Sexuality is very important to humans, for a variety of reasons other than just reproduction.

We want to be able to have sex or at least feel like we’re capable.

We all have a baseline libido. Some of us want to have sex daily and some of us are content with having sex only once a month.

Hypersexual individuals like to have sex a lot. At least once a day and often time more than once a day.

Is hypersexuality wrong?

There is nothing wrong with being hypersexual – having a very high libido.

The problem comes in when hypersexuality is combined with impulsive control disorder, which is similar to any kind of addiction. This is when your relationships, life, job, etc., are harmed due to impulsive and addictive behaviors such as porn binging, cheating on your partner, doing risky things for sex, etc.

This is the criteria for problematic hypersexuality disorder.

A persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior, manifested in one or more of the following (R):

• Engaging in repetitive sexual behavior has become a central focus of the individual’s life to the point of neglecting health and personal care or other interests, activities and responsibilities.
• The individual has made numerous unsuccessful efforts to control or significantly reduce repetitive sexual behavior.
• The individual continues to engage in repetitive sexual behavior despite adverse consequences (e.g., marital conflict due to sexual behavior, financial or legal consequences, negative impact on health).
• The person continues to engage in repetitive sexual behavior even when the individual derives little or no satisfaction from it.
• The pattern of failure to control intense, repetitive sexual impulses or urges and resulting repetitive sexual behavior is manifested over an extended period of time (e.g., 6 months or more).
• The pattern of failure to control intense, repetitive sexual impulses or urges and resulting repetitive sexual behavior is not better accounted for by another mental disorder (e.g., Manic Episode) or other medical condition and is not due to the effects of a substance or medication.
• The pattern of repetitive sexual behavior results in marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Distress that is entirely related to moral judgments and disapproval about sexual impulses, urges, or behaviors are not sufficient to meet this requirement.

It’s like any other addiction.

But as I pointed out, there is a difference between having high libido (hypersexual) vs impulse control disorder. It’s having lots of sex without risk and potential harm, vs doing high-risk things (including frequent sex with different partners, increased number of sexual partners, unprotected sexual intercourse, unprotected anal intercourse, acquired sexually transmitted diseases, and use of drugs and alcohol before sex) associated with potential harm.

Let’s look at what hypersexual individuals have in common, then we can try to recreate that with diet, lifestyle and certain supplements.

A look at hypersexual individuals on the inside

Hypersexual individuals have:

• Higher CRH
• Higher oxytocin
• Elevated dopamine receptors
• Reduced catecholamine breakdown (reduced COMT activity)
• Luteinizing hormone to testosterone

There aren’t a lot of studies looking at hypersexual individuals, but the ones above are what they looked at.

Note: These individuals are genetically different. The expression of their enzymes and receptors is different. Therefore they just are the way they are. They don’t have to take anything to be like that.

On the flip side, we can take things that can also skyrocket our libido in a healthy way. However, if someone is prone to addictive behaviors, boosting their libido could lead to more risk-taking hypersexuality. So just be aware of that.

Hypersexuality disorder programmed

Keep in mind that you can program a certain behavior. Meaning, someone can believe that they are a failure if they don’t bang a different girl every day. Is that true? No, it’s a belief. So now they have to live up to that expectation they created, thus reinforcing their risk-taking behavior. This has very little to do with your hormones and neurotransmitters.

Things that are important for libido:

• Testosterone (total and free)
• Estrogen
• DHT
• Dopamine
• Noradrenaline
• Serotonin
• Prolactin
• Oxytocin
• Cortisol
• DHEA

Let’s dive into each one.

Testosterone, DHT and estrogen

Testosterone is most well-known for improving sexual function and libido. However, most of the pro-sexual effects of testosterone are via DHT, which promotes the release of dopamine (R).

Estrogen is also involved since it can promote the release of glutamate, which helps with arousal. However, too much estrogen promotes the excess release of prolactin, serotonin and cortisol, which lowers testosterone and libido.

Prolactin is a strong libido killer, so it’s important to keep it at or below 7ng/mL. Read more on how to lower prolactin here and here.

