Addiction is defined in the dictionary as “the state of being enslaved to a habit or to something that is psychologically or physically habit-forming, as narcotics, to such extent that its cessation causes severe destruction.” On the other hand, obsession is thought to be “the domination of one’s thought by a persistent idea, image or desire.” There is a fine line between an obsession and addiction. When an obsession “enslaved” a person to a point of “destruction”, then the addiction would become an entity that is threatening. It is hard to imagine “sexual addiction” is an entity that even exists. In Darwin’s theory of evolution, the survival of the fittest is dependent on the ability of the species to pass on the genetic materials through sexual acts, as often as possible. Therefore, the constant desire for sex in men should be considered normal, as it is the main driver of procreation. Will such desire “enslave” men to the point of “destruction” is a debate many psychologists and psychiatrists would engage in. In nature, shouldn’t there be a mechanism for the brain to stop thinking about sex? Is there such thing as “too much sex” in both men and women? When engaging in a discussion about “sexual addiction” it is difficult not to mention Michael Douglas. How much of a truth is there with Douglas’ “demon”? Douglas is best known for his roles in films such as Wall Street, Basic Instinct, Romancing the Stone, and of course Fatal Attraction. For those of us who lived through the 80s, believe it of not, it has been more than a quarter of the century since he mesmerised us with his Academy awarded role in the film, Wall Street. This was the movie that became the archetypal portrayal of 1980s access, with the Gordon Gecko (played by Douglas) declaring: “Greed is Good”. In reality, how much of Douglas’ “greed” for drugs, alcohol and sex were even true? In fact, this is what Michael has to say about his addictions: “Despite all the information one accumulates, and despite the damage you know smoking wrecks on people, they still do it. It’s the same with alcohol. Drinking has nothing to do with highs, thrills, whatever. It has to do with many other causes. I am not self-destructive. Where did this sex addiction stuff come from? Some smart British Editor decided to make the story about sex addiction. That hung around since 1992, and that little lie that got a lot of press, affecting how people looked at me.” So, how much of sex addiction is “media manufactured” and what degree of destruction will have an impact on an individual and society? Lets deal with these questions when addressing Lucy’s query. Dear Dr G, Thank you so much for responding to my email. My name is Lucy, and I am 42 years old. I have an issue in my relationship that I would like you to help me with. My husband and I have been married for 15 years and we have two beautiful children together. When we first got married, the sexual relationship has been very frequent. Strangely enough, despite the advancing age, there seems to be no slowing down of my 43-year-old husband’s appetite for sexual contact. His desire is constantly there even during the time of my pregnancy and breast-feeding. Don’t get me wrong. I enjoy and appreciate the lovemaking. However, I am worried he might have “sex addiction”. I read somewhere, the sex addiction is a disease that can be quite serious and treatment is available. Is there any test to assess his condition? How much sexual contact would be considered too much? Thanks in advance for answering my questions. Lucy Sexual addiction was first termed in mid 1970s when various members of Alcoholic Anonymous sought to apply 12 steps towards recovery from unmanageable compulsive sexual behavior similar to their experienced with alcoholism. In fact, there are sex help groups immerging SAA (Sexual Addicts Anonymous) since the 80s. Sexual addiction is a compulsive participation or engagement in sexual activities despite negative consequences. In clinical setting, sexual dependence may also refer to patients reporting their inability to control their sexual urges, behaviours or thoughts resulting in negative impact on daily lives and relationship. Medical opinions are quite divided among psychologists, sociologists, sexologists and psychiatrists. The controversy is centred on its diagnostic model in a clinical setting. Although the compulsive sexual behaviour has been observed in human and in animal models, the current diagnostic model that uses drug-related concepts as criteria for addiction for sex is ill suited. Recent publications had stated insufficient peer-reviewed evidence to establish criteria needed to identify sexual addiction as a mental disorder. In other words, there is no standardised test that is available for the diagnosis. Despite the lack of commonly recognised diagnostic criteria, cognitive behavioral therapy is the common treatment applied by certified therapist like any other addictions. The use of medications such as SSRI is also well described, however, the efficacy of such intervention is not robust. When the famous Douglas senior, Kirk, heard about the sex addiction, he famously laughed it off and said: “What’s wrong with sex addiction? I have been addicted to sex all my whole life!” The Greek philosopher Epictetus once said: “If one over step the bounds of moderation, the greatest pleasure ceases to please.” So, Lucy, if the current state of affairs continue to please and has no impact on the daily lives and relationship, then it is merely a “guilty pleasure” rather than a “medical condition”. Enjoy it while it lasts. 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