Is My Sexual Behavior Out of Control? (PATHOS)

Compulsive sexual behavior — sometimes called out-of-control sexual behavior, hypersexuality, or 'sex addiction' — describes a persistent pattern of intense sexual urges or behaviors that feel difficult to control and that cause real distress or problems in someone's life, relationships, work, or health. The World Health Organization recognizes a related diagnosis, Compulsive Sexual Behavior Disorder, in the ICD-11. What sets it apart from simply having a high sex drive is the sense of lost control and the distress or harm that follows — not the amount of sex itself, and not anyone else's judgment about what's 'too much.'

PATHOS is a brief, validated six-question screening tool published by Carnes and colleagues in 2012 to help flag possible problematic or compulsive sexual behavior. Its name is a memory aid for the six areas it asks about: being Preoccupied with sex, feeling Ashamed of or hiding behavior, having sought Treatment or help, someone being Hurt, feeling Out of control, and feeling Sad or down after sex. Each 'yes' counts as one point, and a total of three or more suggests it's worth exploring further with a professional. It's a quick starting point for a conversation, not a diagnosis.

It means enough of these experiences resonate that talking with a professional could genuinely help — not that you've been labeled or diagnosed. A screen like PATHOS is deliberately sensitive: it's meant to catch people who might benefit from support, so a positive result is an invitation, not a verdict. Many things can drive these feelings, including stress, shame, mood, trauma, or relationship strain, and they're treatable. A therapist — ideally one familiar with sexual health or compulsive behavior — can help you understand what's going on and what would actually help.

The terminology is debated, but the underlying experience is real and recognized. Many clinicians and researchers avoid the term 'sex addiction,' and instead the World Health Organization's ICD-11 includes Compulsive Sexual Behavior Disorder as an impulse-control condition. Whatever it's called, the core is the same: a pattern of sexual urges or behavior that feels out of control and causes distress or harm. What matters far more than the label is whether it's affecting your life and whether support would help — and effective help exists regardless of the name.

A good first step is a therapist or counselor, especially one experienced in sexual health, compulsive behavior, or addiction — they can assess what's happening and tailor support, which may include talk therapy (such as cognitive behavioral therapy), addressing underlying mood or trauma, and sometimes peer support groups. A primary-care doctor can also help and refer you. If sexual behavior has involved risk of infection, it's worth pairing support with STI testing. And if you ever have thoughts of harming yourself, contact a crisis line or emergency services right away — in the U.S., call or text 988.

Yes. This tool runs entirely in your browser. Your answers are scored on your own device and are never sent to a server, saved, or shared — close the tab and they're gone. It's general educational information based on a published, validated screener; it can't diagnose you or replace a conversation with a professional.