Low libido on the rise, is there a way to increase it?
Alan Reeves used to perform on stage in the 90s and also appeared in the movie Spice World.
Prescriptions for testosterone replacement therapy in the UK increased by 135 percent from 2021 to 2024.
Testosterone therapy has restored libido in some men, but there are also concerns about its side effects and profiteering.
In the 90s, Alan Reeves regularly performed on stage. As a member of the group ‘The Dreamboys’, he would take off his clothes in front of thousands of people. Due to his increasing demand, he and his friends later appeared in the Spice Girls movie ‘Spice World.’
Reeves, who was 24 at the time, said, ‘I was the poster boy for pin-up fame.’ As Reeves turned 30, he found himself in a different situation. His moods were bad and his sex drive had almost disappeared.
He said, “Nothing felt right to me.”
“My lack of sexual desire had a negative impact on my long-term relationships,” says Reeves, now 52. Reeves, who works as a fitness and lifestyle coach in London, started testosterone replacement therapy (TRT) and it has helped restore his libido.
“I’ve gone from a grumbling old man to a young man again,” he says. “It’s an amazing feeling.”
Sexual desire is steadily declining
Women are also turning to testosterone. Blogger Rachel Mason, 37, says the hormone has been “amazing” for her energy levels, concentration and libido. She recounts her experience after menopause.
There has been a huge increase in testosterone prescriptions. The Care Quality Commission has compiled figures from the NHS Business Authority, which show a 135 per cent increase in its prescriptions between 2021 and 2024.
The increase comes at a time when ‘sex drive’ is seen to be declining across the UK. The National Survey of Sexual Attitudes and Lifestyles (NatSAL) asks more than 10,000 people about this every decade.
In 1990, people aged 16 to 44 said they had sex an average of five times a month. By 2000 this had fallen to four times and by 2010 to three times.
The next set of results is due later this year, and researchers say the downward trend is continuing. However, they do not point to any one reason for the decline.
Against this backdrop, a debate is growing rapidly. Can testosterone really improve libido, or is it just a profit-making hype? The frequency of sex in the UK is falling. The National Survey of Sexual Attitudes and Lifestyles asks about 10,000 people about this every decade.
Low libido
According to study author Alan Reeves, the experience of low libido is one example of a trend that is becoming more common. “We’ve seen a decline in all age groups in the last few years,” says study director Soezig Clifton. “There are fewer couples living together now than in the 1990s, which could help explain the decline in sexual desire. But when we look specifically at that group (cohabiting couples), there’s also a decline,” she says.
In fact, the fastest decline in sexual frequency has been among older couples or couples who live together.
“It’s hard to say exactly why libido is declining,” says Clifton. “We don’t have any data yet that can tell us with any certainty that libido is not as high as it used to be,” she says. “There have been a number of studies that have tried to understand why. These studies point to the digital world as a big factor, making it harder to turn off screens, and there are so many other options to spend time with.”
General practitioner and sex therapist Dr Ben Davies says our stress levels are generally much higher than they were 30 years ago. This is also a reason, he says. “There’s a lot going on in people’s lives. Obviously there’s technology, but there’s also an increase in stress, depression and loneliness. All of these things contribute to a decrease in libido,” says Dr Ben Davies.
Professor Geoffrey Hackett, a consultant urologist and member of the British Society for Sexual Medicine (BSSM), says that testosterone levels in men are definitely falling.
According to him, the rise in obesity, type 2 diabetes and an increasingly inactive lifestyle all contribute to low testosterone levels. And declining testosterone levels may be one reason for our lack of libido.
Over the past 20 years, studies have measured hormone levels in men, which have shown that testosterone levels have decreased. But Hackett emphasizes that this graph is very subtle.
Low testosterone increases the likelihood of low libido, but that does not mean that every man with low testosterone has a low libido. Despite this complexity, subway stations, bus stops and social media feeds are now filled with ads like, “Low libido? Tired? Time to get a testosterone test!”
So, can testosterone replacement therapy (TRT) really be a cure for low libido?
Testosterone ‘gave me my life back’
Melissa Green has been taking testosterone for about a year. In his words, it gave him "the zest for life." ’ Not only did it bring her back, but it also saved her marriage. Melissa, 43, had been suffering from a low libido that had taken a toll on her relationship.
Her doctor had already prescribed her hormone replacement therapy, which consisted of estrogen and progesterone, due to early menopause symptoms, but Green says, “the doctor was not prepared to test her testosterone levels. They said she didn’t need the extra hormones.”
