In the 1990s, Alan Reeves was a sought-after performer, captivating audiences as a member of The Dreamboys and even making an appearance in the Spice Girls’ film, Spice World. However, by his 30s, Reeves faced a dramatic shift: his mood plummeted and his libido vanished. Now 52, Reeves recalls, “I just didn’t feel right,” a sentiment that strained his long-term relationship.
Reeves, now a fitness and lifestyle coach in London, turned to testosterone replacement therapy (TRT) and claims it revitalized his libido, transforming him from a “grumpy old man” to feeling youthful again. “It just felt phenomenal,” he says. This personal revival is part of a broader trend as both men and women increasingly explore testosterone therapy.
Rising Prescriptions and Declining Sex Drives
Rachel Mason, a 37-year-old menopause blogger, also praises testosterone for boosting her energy, concentration, and libido. This surge in interest is reflected in prescription data. The NHS Business Authority notes a 135% increase in testosterone prescriptions from 2021 to 2024. This rise coincides with a reported decline in sexual activity across the UK.
In 1990, people aged 16 to 44 reported having sex an average of five times a month. By 2010, this had dropped to three times, with further declines expected.
The National Surveys of Sexual Attitudes and Lifestyles (Natsal) highlights this trend, noting a decrease in sexual frequency across all demographics. Soazig Clifton, Natsal’s academic director, points out, “There are fewer cohabiting couples than there were in the 90s, but even within that group, there’s a decrease.”
Exploring the Causes Behind the Decline
While the reasons for declining sex drives remain complex, experts suggest multiple factors. Dr. Ben Davis, a GP and sex therapist, cites increased stress, depression, and loneliness as significant contributors. “People have so much going on,” he explains, “There’s tech obviously, but there’s also an increase in stress and depression, all of which reduce sex drives.”
Another factor gaining attention is the potential role of declining testosterone levels. Prof Geoffrey Hackett, a consultant urologist, notes, “The rise in obesity, type 2 diabetes, and sedentary lifestyles all reduce testosterone levels, impacting sex drive.”
“Testosterone levels in men are definitely reducing,” says Hackett, emphasizing the nuanced relationship between testosterone and libido.
The Controversy Over Testosterone Therapy
Despite the complexity, advertisements for TRT are ubiquitous, promising solutions for low libido and other issues. However, the NHS advises caution, recommending testosterone only after other factors have been excluded. Dr. Paula Briggs, an NHS consultant, criticizes the commercialization of TRT, calling it a “gravy train” where individuals pay for unnecessary treatments.
Private clinics argue they fill a gap left by the NHS. Jeff Foster, an NHS GP and medical director at Voy, states, “The NHS is not set up to diagnose or treat the thousands of men who may have low testosterone.”
Yet, the efficacy of TRT remains debated. Cheryl O’Malley, who tried testosterone for a year, found it increased her sex drive excessively, leading to intense anger. “I was really horny, but at the same time, I hated him,” she recalls, eventually discontinuing treatment.
Looking Ahead: Weighing Benefits and Risks
For some, like Alan Reeves, TRT has been life-changing. “My libido came back, so much so at first, I wanted sex every night for 10 nights,” he shares. However, he acknowledges that testosterone is not a “silver bullet” and emphasizes the importance of lifestyle changes alongside therapy.
As the debate continues, experts urge caution and comprehensive evaluation before pursuing TRT. Dr. Ben Davis warns of the placebo effect and stresses the need for a holistic approach to addressing low libido. “It’s more than just handing out medication,” he says, highlighting the importance of understanding underlying issues.
Ultimately, the conversation around testosterone therapy reflects broader societal shifts in health, lifestyle, and expectations. As the UK awaits new data from Natsal, the debate over testosterone’s role in sexual health is likely to persist, challenging individuals and healthcare providers to balance benefits with potential risks.
