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Men with hypersexual disorder (HD) may also have higher-than-average levels of oxytocin, researchers reported.

In an analysis of hypersexual men, their mean oxytocin plasma levels were 31 pM, as compared with healthy male controls who exhibited mean levels of 16.9 pM (P<0.001), reported Andreas Chatzittofis, MD, PhD, of the University of Cyprus in Nicosia, and colleagues.

Looking more closely at symptom severity, both Hypersexual Disorder Screening Inventory (HDSI) scores and Hypersexual Disorder: Current Assessment Scale (HD:CAS) scores were positively -- and significantly -- correlated with baseline plasma oxytocin levels, they wrote in the .

"The hyperactive oxytocinergic system in hypersexual men may be a compensatory mechanism to attenuate hyperactive stress," the authors said.

"Oxytocin plays an important role in sex addiction and may be a potential drug target for future pharmacological treatment," Chatzittofis explained in a statement.

The authors also reported on an effective way to reduce oxytocin levels via cognitive behavioral therapy (CBT), which was administered in group session through a combination of lectures and written materials. The was described in 2019 by co-author Jonas Hallberg, of the Karolinska Institutet in Stockholm.

Among the group of men with HD, those who completed the 7-week CBT intervention geared toward reducing hypersexual behaviors saw a significant drop in their oxytocin plasma levels. After CBT, these men had oxytocin levels of 20.2 pM versus pre-treatment levels of 30.5 pM, and this drop in oxytocin levels after CBT also was linked with a drop in hypersexual behaviors. Additionally, these men saw a significant drop post-therapy in HD:CAS scores.

"To our knowledge, this is the first report to indicate a role for oxytocin's involvement in HD and the discovery of oxytocin as a potential biomarker for diagnosis and potential drug target for treatment," the group highlighted.

The longitudinal study took place at the ANOVA clinic of Karolinska University Hospital. A total of 64 adult men were recruited after seeking help for their HD diagnosis. All had a clinically endorsed HD diagnosis, and were on a stable medication regimen of psychoactive compounds for at least 3 months. Men with severe psychiatric comorbidities or with certain paraphilias like sadism and pedophilia were excluded. Healthy male volunteers were matched for age.

Oxytocin levels were measured by radioimmunoassay, instead of "gold-standard stable isotope dilution mass spectrometry," which was a study limitation, the authors stated.

Additional limitations included the possibility of other confounding factors, such as and ethnicity, and no consideration of potential sexual activity before oxytocin measurements. The authors stated that "ejaculation is known to significantly increase plasma oxytocin levels in the short term after ejaculation, future studies should address and properly account for this potential source of bias."

HD is considered a nonparaphilic sexual desire disorder, and hallmarks include excessive and persistent sexual behaviors that occur in a wide range of mood states, paired with an impulsivity component and loss of control.

"HD was originally suggested as a diagnostic entity for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, and a similar disorder is now included in the 11th revision of the International Classification of Diseases (i.e., compulsive sexual behavior disorder, which is classified as an impulse control disorder)," the researchers explained.

Prior research indicated a hyperactive hypothalamic-pituitary-adrenal axis and the oxytocinergic system both likely play a role in the underlying pathophysiology of HD, Chatzittofis' group noted.

Based on current study findings, the researchers suggested that "oxytocin holds promise as a potential biomarker for HD diagnostics and as a measure of disease severity."

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