I am a 48-year-old man writing out of frustration.

I have a dwindling sex life, affecting my well-being; I admit I am a bit overweight and lazy to exercise, perhaps due to an urban lifestyle. My wife and I have been married for 18 years, and I guess regular sexual activities have become mundane.

The fact is, we are hardly having sex these days. The last time I recall being intimate with my wife was more than six months ago, during the Christmas period when we were away on a break. Believe it or not, we used to have sex daily, sometimes even twice a day!

Don’t get me wrong, I don’t have erectile dysfunction (ED), as I can still rise to the occasion and get regular morning erections. However, my libido and drive are simply diminishing.

My wife understands I have a stressful job and am making ends meet. However, I believe if we continue to avoid intimacy, our relationship will drift apart. I want to put Dr G on the spot to find out why my sex drive is dwindling.

I understand sex drive is driven by testosterone; does it mean I have low hormones? Can you enlighten me on ways to boost the drive? I hear testosterone replacement is an option, but I would like to assess the risks. I prefer a natural lifestyle and dietary boost for my libido.

For 2025, I am determined in my New Year resolution to crank up the sex machine!

Yours truly,

Ex Sex Machine Simon

Sex drive, also known as libido, is a person’s overall sexual desire for intimacy and intercourse. Although some perceive male libido as solely driven by testosterone, biologically, the integration of testosterone and neurotransmitters like dopamine is required to regulate sexual urges.

The intricate interactions of biological, psychological, and social factors like work, family, personality, societal values, and stress influence the desire for sexual intercourse.

Using the frequency of sex as a barometer of libido may not be necessarily accurate. A person may desire sex but refrain from acting on it due to moral or religious reasons.

Conversely, a person can engage in sexual activity without any actual desire. Therefore, frequency of sex is not the only measurement of sexual urges.

Illness, medications, lifestyle, relationship issues, and age also play important roles in exciting or dampening the involuntary urge for sex. Diabetes, hyperlipidemia, hypertension, and obesity associated with metabolic syndrome are well-recognised as causes of low sexual desire. Lack of sleep, exercise, or dehydration can also influence the brain’s circadian cycle, dampening testosterone and neurotransmitter production, affecting libido. Medications like antiandrogens, chemotherapy, antifungal, and even hair restoration medicine can also affect testosterone production in men. Therefore, libido in men is perceived as a barometer for overall health.

Testosterone deficiency syndrome (TDS), also known as hypogonadism, is a medical condition characterised by low testosterone levels. TDS associated with advancing age is known as late-onset hypogonadism (LOH) and is estimated to affect 1 in 10 men over 50. Possible causes include defective testosterone production from Leydig cells in the testicles due to ageing, mumps, injury to testicles, and previous radiation or chemotherapy.

Testosterone replacement therapy (TRT) is a treatment for TDS, delivered in various modalities including oral medication, skin patches, injections, gel, and implants below the skin. Although men without TDS may be tempted to enhance their sexual desire with TRT, the intervention can be associated with undesirable side effects. Excessive testosterone can induce undesirable enlargement of the prostate and blood clots caused by polycythemia.

Lifestyle changes are a sustainable way to boost libido in the long term. One of the most crucial improvements in lifestyle is not compromising on the duration of sleep. As testosterone production occurs during deep sleep cycles, uninterrupted sleep of more than seven hours is vital. In addition to sleep, regular exercise and adequate hydration are known to increase testosterone production in ageing men. Stress is well-recognised for dampening sex hormone production, so reducing stress is also important to boost libido.

Lastly, dietary intake is also known to enhance drive. The dietary guide to enhancing sexual libido is as simple as ABCDEF.

A stands for avocados, considered aphrodisiacs as they contain vitamins and minerals enhancing blood flow to the genitals.

B stands for berries such as blueberries and strawberries, known to be high in selenium and antioxidants good for testosterone production.

C stands for cocoa and chocolate, which promote the release of phenylethylamine and serotonin that enhance sexual urges.

D stands for dark green vegetables like broccoli and sprouts, known for their high levels of allicin to enhance desire.

E stands for eggs, which contain proteins and good cholesterol crucial for sperm and hormone production.

Lastly, F stands for fish and shellfish, which contain omega-3s crucial for testosterone production.

Finally, keep the “health” of the relationship in check by constant communication with partners, as this can outline preferences to revive those loving feelings in the bedroom.

When urbanites put Dr G on the spot to crank up their sex machines, his advice is that the quest for sexual libido is a long journey of self-discovery of harnessing inner energy.

Optimal physical and mental health can unleash the quantitative magnitude of inner instinct under the word Love, without testosterone.

On that note, wishing everyone enhanced drives in 2025!