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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
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Experience:  Dr. Mark is a PhD in psychology in private practice
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Im a 47 year old man with an abnormally high sex drive. If

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I'm a 47 year old man with an abnormally high sex drive. If I don't typically have sex twice a day, it causes me to feel unhappy during the day. If I'm around my wife, I want attention from her frequently. I get upset if I don't get it. This has been going on for about a year and a half. I am recovering from an very brief affair that my wife had 8 months ago. My problems with needing attention and sex seem to have gotten worse since that event. Even though my wife is trying very hard to make up for what she did and help me with my sexual issues, I still feel very hurt and broken and feel like I can't get past these issues. We thought that the sexual issue would pass in time but it seems like that is not happening. Do you think this is part of a mid life crisis or is this something I need to see a doctor about and if so what kind of doctor? What kind of condition do you think this is and are there medications that could help?
I also find that I want to get back at my wife by having my own affair. Also, I have seen a urologist about the high sex drive and was told it was fine. He also did blood work to check testosterone level and it was normal.
In addition to the sex twice a day, more times than not I find that I need to masterbate mid-day while watching porn. I also drink alcohol more than I should in the evenings.
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 5 years ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.

You imply that this has been going on for 1.5 years. Can you tell me what your sex drive and needs were like before 1.5 years ago?

Did your wife's need for an affair ever get worked on? Women don't typically have an affair without something being wrong and/or unsatisfying in their marriage. Has this been identified what was going wrong for her?

It sounds like you have a lot of anxiety. Is this true? For a long time?

Do you need to drink every night? How much?

Any extra information that will help, feel free to share.

Let's go forward from the answers to these questions.

I see you are offline at this time. I may be away from the computer before you respond. If so, would tomorrow be okay for me to respond?

Dr. Mark

Customer: replied 5 years ago.

My sex drive prior to 1.5 years ago was pretty much average. I did not need the constant attention from my wife.

Yes. My wife's needs have been addressed.

Yes my anxiety has been going on for the last 1.5 years since all of this started.

Yes. I feel I need to drink 4 to 5 drinks every night. I have been drinking long before any of the issues being addressed came up.

Expert:  Dr. Mark replied 5 years ago.

Thank you for the added information. It helps a lot. I believe I can now be of help with this issue.

First, let me say I can imagine how distressing this situation must be for you. That this problem began at that definite date is really pointing to an anxiety disorder. That you wife all of a sudden had an affair a few months later seems related.

And this is actually the key to my answer to you that you need to consider and think about. First of all, you can try to deal with the symptoms themselves. But I'm not convinced that you're going to be happy with the results necessarily. One method is to take testosterone lowering medications. But those may have unpredictable results wherein your sex drive is eliminated. So you may not want to mess with them. Another way is with antidepressants. They are sometimes used for premature ejaculation because they weaken sexual drive. They may work to lower your sex drive as well. Antidepressants do have side effects, especially with extended use. But this is an option you can discuss with your doctor.

Okay. Those are the pharmacological options you can consider. But they are not great choices in and of themselves. The psychological option sounds more promising but it has the drawback of being slower in effect. There are three approaches to therapy you might consider.

The first is to treat this as a symptom of an anxiety disorder. It's not clear what the trigger was 1.5 years ago for the anxiety disorder but it led to dysfunction in the marriage which then has led to ongoing dysfunction in your relationship with your wife which is manifesting in this hypersexual behavior. This would be treated with Cognitive Behavioral Therapy.

You might find that this approach is too superficial, focusing too much on the behavior and not enough on your emotions of hurt, disappointment, betrayal, etc. This would mean working in a more psychodynamic and/or humanistic therapy to find the source of the emotions that are expressing themselves through anxiety and hypersexuality.

If you don't have a good referral source for yourself, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (you can see a photo of the therapist!) look at the listing and see if they list CBT, psychodynamic, and/or humanistic psychotherapy in their orientations, or a combination of these.

Another approach is to treat this as a relationship problem in your marriage and to go to couples therapy with your wife. One type of therapy is called Emotionally Focused Couples Therapy. This one is the one I would use in your situation first. Why? Because it focuses on how there have been created emotional barriers and how to get through those barriers. Please consider it before you take other action. Here is the web address for their therapist finder:

On the website you'll also find excellent books by the founders, Sue Johnson and Leslie Greenberg. You may not find an EFT therapist in your area, though, so you might have to seek someone from the Psychology Today directory that seems experienced.


Clearly there is an emotional divide you are feeling with your wife and you are both trying to bridge it with sex and punish her with sex. The psychological aspect of this seems very clear. The doctors' reports seem to confirm this. These three options are your best way to approach it. My recommendation would be to try the couples therapy first to see if you can move closer emotionally to your wife and if the hypersexuality will ease up as you two learn to be more emotionally intimate instead of sexually intimate.

I wish you the very best!

Please remember to click the green accept button. Feel free to continue the discussion; my goal is to get you the best answers possible. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX

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