I fear I am addicted to masturbation. If I do not masturbate three or four times a day, I feel incredibly frustrated. On particularly “active” days, I can masturbate upwards of 12 times. I find it very difficult to maintain a relationship because I have very little to no sexual desire and find it extremely difficult to maintain an erection. I have tried to cut down, but going cold turkey affects me negatively. I find myself in an almost drunken stupor, and sometimes this manifests itself in saying inappropriate things to friends and co-workers.

Many experts are uncomfortable with the concept of “addiction” being applied to sexuality, since it implies that sex is not essentially a normal and healthy human activity. But the kind of sexual compulsivity that you have described is a serious condition that requires urgent professional treatment. Sex – including masturbation – is normal and healthy UNLESS it is practised in a way that causes lasting harm or is coercive in any way. And when it negatively affects one’s daily life – as is the case with you – it becomes a serious problem that needs to be addressed. Constant compulsive urges can occur in many forms other than sexual – for example, to touch certain objects such as doors or light switches, to wash one’s hands very often – can be aspects of Obsessive Compulsive Disorder (OCD). So if OCD is expressed sexually, it is not one’s sexuality per se that is the problem, but rather, a treatable “hiccup of the brain”. Get help from a psychologist, or perhaps join a programme that is based on a 12-step method. Whatever you decide, remember that your basic sexual desire itself is not evil or abnormal; you just need help with the urge to express it excessively and compulsively.

• Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

• If you would like advice from Pamela Stephenson Connolly on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Submissions are subject to our terms and conditions: see gu.com/letters-terms