite has increased, as there is more bloodflow to the brain and more bloodflow to the penis – a wonderful, nice phenomenon.

Now the “addiction” part. Are you finding yourself constantly searching for women on line? Are your finances in trouble because of spending money on escorts? Are you neglecting your partner at home because you are on line for hours either porn surfing or communicating with sex workers? Is searching and interacting with paid sex professionals taking over your private life? If you are neglecting other aspects of your life such as your partner, kids and work, then you probably have some issues of compulsivity. But just having increased thoughts of sex and a high sex drive does not sex addiction make.

I work worldwide with men who have been branded by others as “addicts.” We enter into a twice-a-week coaching program via Skype or ooVoo for a minimum of three months. Oftentimes we find that there are other issues, sometimes even psychiatric ones requiring medication, that have nothing to do with “addiction” at all. This means depression, impulse control disorders, etc. that mask as “sex addiction.” It’s a very complex issue that cannot be answered simply as “you are an addict, stop having sex for X amount of time.” That’s why “support groups” often fail – they deny the physical necessity of sex while shaming the individual.

I believe that if you are having problems in your daily life where sex takes up much of your time, then there are underlying issues that need to be addressed in therapy or coaching. But just having increased sexual thoughts and wanting to engage sexually is normal, particularly if you’re young, healthy and have an otherwise happy life.

Christine Milrod, PhD