Experts from the Society for the Advancement of Sexual Health estimate that three to five percent of the population have compulsive sexual behavior, also known as hypersexual disorder. About 90% of those with the disorder are middle-aged men, but it appears to be increasing among females, teenagers, and senior citizens. The number of sex therapists that provide treatment increased from 100 to 1500 in the past ten years.

"It used to be 40- and 50-year-old men seeking treatment," said Tami VerHeist, vice president of the International Institute for Trauma and Addiction Professionals. "Today grandfathers are getting caught with pornography on their computers by their grandkids, and grandkids are sexting at 12."

The usual explanation for the increases in the number of sex addicts is the increased availability of pornography. Newsweek is reporting that every day 40 million people visit the 4.2 million websites that offer free pornography on a 24/7 basis. The theory is the more people watch pornography and send each other provocative images of themselves, the more they want the real thing.

Whether sexual addiction is similar to drug and alcohol dependency and whether it causes changes in the chemistry of the brain is a controversial question. Many people in the therapeutic community, including Robert Weiss, founder of the Sexual Recovery Institute in Los Angeles, believe hypersexual disorder is a brain disease that should be considered a medical condition.

"It’s about chasing that emotional high: losing yourself in image after image, prostitute after prostitute, affair after affair," he said. "They end up losing relationships, getting diseases, and losing their jobs."

Others believe there is no such thing as sex addiction, and that it is not an epidemic.

Psychologist and author Dr. David Ley believes sex addiction is modern mythology.

"The sex addiction concept is a belief system, not a diagnosis," he told Newsweek. "It is not a medically supported concept. The science is abysmal. The thing that drives me crazy is it that over the past year or two, they have started trying to use brain science to explain it. They are now talking about morphological changes that supposedly happen in the brain when somebody watches pornography or has too much sex."

Several celebrities, including Tiger Woods and Charlie Sheen, are reputed to be sex addicts. There are many treatment programs available for the condition.

Harry Thomas Jr., U.S. Ambassador to the Philippines, said sex tourists include Americans and that all should face tough prosecution. Thomas has participated in forums about human trafficking with members of the Supreme Court and the U.S. Department of Justice, among others. The U.S. has already assisted the Philippines with more than $6 million support for training officials in anti-human trafficking.

In some parts of the Philippines, the crime has grown so severe that treatment and recovery centers have been established for people who have been victims of sex tourism or human trafficking. Reports include rape and forcible acts of prostitution.

Costa Rica, Cuba, the Netherlands and Kenya are among other countries that are linked with increasing numbers of sex tourism cases. In some cases, tourists can work with sex tourism agents for cheaper travel costs and access to prostitution once they arrive.

Officials are increasingly alarmed about children becoming involved in sex tourism, both with pornographic materials and child prostitution. Many human rights organizations say the sex tourism industry boosts human trafficking across the globe. The industry is believed to involve a quickly growing labor force across the globe, with laborers numbering into the millions.

Actress Gwyneth Paltrow is slated to play a sex addict in a highly anticipated comedy-drama, “Thanks for Sharing.” Her character, Phoebe, is a successful businesswoman who meets sexual partner Mark Ruffalo in a 12-Step sex addiction recovery group, as well as another couple played by Tim Robbins and Joely Richardson.

Another film, “Shame,” explores the harsh realities of sexual addiction. Irish actor Michael Fassbender plays a sex-obsessed Manhattan executive in Steve McQueen’s film. His character has a number of casual, joyless sexual encounters that fill him with shame and self-loathing. In an effort to feel better, he seeks out more emotionally devoid sexual encounters. The film made a big impression at the Venice film festival and has received overwhelmingly positive reviews.

Sex addiction has also become a topic of interest on the stage. A play about actor Neil Watkins’ battle with compulsive masturbation and sexual addiction, called “The Year of Magical Wanking,” is also making headlines. Watkins has publicly performed the play a number of times while privately undergoing therapy for his addictive behaviors.

In response to the honesty and deep emotions he channels in the play, a number of audience members have opened up about their own struggles. He hopes that bringing the issues out into the open will help reduce shame and encourage others to “sit with their feelings.”

As weighty subjects like sex addiction make their way into popular media, it is clear that hypersexuality has a tremendous impact on our lives. Even those who are not directly affected are certainly intrigued. While media portrayals of sex addicts cannot fully explore the depth of the problem, there is hope that greater awareness will breed more understanding and less shame around the disease.

