I'm sure that's true. Butt my database is 100s if not thousands of men and women. I've had middle-aged women wanting sex daily and men who are happy with annual sex. This is just one of those things that isn't as rigid as defecation and urination. And that changes with time. For what it's worth, the doctors I know appreciate very well that hormones are important.  For my part, I just don't feel comfortable pathologizing all changes. Not that supplementing is bad, not naively assuming all bodily changes are "natural". But not every stage of life needs to be "fixed". No one claims 80+ year old men need weekly sex. Nor children. Sex is great, but we're not all on the same schedule, and that's fine.  

 You wouldn’t check a male’s testosterone level if they only wanted sex annually? I am certain I don’t know any couples who have fulfilling marriages who only have sex once a year and that includes 80+ year old. 

 Just as you are certain you don't know, I'm certain I do. I've checked many, MANY, MANY, testosterone levels in my years. Sometimes it's relevant, sometimes it's not. The premise is the problem. I just don't see evidence that intercourse frequency is a biologically or hormonally contingent reality. It's an emergent phenomenon of which hormone levels play a part, but they're not the whole story, or even frankly the biggest part. 

 In women it’s not a hormonally contingent reality?!?! Physicians like you are exactly the ones who don’t take women or female sexual dysfunction seriously. Thank goodness for doctors like Dr Mary Haver, Dr Louise Newsom and Dr Kelly Casperson who have helped women who have been gaslit by physicians and their hormonal changes. 

 I’d add this. How much time are you spending with your patients to ascertain that they have fulfilling and happy marriages. I’ll be REALLY generous here with one hour every 6 weeks? That seems relevant and lol. 

 sorry, fell asleep. Valid points. Can only go by what patients tell me. I will say that I'm in primary care so see patients 3-4 times annually for years, so get to know them. And we talk about relationships and sex frequently, as it's part of health. And my partner is a gynecologist who has similar experiences to mine. All I'm saying is that there's no one right frequency for everyone nor biologically determined right frequency. 

 I appreciate your perspective! There definitely is no right frequency as evidenced by the men responding to this note and I did say most not all men. I’d counter that you should consider that patients are not always forthcoming with their physicians when it comes to intimate matters. Join any menopause forum and will you find a few women that have higher libidos than their partners? Sure, but overwhelmingly the complaint is low libido compared to their spouse that they either don’t feel comfortable discussing with their doctor or feel that it was minimized when they brought it up.