Women’s bodies produce low levels of this hormone, and according to NHS guidelines, women can only be given testosterone if they have ‘hypoactive sexual desire disorder’. That is, their sex drive is very low or almost non-existent. It can affect women of any age, but it peaks during menopause.
Eventually, Green went to a private clinic, had a blood test, and was told her levels were low. After taking the test report to her doctor, she was given some testosterone from the NHS.
‘It’s given me my life back. I feel like I’m in my 20s again,’ she says.
While some people are enthusiastic about the effects of testosterone on sex drive, others say it has some unpleasant side effects.
Cheryl O’Malley took testosterone for a year, she says, and while it may have helped restore some of the energy lost during the menopause, it also increased her libido and made her feel very angry.
‘I was feeling very horny. I wanted to have sex with my husband, but there were times when you felt like it wasn’t right, it wasn’t me. I felt like everything was out of my control.
Rachel Mason says, “When she posts about TRT, she sees, ‘Many women are very scared to start testosterone, they worry that they’ll look like a man, they’ll grow facial hair, or they’ll lose their identity.’
Mason has also developed hair growth on her arms. But that’s nothing compared to the benefits she gets from the hormone. In addition to body hair growth, TRT can have many other side effects.
In women, excessive hair growth, dandruff, and weight gain can occur. These can be resolved when the dose is reduced or stopped.
In men, side effects can include weight gain, prolonged erections, male-pattern hair loss, and mood swings. It can also reduce sperm production, which can affect fertility. There are treatments available that can help, but medical advice is recommended.
Money-making pot
Some NHS GPs and specialists say private clinics are making a profit by selling testosterone replacement therapy as a quick fix for a complex problem.
NHS consultant in sexual and reproductive health Dr Paula Briggs says it is a way of making money and people are paying huge sums for something they don’t need. “It’s getting out of hand,” she says.
What do you mean, private clinics?
They say they are improving people’s lives by providing a service that the NHS is failing to provide. Jeff Foster, medical director of the multi-million pound clinic Boy, which specialises in men’s health, and an NHS GP, says the private sector is filling a gap that the NHS is failing to provide.
Michael Cox has been providing TRT through his company Balance My Hormones since 2016. He says he has seen a “tremendous” increase in demand for it in recent years.
Some of his patients had been tested on the NHS, but were turned away because their levels were not low. They then went into the private sector. “Even if they are slightly above the NHS limit, TRT can help,” says Cox.
The proportion of people who benefit is small
What constitutes a healthy testosterone level in men depends on which organisation you ask and which studies you read. According to the BSSM guidelines, men with levels below 12 nmol/L should consider TRT, especially if they have symptoms of ‘hypogonadism’, a condition in which the testicles are not producing enough hormones.
NHS guidance can vary by region. But levels below 6 to 8 nmol/L can be considered low testosterone.
In women, testosterone levels start to fall between the ages of 20 and 40 and stabilise at menopause. Low levels are normal, but the question is how much this affects sex drive and overall health.
Tests are available for women but it is difficult to get an accurate reading because the doses needed are so low. There is no licensed treatment for women on the NHS. Dr Briggs is wary of the hype and hype surrounding TRT. . She says ‘Many patients come in complaining of a lack of sexual desire. They say they have done a study, which usually means they have seen someone posting about life-changing effects on social media. ‘Even if it works for a celebrity, it doesn’t work for everyone.’
She has a flood of patients asking for testosterone tests in her area. Some take a prescription and then return after a few months because the effects have diminished. The clinical evidence suggests that TRT is only effective in women who have gone through menopause and have a low libido.
‘The advertising from private clinics has exaggerated everything,’ says Briggs.
This therapy is not a miracle cure
Cheryl O’Malley has stopped taking testosterone. The intense anger and hypersexuality that came with the treatment have now subsided, and her libido has returned to a comfortable level.
“It’s been a huge relief for me to get off it,” she says. There are many factors that can cause low libido, and testosterone is not the only solution. But Alan Reeves has been on TRT for seven years and his life has improved dramatically.
“My libido has returned, and at first I wanted to have sex for 10 nights straight,” he says. “Now I’m calm and in a better mental and physical state.”
According to her, it’s not a miracle drug, and TRT is meaningless without lifestyle changes. “It’s like putting a Ferrari engine in a junk car,” she says.
