Understanding the symptoms and treatment methods for sexual OCD can help you overcome potential issues in your sex life.
Obsessive-compulsive disorder (OCD) can cause problems with sex in a number of ways. However, problems generally arise through obsessive thoughts surrounding sex or sexual orientation and compulsions to manage these obsessions (which might include avoiding sex entirely).
The source of sexual challenges for someone with OCD could be related to religious values, past trauma, anxiety, shame, or something else. Each person’s experience with OCD and sex is different.
Regardless of what is causing challenges in your sex life, treatment options are available to help manage OCD symptoms and become more comfortable with sexual intimacy.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) describes obsessive-compulsive disorder (OCD) as involving
OCD can interfere with your sex life when intrusive thoughts occur
Someone living with OCD may be
The intrusive thoughts could be as simple as wondering if you remembered to turn off the stove. Other times, it can involve thoughts of
Sexual OCD is not an official diagnosis but it’s a specific way that OCD can manifest. This type of OCD involves unusual and extreme sexual thoughts or urges. Your thoughts might be troubling or distract you from the moment.
A person may not have obsessions or compulsions directly related to sex and still have their sex life affected by their OCD symptoms. A person with “sexual OCD,” however, would experience intrusive thoughts specifically related to sex or sexual orientation.
Sexual OCD can disrupt or prevent intimacy because it triggers
While many people deal with intrusive thoughts, those with OCD can become overwhelmed by them. Your brain sends off false danger alarms, making you fearful when there’s no actual threat.
When the thoughts bring negative feelings and distress, they continue playing repeatedly. It triggers anxiety and may cause you to avoid anything that involves undesired sensations.
When it happens before or during sex, it can cause you to lose desire. You may not want to engage in intercourse when intrusive thoughts keep taking over your mind.
You might not know if your symptoms indicate sexual OCD. Knowing the symptoms is the first step to beginning to manage them.
- lack of sexual excitement
- fear of performance failure
- avoiding intercourse and physical contact
- overwhelming worry about contracting a sexually transmitted disease
- fear of genital fluids
- unwanted sexual fantasies
- distraction during intercourse
Navigating intimacy when you live with OCD is possible. You can learn to enjoy intimacy without feeling overwhelmed by intrusive thoughts. Some of the treatment methods include:
Exposure and Response Prevention
Exposure and response prevention (ERP) is a type of cognitive behavioral therapy (CBT) and a common treatment for OCD. Research shows that up to 85% of patients who complete the ERP experience alleviated OCD symptoms.
It helps you face your fears and experience obsessive thoughts without turning to compulsions. During ERP, you’ll experience exposure to your obsessions, and you must work to avoid compulsive behaviors. As you resist compulsions as anxiety relief, the temptation to perform that compulsion will lessen over time.
This therapy helps you understand that what you fear isn’t likely to occur. You’ll know that you can handle intrusive thoughts without experiencing such high anxiety.
When it comes to sexual OCD, exposure is private. Rather than avoiding sex and allowing OCD symptoms to control you, you might consider continuing to expose yourself to sex with a partner you trust. You can start slowly, only doing what you’re comfortable with and taking breaks when needed.
Experts indicate that when you try not to think about your intrusive thoughts, they become hard to push away. Rather than trying to ignore them or think of something else, you can practice mindfulness to help overcome compulsions.
Mindfulness requires you to stay present at the moment when intrusive thoughts occur. Notice your thoughts when they come to mind, and then allow them to pass naturally.
Try not to do anything to try to alleviate the thought. Instead, process it without judging yourself.
Letting it pass without trying to push it away or criticizing yourself can help ease some of your compulsions. Experts admit more research is necessary for mindfulness as an OCD treatment, but initial findings are favorable.
Using ERP and Mindfulness Together
You can use mindfulness during ERP therapy to resist your compulsions. When intrusive thoughts occur before or during sex, allow them to come and pass naturally.
Rather than giving into compulsions when obsessions take root in your mind, let the thought flow. Avoid ruminating on the intrusive thoughts or trying to push them away. Your goal is to handle the undesired thoughts or images and continue intercourse mindfully.
Staying present in this situation allows you to overcome urges and continue living your life. As you do this more often, it becomes easier, and the thoughts might occur less frequently.
Another common treatment option for OCD is medication, generally antidepressants. Medication for OCD can help reduce symptoms and improve issues in your sex life.
A doctor must prescribe your OCD medication. Consider scheduling an appointment with a medical professional if you’re interested in discussing the best treatment plan for you. You may combine medication with other treatment options as well, especially therapy.
You may also want to consider speaking with a sex therapist about how to make sex less anxiety-provoking for you. Perhaps you and your partner seek sex therapy together to learn how to better communicate about sex and approach intimacy.
While sexual OCD can interfere with your life, you can overcome the symptoms. If you learn to live with OCD, you can regain control of your life, including your intimate life. It’s a process, but not impossible.
Speaking with a professional about your thoughts and feelings can help you find the treatment you need. Commitment to your treatment plan helps you learn to manage your symptoms and reduce anxiety surrounding sex.
You can overcome the disorder and find fulfillment in things you once feared. The International OCD Foundation has more information about getting help and living with OCD.