Dear Dr. GI am in my early thirties and have some troubling issues in the bedroom.My wife and I have been married for five years.Although life has been hectic for both of us, I continue to have good libido and engage in sexual activities almost daily with my wife.In recent months, my wife has not been too receptive in the bedroom.She initially tells me she was worried about pregnancy, and other times she mentioned that hormones might have dampened the sexual appetite.The reality is, we have this disparity in appetite for sex.My wife thinks it is abnormal to have too much sex at our age.She also reckons that too much sex can cause male infertility and result in less sperm count for fertilisation when we plan to conceive next year.In fact, she reckons too much sex is harmful for health.Hence, I am putting Dr. G on the spot to set the record straight.Firstly, how much sex is considered normal at my age?Isn’t frequency of sex a reflection of happiness in a relationship?Is too much sex harmful for the body?Can frequent sex really reduce the sperm quality and cause male infertility?Lastly, I recall you mentioned something about frequency of sex and prostate cancer risk, can you remind us of the study again?Much obligedYours truly,Over-sexed Oliver The experts in the field of sexual health, including psychiatrists, sociologists and sexologists are all involved in some form of study determining the frequency of sexual activities. Many factors can influence how often people have sex. Relationship status, health, age, culture and religious beliefs all play important roles in the frequency of sexual encounters. The famous Kinsey Institute performed a National Survey of Sexual Health and behavior in the USA revealed interesting statistics about the sexual appetite of the nation. Only 2% of single men and 5% of single women between the ages of 18 and 24 years old have sex more than four times a week. And this is compared to 21% of married men and 24% of married women. Age is not necessary a deterrent to sexual frequency, but the number of intimacy naturally declines. In Malaysia and Asia-Pacific countries, an Australian sexual health expert, Rosie King, and I were also involved in a similar study a few years ago. Our study revealed the frequency of sexual activities in Malaysia is around twice a week for the under 40s and this declines to six times a month for those aged 40 and above. Admittedly the sample size was small and most of the respondents were urban participants answering the questionnaires online. Another sexual health expert from New York, John Mulhall also recently published more data on frequency of sex in larger demographic. The study revealed although the frequency of sex amongst couples in Europe, Russia and Brazil can be as high as 8 times a month, but the frequency can be as low as 3 to 4 times a month in Taiwan and Japan, mainly due to work commitments and other priorities of life. Contrary to the old wives’ tales cautioning harm in having too much sex, studies have shown frequent sex to be beneficial to the health for both men and women. Sex activates a variety of neurotransmitters that impact on the brain and overall health. The benefits of sex include lowering of blood pressure, enhancing the immunity, improvement of sex confidence and stress reduction in physiological and emotional sense. The correlation of sexual frequency and male fertility is also a subject of intense scrutiny. Having frequent sex doesn’t have an impact on sperm count unless the male has fertility issues to start with. In fact, various studies confirmed regular sex boosts sperm quality and chances of pregnancy. In a study published in 2015, collected semen samples from men who ejaculated daily for two weeks showed a slight decline in overall sperm counts, but other parameters such as motility and morphology improved. Hence, enhancing the overall fertility. The most compelling evidence of the protective effect of sex comes from the correlation of frequency of sex and prostate cancer. A 2016 United States publication from New England, tracking 32,000 men for 18 years observing their frequency of ejaculations. The study revealed men who ejaculated at least 21 times a month had about 20% lower risk of prostate cancer, as compared to those who ejaculated less than seven times a month. Another study from Australia also echoed similar correlation, showing men who ejaculated daily having a 36% prostate cancer risk reduction. The exact reason for such reduction is largely unknown, however, some believe that it can be the excretions of harmful material in the semen that will protect against malignancy. Although the overall benefit of frequent sex is well documented, the sexual relationship dynamic in every couples is different. It takes two to tango and the “right” frequency is the one that satisfies both partners. Researchers from Carnegie Mellon University conducted a study on 64 couples aged between 35 and 65. Half the couples were instructed to double the weekly frequency of sex and the other batch reduced to half. When assessed the level of happiness, those who had more sex were not happier, instead the level of happiness decreased. It takes effort to figure out what is the right intimacy frequency and to focus on the importance of love and communication. 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