A sex addict is someone who continues to engage in sexual behaviors, even when they have physical, career, legal or emotional consequences. For some sex addicts, the sexual behaviors consume time, energy or focus that was traditionally used for other things such as work or family. For sex addicts, the sexual behavior runs counter to the person's core values and beliefs, so much so that they promise themselves and others that the current episode is the absolute last time they will behave this way, albeit with disappointing follow through. Many sex addicts, both men and women, find themselves leading double lives in order to keep the sexual behavior hidden from family, friends or co-workers. Admitting to sex addiction is often harder for women than men, given our societal constructs that label oversexed men as "studs" and oversexed women as "sluts". The behaviors most commonly associated with sexual addiction include watching internet porn (with or without masturbation), voyeurism, exhibitionism, engaging in online and smart phone "hook-ups", frequent episodes of anonymous or casual sex, habitual use of prostitutes or escorts, sensual massage, engaging in one or more affairs or frequent sex outside of primary relationship, and compulsive masturbation. A sex addict does not necessarily need to engage in sexual behaviors with others. In fact, some addicts are too fearful of being discovered, catching a sexually-transmitted disease (STD), or being rejected to engage in sexual behaviors with others. Compulsive masturbation, often beginning in childhood or adolescence, is particularly problematic for sex addicts and they can spend hours each day masturbating in isolation, even to the point of injury. Others will require masturbation to get to sleep at night or must engage in the behavior each morning upon waking. However, these people are also the most likely to be in denial about having a sexual addiction. Contrary to what some may think, sexual addiction is not necessarily synonymous with having an overactive sex drive, unless the person is also not honest about their situation. Sex addicts tend to lie to themselves, their spouses and loved ones, keep secrets, and sneak around in order to engage in recreational sexual behavior. Sexual addiction is a bona fide medical disorder wherein the addict uses cruising, flirting, fantasy, intrigue, and the sexual acts themselves to manage and tolerate feelings, stress, and emotional issues. However, no amount of sex will make the problems go away. Although not always able to admit it, many sex addicts have a history of problems with relationships and intimacy. Despite being surrounded by supportive friends, family, or partners, some sex addicts will use sex in place of the daily dose of support and intimacy that humans crave. Sex addicts report overwhelmingly intense feelings (much like being in a trance or experiencing the rush of adrenaline) when either fantasizing about acting out sexually, or actually preparing to do so. These anticipatory feelings often end up being stronger than the feelings experienced during the actual sexual behavior. Gay men, in particular, often have trouble admitting that they have a problem with sex addiction. Already having gone through years of feeling stigmatized for their sexual orientation, some gay men resist having to take on another label related to their sexuality. Aside from the gender of their sexual partners, however, there is little difference in sexual addiction between straight and gay men. While straight men may exhibit their addictive behavior in strip clubs, massage parlors, and movie theatres, gay men frequent similar types of places (e.g., sex clubs and bathhouses). In fact, some of the most reputable sex addiction recovery programs welcome both gay and straight patients at the same time. Sexual addiction is not the type of disorder that can be treated with medication alone. Although there are some anti-depressants and hormones that can reduce sex drive or the compulsive nature of the sexual behavior, the emotional issues that underlie the sexual addiction must also be addressed. Sexual addiction treatment professionals recommend addiction-based counseling and 12-step support groups as ways to effectuate long-term change. Unlike with addiction to drugs or alcohol, sobriety for the sexual addict does not necessary mean a complete abstinence from sex. Instead, sexual sobriety is mapped out using a "sex plan" or contract between the addict and their 12-step sponsor, therapist, or clergy member and prohibits the behaviors that were illegal or abusive or made the person feel shameful or secretive. The plan clearly defines the behaviors from which the sex addict has agreed to abstain in order to be "sober"; for instance, some plans will call for no sex outside of the marriage or partnership while others will prohibit sex unless involved in a committed relationship. As the sex addict begins to understand his or her own disease, the list of prohibited behaviors may change or even shorten. One way to determine if you are a sex addict is to refrain from engaging in sexual behavior for thirty days. If you are unable to keep this commitment relatively easily, you should probably be evaluated by a trained sex addiction therapist.