Comments about the sites were offered in a recent Christian Post report, in which Brent Hartinger, a "relationship expert" for the website 365.gay.com, discusses the issue. Following the national dialogue about sex as an addiction, Hartinger told readers that he is unclear on the addictive nature of the hook-up sites. In the Christian Post report, his writing is summarized, including comments that the consequences for sexual experiences with strangers may be nothing more than a diversion from having a legitimate, positive relationship.

Christian Counsel International counselor Rob Jackson states in the article that not only has the Internet modified the way sex is viewed in America, it has also dramatically hastened the levels of sexual addiction in the U.S. Jackson, who has counseled people with sexual addictions for nearly two decades, believes patients move more quickly toward addiction and at more intense levels because of the accessibility of Internet sex-based sites. He also believes people fall into sexual addiction at even younger ages due to Internet exposure.

Further comments Jackson provided in the article point to sexual addiction as a type of addiction similar to drugs or alcohol, in that the person’s brain becomes addicted to the rewards of the behavior, rather than becoming addicted to the actual sex act itself.

In contrast to Hartinger, Jackson does believe the use of sexual hook-up Internet sites can lead to an addiction to the behavior because the brain adapts to the euphoria or feelings of escape that come from the activity.

The term “sexting” is gaining recognition nationwide, in light of the recent report of Congressman Anthony Weiner sending sexual photographs of himself to multiple women. Weiner is alleged to be seeking professional help for a problem that has not been officially named, creating questions around the behavior of sexting and the topic of sexual addiction.

Technology is a core element of this conversation, says Mark Bell, a sexual addiction therapist, who adds that advancements in technology have spurred a type of sexual revolution involving both teens and adults. For many, this revolution includes excessive Internet pornography use, sexting messages or involvement in sexually-related Internet chatting.

Many of the legal initiatives to help protect people from sexting pertain to teens and children, but adults can find themselves engaged in the behavior or a victim of it, adds Bell in a KTAR article. The anonymity of sending messages with a cell phone or computer lures some into the behavior, because they can feel wanted or engage in an alternate reality without having to interact with people in a real-world basis. “Sexted” messages or photos they don’t enjoy can be removed with a simple delete function.

While sexting messages can be sent and received in mere seconds, the effects can last a lifetime, reminds Bell. He also adds that the emotional consequences of sexting have led some people to attempt to end their own lives for fear of their family finding out about the behavior.

Both drug addictions and sexual addictions cause dopamine levels to increase in the brain, creating a sense of pleasure and release. Over time, people with sexual addiction can build a tolerance to pornography, sex with their partner or multiple partners, masturbation or other outlets – needing more of the material to get the desired high. Like drug addictions, people with sexual addiction become unable to stop their behavior or the cravings for it, even when they fully realize the consequences, including the devastation of personal relationships, careers, families and finances.

The all-consuming element of sexual addiction has been the subject of books and news reports by people who have recovered from it, similar to drug addiction recovery stories. The recovery from sexual addiction, like substance abuse addictions, can be a day-to-day focus over a lifetime and require support from professionals and family.

When engaged in sexual addiction, a spouse may spend hours away from work, family or children and keep the addiction secret as the marriage falls apart, as addressed in recent articles. Serious problems with emotional intimacy, low self-esteem and high stress levels have all been called factors related to sexual addiction.

Like treatments for drug abuse, professional sexual addiction counselors and therapists can help people break free of the addiction and address root causes. Research toward biological factors that may be associated with the disorder may also open doors toward medications that can help people regain emotional and physical wellness.

Robert Weiss, sex addiction treatment professional and founder of The Sexual Recovery Institute – a specialty therapy agency directed toward the treatment of sexual addiction and founded in 1995 — explains in a PsychCentral blog that people with sexual addiction live with a real diagnosis, which can control their lives and cause catastrophic loss. Despite stereotyped beliefs that a person with hypersexuality disorder or sexual disorder is after the pleasure from sexual engagement, Weiss explains that the behavior is often an escape from deep-seeded fears of intimacy and very low self-esteem. The actions of someone with sexual addiction reflect a similar pattern as someone with an alcohol or drug addiction – including an inability to control their actions despite the consequences, and the persistent escalation of the destructive, all-consuming thoughts and behaviors that destroy their families, finances and careers.

