Dear Dr G,

I greatly admire your sense of humour when dealing with taboo subjects of sexual health in a conservative country like Malaysia.

I am 31 years old and sexually very active, but I often feel guilty after engaging in sexual activities.

My parents used to tell me about the harmful effects of too much sex.

One issue that worries me is whether excessive sex can deplete my sperm count and render me infertile.

My wife and I have been married for two years, and we were hoping for a Dragon Child in 2024.

To our disappointment, as we venture into 2025, there is still no outcome.

We consulted doctors who suggested I consider abstinence before my wife’s ovulation period.

Specifically, I was told not to ejaculate for at least three to five days, saving all the good sperm for the right moment.

I am determined to put Dr G on the spot to debunk the myth that too much sex is harmful to sperm.

Can you clarify what the normal frequency of sex is?

How frequently do “normal” people have sex in Malaysia?

What exactly is the duration of sperm production required for a fresh new batch?

Can too much sex diminish the quality of sperm in a man?

On the other hand, what is the basis of abstinence and fertility?

And finally, what exactly should we do to have a baby in the Year of the Snake?

I look forward to your views.

Frequent Frank

Old wives’ tales are a mix of superstition, misinformation, and perceptions passed down through generations. Some Western beliefs are rooted in the concept that sex is bad and that excessive indulgence leads to future adversity, including infertility, blindness, impotence, and hairy palms.

In the East, concerns focus mainly on losing bodily strength and energy in the form of chi. In Oriental teachings, chi is believed to originate from the kidneys, leading to fears that too much sex could impair kidney function. To date, no scientific data supports the threats posed by these Eastern or Western beliefs.

The frequency of sex is multifaceted, dependent on one’s state of mind and health. Cultural upbringing, religious beliefs, and values are key factors influencing the desire to engage in sexual activities. Meanwhile, lifestyle and physical activity determine the ability to perform more frequently. These cultural and physical health factors vary significantly between countries worldwide.

A respected researcher, Rosie King, conducted a study involving 2,016 men and 1,941 women across 13 countries in the Asia-Pacific region. The APSHOW (Asia Pacific Sexual Health Overall Wellness) study, which included Malaysian participants, revealed that many men and women in Asia-Pacific prioritise career, financial wellbeing, physical health, and family life over sexual relationships.

In countries like China and Hong Kong, the frequency of sexual intercourse can be as low as five times per month. In contrast, in countries like India and the Philippines, it can be as high as four times per week. In Malaysia, the average frequency is about eight times per month for participants under 40 and six times per month for those older.

With the focus on frequency, the question arises: is too much sex harmful to sperm production, depleting all good sperm? Sperm maturation generally takes two to 11 days from the epididymis to the prostate.

The 1999 WHO guidelines recommend a two to seven day period of abstinence before providing a semen sample for analysis, indicating that overly frequent ejaculation may be detrimental to sperm counts.

A 2016 study published in Translational Andrology and Urology examined the impact of sperm quality during a two-week period of daily ejaculations. Twenty normal men, with a mean age of 25, were recruited for daily ejaculation over 14 consecutive days, following a 3–5 day abstinence period. Semen samples were collected at the study’s start and on days three, seven, and 14.

The study revealed significant decreases in mean semen volume, total motile count, and sperm concentration during the study period, without significant changes in motility or morphology. A large initial change in ejaculate volume, sperm counts, and sperm concentration was observed, followed by a plateau in values after day 3 of daily ejaculations.

These findings generally support an approach of a short period of abstinence followed by daily copulation around ovulation to maximise sperm availability and optimise conception. The old wives’ tales clearly date back to the dark days when sexual and reproductive health were unknown entities.

Although there has been a quantum leap in understanding sexual physiology in the 21st century, sexual myths and taboos still cause confusion and guilt. Such thoughts are often hard to erase completely from our culture and beliefs. Adults feeling guilty about overindulgence in sexual activities rendering infertility often put Dr G on the spot for opinions.

His advice is: “Although initial overindulgence in sex may put a dent in the total sperm reserve, the rest of the daily activities is just plain sailing!”