Sex and pornography addiction

What is sex and pornography addiction?

This guide is for people whose sexual behaviour or pornography use feels out of control and is causing them distress, or harming their relationships, work or wellbeing. The distress is real and deserves compassionate, non-judgemental help.

It is important to be honest about the diagnosis, because it is debated. The World Health Organisation recognises "compulsive sexual behaviour disorder" (CSBD) in ICD-11 as a persistent failure to control intense sexual impulses leading to repetitive sexual behaviour over a long period, with clear distress or harm. Crucially, WHO classes it as an impulse-control disorder, not as an addiction. The terms "sex addiction" and "pornography addiction" are widely used but contested: experts disagree about whether these are best understood as an addiction, a compulsion, an impulse-control problem, or sometimes a reflection of distress, shame or another condition. There is no agreed single "pornography addiction" diagnosis.

Because of this uncertainty, good care avoids overstating things. It focuses on the actual distress, loss of control and harm, looks for any underlying issues such as anxiety, depression, trauma or relationship difficulties, and offers evidence-based talking therapy. It also separates genuine difficulty from shame driven by personal, cultural or religious beliefs about sex, which is a different problem needing a different, respectful approach.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

What this is, and what it is not

Feeling guilty about pornography or sex is not the same as a disorder. A good clinician separates real loss of control from shame driven by personal, cultural or religious beliefs, and respects both.

Preparing for your treatment

• Note specific examples of how the behaviour is affecting your life: relationships, work, mood, finances or wellbeing.
• Think honestly about whether there is real loss of control, or mainly distress and shame about the behaviour itself.
• Consider what might be underneath it, such as stress, low mood, anxiety, loneliness or past trauma.
• Tell your clinician about your mood, any thoughts of self-harm, and any alcohol or drug use, as these are treated alongside.
• Be reassured that therapy is confidential and non-judgemental; you will not be shamed.
• Save crisis numbers in your phone in case they are needed: 999 and Samaritans 116 123.

What happens

Help usually begins with a careful, non-judgemental assessment. A therapist or clinician looks at the behaviour, whether there is genuine loss of control, the distress and harm it causes, and what might be driving it, including any depression, anxiety, trauma or relationship difficulty.

A good clinician is honest that this is a debated and evolving area, avoids labelling ordinary sexual behaviour or pornography use as an illness, and pays attention to whether distress is being driven by shame or by personal, cultural or religious beliefs, which need a respectful rather than a medicalising approach.

Where there is a genuine problem, treatment is mainly talking therapy, often CBT, sometimes wider psychotherapy. Any underlying mental health condition is treated too, and couples support may be offered where a relationship is affected. There is no specific licensed medication for this, though medication may be used for an underlying condition.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The main risks here are getting the framing wrong and increasing shame. "Sex addiction" and "pornography addiction" are contested terms, and some approaches risk pathologising normal behaviour or moralising rather than helping. Good care is non-judgemental, evidence-based, honest about uncertainty, and careful to separate genuine loss of control from distress driven by beliefs about sex. If shame, low mood or hopelessness ever become overwhelming, treat it as an emergency: call 999 or the Samaritans on 116 123.

Published figures to discuss

Reliable figures are very limited here, partly because the diagnosis itself is debated and definitions differ. Estimates of how common compulsive sexual behaviour or problematic pornography use are vary widely and are affected by stigma and by differing thresholds. Because the evidence is uncertain and evolving, we do not quote precise percentages, which could be misleading.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

This is about what happens after you seek help, so "recovery" here means how control, distress, relationships and wellbeing improve over time. Progress is usually gradual and is measured by life and mood improving, not by any single number.

• Embarrassment or shame early on that eases as trust builds
• Urges that come in waves and gradually become easier to manage
• Difficult emotions surfacing as underlying issues are explored
• Ups and downs in mood and motivation during therapy
• Gradual rather than sudden improvement in distress and daily life

Aftercare

• Keep attending therapy and use the coping strategies you have agreed for urges and triggers.
• Continue treatment for any underlying depression, anxiety, trauma or substance use.
• Be kind to yourself about setbacks; recovery is rarely a straight line.
• Where relevant, keep working on honesty and trust in your relationship, with support.
• Look after sleep, routine, exercise and social contact, which support wellbeing.
• Agree who to contact if things slip or if your mood drops significantly.
• Keep crisis numbers to hand and use them if shame or low mood becomes overwhelming.