For the three to eight percent of the U.S. population who live with sexual addiction there is little or no pleasure associated with the act of having sex with multiple partners, obsessively abusing pornography or frequenting strip clubs. As described by Weiss, the compulsive sexual behaviors have become a coping mechanism to avoid stress, negative emotions and a painful inability to form intimate personal relationships. They live with chronically low self-esteem, shrouded in shame, and feel they must hide their disorder from others.

Like people recovering from alcohol abuse, Weiss suggests that people with sexual addictions or porn addictions must also work daily to maintain an attitude of abstinence, because the behaviors can return as a relapse and hamper their progress toward recovery.

Even though addictions to sex, hypersexuality and sexual compulsivity have been the source of debate over official diagnoses, addiction experts say the numbers of people seeking treatment for the conditions continues to grow, as noted in an April 2011 article on the Online Journal.

Sexual therapists who began treating people with sexual addictions in the late 1990s banded together to share information and expertise, being only a few in the area of specialty. Today, centers are being established worldwide as are group-based therapy programs and new Internet resources for recovering from sexual addiction.

Alexandra Katehakis, founder of the Center for Healthy Sex, believes celebrity announcements of sexual addictions and sexually compulsive behaviors have helped ignite the progress toward recognition of the problem. Without celebrities addressing their sexual addictions, Katehakis doesn’t believe as many treatment centers would be available.

Because federal regulations to determine exactly how many people are receiving professional assistance for sexual addictions are not yet in place, it is unclear how widespread the problem may be. Further complicating the issue is the reality that while people with sexual addictions may neglect their families and jobs, see financial ruin and the destruction of their families, scientific research to demonstrate withdrawal symptoms has not yet been officially documented.

Experts expect scientific studies addressing sexual addiction withdrawal symptoms and tolerance issues to emerge soon, with potential to place the field of sexual addiction into a similar field as alcohol or drug addiction.

The clinic, known as Boston Medical Group in Costa Mesa, California, has also sent out salesmen to respond to alluring ads for a one-office-visit cure for erectile and sexual dysfunction. Attorneys have been involved in several cases where clinic clients have experienced priapism, in which blood cannot move out of an erect penis and without treatment, irreversible dysfunction or scarring can occur.

The condition of priapism and other side effects for the injection treatments are serious and require medical help – yet men are lured in because having sexual dysfunction or being impotent is a touchy subject that men can become desperate to resolve, as described in an article from the Daily Mail. When they visit the clinics, they are given injections while they have reached an aroused state, and then told that further purchases of injections will be effective.

Clinics offering injections or other treatments for erectile dysfunction began to increase when the erectile dysfunction drug Viagra hit the market in the late 1990s. The clinics are usually medically unregulated, and patients have been prescribed treatments or injections by phone calls even when they have reported serious health problems. In some cases, the results of the injections can include surgery and physical deformities.

The shots are often marketed as the next step if medications like Viagra are ineffective. Experts warn that the injections could cause irreversible damage, serious health risks and come with high price tags for sexual dysfunction problems that could be treated with approved, regulated methods.  

The definition of addiction is becoming broader, and perhaps more convoluted as American adults work through addictions to sex, alcohol, drugs, food and prescription painkillers – a topic addressed recently by Maia Szalavitz writing for a Time Healthland report.  Addiction is a mainstream topic among celebrities and laypeople; it’s boosting the numbers of treatment centers; and it’s popping up with Senators and lawmakers nationwide.

Still, the topic of sexual addiction continues to raise eyebrows and generate new concerns for the health of families across the country. In April 2011, more than 40 Senators asked Eric Holder, Attorney General, to strengthen the legal consequences for pornography for its link to sexual addiction, Cybersex and online sexual crimes. 

In the statement from Senators to Holder, sexual addiction is described in the same terms as substance abuse addictions, in which the brain begins to believe that the activity is needed in order to exist. Research is backing theories that sex causes a similar brain-level response as does illegal drugs, coining the phrase “natural addiction” – referring to addictions that come from typical, natural behaviors like eating or sexual activities. However, for the person with sexual addiction or compulsive sexual behaviors, the ability to stop the behavior once the negative consequences set in has been lost. 

Analysts on the topic are addressing what makes someone become addicted to a natural behavior designed to bring pleasure, while others aren’t. The conclusion is complicated, even as experts and physicians continue to study the reasons an act like sex becomes addictive and how much of this is related to brain-level responses that can vary from person to person.

More research is needed, says Szalavitz, into what triggers an addiction to sex, food or other substances, and what constitutes normal, non-addictive behaviors in these arenas if experts are to understand how to lead people toward healthy lives.