High testosterone and free testosterone can promote high libido, but it’s the combination of high testosterone and cortisol that is implicated in risk-taking behaviors. Also, you might wonder, if someone has high T, why do they struggle with assertion, dominance, confidence, etc? This is because status-relevant behaviors such as aggression and dominance are positively related to testosterone only when the levels of cortisol are low but not when cortisol levels are high (R, R).

LH also seems to play a separate role, as this study found that hypersexual men had (slight but significantly) higher LH than non-hypersexual men. However, men on TRT with no LH can also be hypersexual (R).

Lastly, if you want to be able to bang a lot (a few times daily), make sure your DHT is high. According to this study, serum DHT concentration was the only independent hormonal predictor of the frequency of orgasms (R).

Cortisol, DHEA and opioids

The HPA axis starts in the hypothalamus, which releases CRH, which stimulates the pituitary to release ACTH, which stimulates the adrenals to release DHEA and cortisol.

There is a link between stress, trauma, CRH and hypersexuality. Stress promotes the release of CRH, which in turn promotes the release of POMC (POMC is a large protein that is cleaved into smaller proteins such as beta-endorphin, alpha-melanocyte stimulating hormone (MSH), adrenocorticotropin (ACTH), and others (R)), glutamate (R), dopamine, endocannabinoids, oxytocin, etc.

This also sets someone up for addiction and impulsive behavior.

Hypersexual individuals have higher CRH, ACTH and oxytocin (R, R). Any stressful event that triggers the release of CRH can also cause addictive behaviors to surface, such as binging on porn, obsessive masturbation, etc.

Initially, this promotes libido, but over time, it can cause dysregulation of those systems, causing low motivation, brain fog, depression, poor focus, low libido, inability to experience pleasure, etc.

Acute stress-related increases in cortisol can enhance the incentive to participate in addictive behaviors. “This might explain why acute stress is considered a trigger of pornography use and relapse and why individual stress response might be a risk factor for developing a problematic pornography use.” (R)

As mentioned above, stress increases CRH, which increases beta-endorphins, our natural opioids. Opioids of any kind will have a negative effect on LH and testosterone. Hypogonadism, sexual dysfunction and hyperprolactinemia are often caused by opioids, natural or synthetic.

This release of opioids also contributes to impulsive addictive behaviors. Blocking the opioid receptor with naltrexone can be very helpful for pathological risk-taking hypersexuality and other addictive behaviors (R). Certain people frequently use opioid agonists to enhance their sexual experiences, however in the long run it causes hypogonadism and sexual dysfunction.

We don’t want to increase CRH or cortisol for libido, but we want to make sure we manage chronic stress, since that is the biggest drain of libido. Stress lowers the DHEA to cortisol ratio, and DHEA is converted to androsterone and other 5-alpha-reduced steroids involved in libido.

A few good adaptogenic (that will increase the DHEA to cortisol ratio) aphrodisiacs are Tribulus Terrestris, Mucuna Pruriens, Cistanche, Tongkat Ali, etc.

Dopamine, noradrenaline and serotonin

Dopamine

In general, dopamine and noradrenaline promote libido and sexual function whereas serotonin has the opposite effect.

It’s moreso the dopamine to serotonin ratio that’s really important. Chronic stress can put someone in a hypodopaminergic state and cause dysregulation of the serotonergic system.

Dopamine agonists for the treatment of hyperprolactinemia, such as bromocriptine and cabergoline, are known to induce hypersexuality or “dopa-testotoxicosis”. Dopamine agonists lower prolactin, thus increasing testosterone production. Someone thus ends up with higher dopamine and testosterone, significantly enhancing libido.

L-dopa use and other dopamine-boosting therapies in Parkinson’s patients also frequently cause hypersexuality.

Hypersexual individuals tend to have slower activity of COMT (resulting in the reduced breakdown of dopamine, noradrenaline and histamine (R)) and higher dopamine D2 receptor expression (R).

Zinc and vitamin B6 are commonly used to lower excess prolactin. They can also increase testosterone and norepinephrine and lower excess serotonin (R, R). This all translates to better libido.

