Distress over controlling sexual urges and impulses is a more common problem than previously thought — for both men and women — and could be interfering with the jobs, relationships and happiness of millions of Americans.
That's the takeaway from a new University of Minnesota study, which examined responses to a national survey on sexual behavior and found that 8.6 percent of people reported "clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behaviors."
Previous research estimated that 2 percent to 6 percent of people struggled with control of their sexual impulses, said Janna Dickenson, the lead author and a human sexuality researcher in the U's School of Medicine. "This is a much higher prevalence than we thought," she said.
The types of behavior causing distress could vary, Dickenson said, from having more sex than desired, to masturbating during work hours, to habitual sexting or viewing pornography. People who commit sexual assault could be included in this group, but Dickenson said the survey reflects a much broader array of people struggling with everyday problems rather than illegal actions.
Media coverage of sex scandals involving celebrities such as Tiger Woods has raised the possibility that sexually compulsive behavior is becoming more common, the authors noted, but few studies have checked to see whether that's true.
Distress over sexual urges is a key symptom of compulsive sexual behavior (CSB) disorder, which is newly recognized in the World Health Organization's latest compendium of medical diagnoses, the ICD-11. Not all people who expressed such feelings in the survey have the disorder, though.
University of Minnesota researchers analyzed responses by 2,325 adults to the 2016 National Survey of Sexual Health and Behavior. Considered one of the richest data sets regarding sexual attitudes, the survey is conducted by Indiana University and funded by the parent company of Trojan Condoms.
Within the survey, respondents answered 13 questions on a five-point scale ranging from 1 (never) to 5 (very frequently). Questions included whether respondents' sexual activities ever caused financial problems, or whether they had created excuses to justify their sexual behaviors. Scores of 35 or higher suggested compulsive problems.
Researchers said they were surprised to find only a modest gender split: 7 percent of women exceeded that score, compared with 10.3 percent of men. This in some ways defies old cultural expectations that men are "irrepressible" and women are "sexual gatekeepers" who keep their impulses in check, the authors wrote.
The study found that distress was most common among people with low incomes and without high school diplomas, but also was more common among the highest-income earners. It also was more common among people who are members of racial minorities or who are gay, but the authors urged caution in interpreting those results. Their scores may reflect the higher level of stress that comes from being marginalized individuals in the first place.
Based on survey responses in a single year, the study couldn't answer whether sexual distress is a rising problem, or why it is common. It's possible that compulsive behaviors are exacerbated by the contrast between hypersexualized media messages and the social norms of sexual restraint.
Dickenson said she hopes the study, published in the Journal of the American Medical Association's online open network, will raise the profile of compulsive sexual behavior as a problem requiring doctors' attention.
"CSB is clearly an important sexual health concern," she said, "that needs greater attention."