• Coping strategies for urges and triggers written down
• A plan for treating any underlying mental health condition
• Details of your therapy and follow-up
• Relationship or couples support arranged where relevant
• Crisis numbers saved: 999, Samaritans 116 123
• Agreement on who to contact after a setback

⚠ Get urgent help if…

• Thoughts of self-harm or suicide — call 999 or the Samaritans free on 116 123 at any time
• Overwhelming shame, hopelessness or feeling unable to cope
• Sexual behaviour that puts you or others at risk of harm
• Any behaviour involving children or non-consenting people — this is a safeguarding and legal matter and needs urgent, appropriate help
• Worsening depression, anxiety or substance use
• Behaviour that is escalating despite your efforts to stop
• Feeling completely isolated or unable to seek help

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your psychiatrist gives you.

Results & realistic expectations

A good outcome is feeling more in control, less distressed and less ashamed, with relationships and mood improving and any underlying condition treated. It is judged by your wellbeing and life improving, not by any single measure of behaviour.

Because this is a debated and evolving area, no responsible clinician can promise to "cure an addiction". What therapy can do is help you understand and manage genuinely out-of-control behaviour, address what is underneath it, reduce shame, and decide what a healthy relationship with sex and pornography looks like for you.

For most people this is about reaching a more settled, less distressing relationship with sex and pornography rather than a one-off fix. Patterns can return at times of stress, low mood or relationship difficulty, so keeping helpful strategies in place and any underlying condition treated supports lasting change.

Related tests, treatments or support

Support here is often combined with treatment for depression, anxiety, trauma or substance use, and with relationship or couples therapy where a partnership is affected. Where another mental illness is present, both should be addressed together rather than separately.

Follow-up & long-term care

Follow-up is usually through ongoing therapy and review of how distress, control and relationships are improving. After a setback, more frequent contact is normal. Ask your therapist who to contact and how to get help quickly if your mood drops or you feel unsafe.

• Keep using coping strategies for urges and high-risk moments
• Continue treatment for any underlying mental health condition
• Maintain routines around sleep, exercise and social contact
• Keep working on relationships and honesty where relevant
• Stay alert to patterns returning at times of stress or low mood

Repeat, follow-on and what comes next

• Assessment may conclude that behaviour is not a disorder and that distress is belief-driven, and the plan should reflect that honestly.
• Setbacks are common and lead to the plan being reviewed, not abandoned.
• If an underlying condition emerges, the focus of treatment may shift towards it.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Non-judgemental, confidential care from a properly trained and registered therapist.
• An honest formulation that separates genuine loss of control from belief-driven distress.
• Treatment of any underlying mental health condition, coordinated with this work.
• Relationship support where a partnership is affected.
• A clear route to urgent help if mood drops, shame becomes overwhelming, or there is any safety concern.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether you use NHS or free services or pay for private psychotherapy
• Number and length of therapy sessions
• Whether wider or specialist psychotherapy is involved
• Whether couples or relationship therapy is included
• Whether assessment and treatment of an underlying condition is part of the plan
• How much ongoing support and follow-up is provided

• The therapist's training, registration and experience in this area
• What the assessment includes and whether it considers underlying conditions
• How many sessions are included and what they cover
• Whether couples or relationship support is included where relevant
• What follow-up and support is available after the main sessions
• The cancellation and missed-appointment policy

On the NHS? Some NHS psychological and sexual health support is available but dedicated services are limited; private psychotherapy is commonly used, and your GP can advise on options.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the psychiatrist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good psychiatrist will welcome every one of these.

• Is this genuinely out of control and harmful, or distress driven mainly by shame or beliefs?
• What underlying issues, such as low mood, anxiety or past trauma, might be involved?
• What does the evidence actually support for treatment, given the uncertainty?
• Will the approach be non-judgemental, and how will you avoid increasing shame?
• Should my partner or relationship be part of the support?
• What should I do if my mood drops or I feel unsafe?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the psychiatrist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified psychiatrist for sex and pornography addiction

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: ICD-11 — compulsive sexual behaviour disorder (WHO) Impulse control disorders and behavioural addictions in ICD-11 — PMC Treatments for compulsive sexual behaviour disorder (systematic review) — PMC Contested classification of CSBD (commentary) — PMC NHS — mental health support services Samaritans (free, 24/7) — 116 123

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.