Reshaping reality and society.

The year is 2043.

20 years ago, humans would die at an average age of 100, and were still susceptible to diseases and injuries, but that was before medical technology perfected nanomachines which effectively make humans immune to by disease, and able to rapidly heal from most injuries that are less than catastrophic. Also, the internal aging process is vastly slowed, and no one yet knows how long the human lifespan will now be. Speculation is several hundred years, but the possibility of thousands exists.
Humans now stop physically aging at about 25-35, and have on average twice the libido

A side effect of this technology was vastly reduced fertility (0.001% of previous pregnancy rate), and a change in the gender ratio of pregnancies which occur: 25% of births are now male, 70% female, and 5% of the human population is born with some fully functional combination of both genders. Everyone is born physically the gender they will be mentally when adult.

18 years ago, efforts to offset this side effect resulted in vastly increased fertility (487.5% of pre-nanotech) and more stereotypically fertile bodies (wider hips, larger asses, massive tits) for females - periods were eliminated, and human females now always become pregnant when fertile sperm makes it to an egg. Most birth control methods that existed before were rendered ineffective as well, but the majority of women don't really care, as this change also brought with it a higher desire for children in most cases, along with another doubling of average female libido. However, human males were still significantly less fertile than before...and the nanotech also rendered Viagra and similar chemical aids as ineffective as most birth control.

While the increase in overall libido meant sex and other forms of sexual relief became far more commonplace, with results including "libido control breaks" at workplaces, lingering remnants of the taboos from before TNA (The Nano Age) still exist.

Despite an estimated ~500% increase in "copulation events", population growth dropped rapidly, and while many think this will be fine since lifespans are much longer, the combination of side effects leaves many women without a male partner capable of satisfying their desires.

This has led to a huge market growth in sexual stamina and enhancement aids for men, the vast majority of which are quackery and lies.
Most of these are sought even by females, seeking ways to improve their partner's capability.

But few of them work.

Vast amounts of money and time are currently invested in various startups and the like whose proposals seek to increase male (or even the small number of dickgirls, futanari, and other gendermix individuals who have penises) sexual stamina and fertility, but so far attempts have run up against the wall of nanotech, which rapidly removes chemicals which were not included in their programming from the human body.
And for that matter, maintains the DNA of the human they are in. Which means attempts to DNA alter have failed as well.

Most experts speculate that reprogramming the nanomachines will end up being the fix, but some unknown organization or person has been killing off those who designed and programmed the original nanotech and anyone who even hints they are working on reprogramming them.
Few are willing to risk to fix the issue, but rumors of secret projects abound.