Increased Oxytocin Levels Could Be Driving Hypersexual Disorder in Men

A longitudinal cohort study from patients at a medical center in Stockholm, Sweden suggests men with hypersexual disorder had higher levels of oxytocin in their blood than men without hypersexual disorder.

The study, which compared data obtained from blood samples of 64 men with hypersexual disorders and 38 healthy men, produced results suggesting the hyperactive oxytocinergic system in hypersexual men could be a compensatory mechanism to mitigate hyperactive stress.

“We discovered that men with compulsive sexual behavior disorder (CSBD) had higher oxytocin levels compared with healthy men,” said Andreas Chatzittofis, MD, PhD, of the University of Cyprus Medical School in Nicosia, Cyprus and Umeå University in Umeå, Sweden, in a statement. “Cognitive behavioral therapy led to a reduction in both hypersexual behavior and oxytocin levels.”

Citing previous studies suggesting oxytocin could play a role in the pathophysiology of hypersexual disorder, Chatzittofis and a team of colleagues from the Karolinska Institute and Umeå University designed the current study to assess the levels of plasma oxytocin levels in patients with hypersexual disorder compared with age-matched volunteers. Investigators also planned to assess whether cognitive behavioral therapy might influence plasma oxytocin levels.

The single-center, longitudinal cohort study leveraged data from a subgroup of patients included in a randomized clinical study of group-administered cognitive behavioral therapy treatment program for hypersexual disorders at the ANOVA clinic at Karolinska University Hospital from 2013-2014. For inclusion in the hypersexual disorder cohort, patients needed to be at least 18 years of age, have a clinically endorsed diagnosis of hypersexual disorder, and be on a stable medication regimen of psychoactive compounds for at least 3 months prior to enrollment.

A total of 64 patients with hypersexual disorder were identified for inclusion in the hypersexual disorder cohort, which included a subgroup of 30 patients who completed the 7-week cognitive behavioral therapy program. Controls for the study were recruited from the Karolinska Trial Alliance database. Controls were matched to patients based on age and equivalent blood sample collection times to control for possibly interfering seasonal variations. Investigators identified a total of 38 healthy controls for inclusion in the study.

The primary outcomes of interest were plasma oxytocin levels, Hypersexual Disorder Screening Inventory (HDSI) score, and Hypersexual Disorder: Current Assessment Scale (HD:CAS) score. Investigators pointed out plasma oxytocin levels were measured using radioimmunoassay.

Upon analysis, results indicated mean plasma oxytocin levels were significantly greater in patients with hypersexual disorder (31±9.0 pM; median, 28.0 [17-55]) than the healthy controls (16.9±3.9 pM; median, 16.0 [8-27]) (P <.001). In correlation analyses, investigators observed significant positive correlations between baseline plasma oxytocin with HDSI and HD:CAS scores among study participants (rho=.649, P= .0000002; rho=.661, P=.0000002).

When assessing the influence of cognitive-behavioral therapy, results indicated treatment was associated with reductions in symptoms among patients with hypersexual disorder. Additionally, a paired t-test suggested patients with hypersexual disorder who completed the intervention experienced a significant reduction of oxytocin levels from pretreatment (30.5±10.1 pM) to posttreatment (20.2±8.0 pM; P=.0000019). Further analysis pointed to a significantly positive correlation of changes in HD:CAS with plasma oxytocin levels before and after cognitive-behavioral therapy (r=.388, P=.0344).

This study, “High Plasma Oxytocin Levels in Men With Hypersexual Disorder,” was published in The Journal of Clinical Endocrinology and Metabolism.