Dopamine synthesis requires iron, B1, B2, B3 (NAD (rate limited factor)), B6, folate, B12 and phenylalanine and/or tyrosine.

Dopamine is converted to noradrenaline by dopamine hydroxylase with the help of copper and vitamin C.

Another great way to boost dopamine is to get lots of sunlight. Sunlight increases testosterone, dopamine, beta-endorphins, etc., which enhances sexuality. Read more about why you can benefit from sunlight here.

Serotonin

Serotonin, opposite to dopamine, lowers testosterone production, promotes the release of cortisol and prolactin and causes sexual dysfunction.

A very common side effect of SSRI and SNRI use is sexual dysfunction (or PSSD as it’s being called).

Specifically, it’s mainly the serotonin 5-HT2A and 2C that contributes to sexual dysfunction. Blocking them with cyproheptadine, for example, can enhance sexuality (R, R).

I wouldn’t necessarily focus on antagonizing serotonin receptors with a drug unless you have PSSD (then it’s worth a try), but rather on optimizing dopamine levels and receptors.

My go-to stack for this would be Tribulus Terrestris (it lowers prolactin and cortisol and increases dopamine, DHEA and DHT) and uridine (increases D1 and D2 (R, R)).

Related articles

• Tribulus Terrestris – not so useless
• How to increase dopamine
• How to fix serotonin dysregulation
• How to increase dopamine receptors
• Drugs, herbs and strategies to resolve PSSD
• PSSD, the why and the how to get it fixed

Oxytocin

Oxytoxin is elevated in hypersexual men. This is thought due to high CRH as oxytocin may be a compensatory mechanism to attenuate hyperactive stress (R).

Oxytocin is a key inducer of libido, penile erection, ejaculation and orgasm intensity (R). Oxytocin stimulates 5-alpha reductase, thus increasing DHT levels.

Intranasal oxytocin application in men resulted in an increase in epinephrine plasma levels during sexual activity and enhanced arousal (R).

The results suggest that the hyperactive oxytocinergic system in hypersexual men may be a compensatory mechanism to attenuate hyperactive stress. (R)

A few ways to increase oxytocin include:

Fenugreek (R), vitamin C (vit C rich fruit such as kiwi, oranges, etc.), pistachio (R), vit D and magnesium can increase oxytocin.

Histamine

Histamine has very similar qualities to dopamine and noradrenaline, when it comes to cognition, libido and sexual function. Dr. Pfeiffer found that a common symptom of histadelia (people with high histamine) is hypersexuality.

Histamine acts in the ventromedial nucleus of the hypothalamus (VHM) to modulate sexual behavior. The H2 antagonists, such as cimetidine and ranitidine, have been shown to cause loss of libido and erectile failure (R).

Histamine is broken down via HNMT (methylation) and diamine oxidase (DOA; found in the kidney). Using niacinamide, which reduces methyl donors, increases histamine a bit. DOA uses copper and B2 as cofactors. Excess copper can cause lower histamine, so it’s important to balance it out with zinc.

Inhibiting the histamine autoreceptor, H3, will also promote the release of histamine.

A simple way to skyrocket histamine is to use:

• 2g histidine (amino acid precursor)
• 400mcg folic acid
• 500mg niacinamide (50-100mg niacin; it also reduces methyl donors and promotes vasodilation as well)
• Holarrhena antidysenterica contains conessine, which is an H3 antagonist (R).

Final stack

• DL-phenylalanine (500mg x2 daily) – promotes dopamine release and provides the precursor for dopamine synthesis.
• Tribulus Terrestris (1 cap x3 daily) – Increases dopamine, DHEA, androsterone, DHT and lowers prolactin
• Fenugreek (2 caps) + vitamin C (kiwi/orange juice) – Increase free T and oxytocin
• 100-150mg uridine (over 300mg can be sedating) – Increases D1 and D2
• Rhodiola (1 cap 2-3 daily) – inhibits COMT and MOA-B (which breaks down dopamine and noradrenaline) (R)
• 2g histidine + Holarrhena antidysenterica (1 serving) – increase histamine

Contact me to find the root of your low testosterone, by reaching out or scheduling a free call here.