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Rise in testosterone prescriptions amid waning sex drive
Prescriptions for testosterone replacement therapy (TRT) in the UK have jumped 135% between 2021 and 2024, as more people turn to the hormone to revive flagging libidos, according to NHS data.
This increase coincides with a steady decline in sexual frequency across the country. National Surveys of Sexual Attitudes and Lifestyles (Natsal) data shows that people aged 16 to 44 reported having sex five times a month in 1990. By 2000, that number had dropped to four, and by 2010, to three. The next set of results, due later this year, is expected to show a continued downward trend.
Personal stories highlight hormone therapy's impact
Alan Reeves, a 52-year-old fitness and lifestyle coach from London, once performed as a stripper in the 1990s, earning a reputation as a pin-up with his dance troupe, The Dreamboys. However, by his 30s, his mood and libido had plummeted, straining his long-term relationship.
"We were going without sex for three or four months at a time. I just wasn't interested," he recalls. After starting TRT, Reeves says his libido returned, transforming him from a "grumpy old man" back to feeling like he was in his 20s. "It just felt phenomenal," he adds.
Women are also increasingly turning to testosterone. Rachel Mason, a 37-year-old menopause blogger, describes the hormone as "amazing" for her energy, concentration, and sex drive. Melissa Green, 43, credits testosterone with saving her marriage after her low libido strained her relationship. "It's given me my life back," she says.
Debate over testosterone's role in declining libido
Experts remain divided on whether testosterone is a solution or simply part of a broader trend. Soazig Clifton, academic director of Natsal, notes that sexual frequency has declined across all demographics, including older, married, or cohabiting couples. "No data we have so far can really tell us with any confidence why, as a population, we are no longer having sex as much," she says.
Dr. Ben Davis, a GP and sex therapist, points to rising stress, depression, and loneliness as potential factors. "People have so much going on," he explains. "Tech, stress, and mental health all contribute to a reduction in sex drives."
Prof. Geoffrey Hackett, a consultant urologist, links declining testosterone levels to rising obesity, type 2 diabetes, and sedentary lifestyles. However, he cautions that low testosterone increases the likelihood of low libido but does not guarantee it.
Private clinics fuel demand amid NHS restrictions
Private clinics have capitalized on the growing interest in TRT, with ads promising to restore energy, focus, and libido. Michael Kocsis, founder of Balance My Hormones, says demand has grown "exponentially" in recent years. Some patients, told by the NHS that their testosterone levels are normal, turn to private clinics for treatment.
"Just because their level of testosterone might be a bit higher than the threshold set by the NHS, does not mean that TRT can't help them," Kocsis argues. "It's not black and white."
However, NHS guidance varies by trust, with some setting thresholds as low as 6 to 8 nmol/L for testosterone deficiency. For women, testosterone is prescribed off-label, as no licensed treatments exist on the NHS.
Side effects and skepticism cloud therapy's benefits
While some users report transformative effects, others experience unwelcome side effects. Cheryl O'Malley, who took testosterone for a year, says it left her with intense rage and heightened sexual arousal. "I was really horny. I wanted to have sex with my husband, but at the same time, I hated him," she recalls. She has since stopped the therapy.
Dr. Paula Briggs, an NHS consultant, criticizes private clinics for profiteering. "It's out of control," she says. "The wellbeing industry has created this gap in the market they're using to their advantage."
Briggs warns that TRT can have a placebo effect, with many patients paying for medication they don't need. "Just because it works for a celeb does not mean it works for the general population," she adds.
Lifestyle changes and nuanced solutions
Alan Reeves, who has been on TRT for seven years, acknowledges that the therapy is "not a silver bullet." He emphasizes the importance of lifestyle changes alongside treatment. "There's no point in taking testosterone without making other changes," he says. "Otherwise, it's like putting a Ferrari engine in a clapped-out car."
Dr. Davis echoes this sentiment, noting that low libido often stems from complex factors, including relationship dynamics, self-perception, and stress. "GPs might not have time to discuss what's behind a patient's low sex drive," he says. "Testosterone is not the only answer."
