I tend to be of the camp that understands excess sexual behavior as a compulsion for some and an impulsive behavior for others. By compulsion, I mean that the person feels driven to act out this behavior and feels quite anxious or uncomfortable if they cannot. Think of the person who cannot leave the house because they have to continue to check to make sure the stove is off. If viewed this way, one could start to make a distinction between some excessive, compulsive sexual behaviors, and other sexual behaviors. Still others tends to use sex in an impulsive way, not feeling compelled to act, but wanting to do it anyway.
Another difficulty with the use of the term "sex addiction" is that it is a bucket term that can include anything from excess masturbation, to excess time viewing pornography, to promiscuous sexual activity with one or more partners, or any combination of the above. The reason why someone might engage in impulsive or compulsive sexual activity can be varied too. Some people act out this way because it is the only way they feel comfortable with closeness to another person, some have low self-esteem and are trying to get approval, others find that they get a much quicker arousal response from intense stimuli or interactions and find this easier than the lower intensity of a long-term relationship.
More Answers from Madeleine Castellanos MD