e11 Kirecci SL, et al. Postgrad Med J 2022;98:e11. doi:10.1136/postgradmedj-2020-139033 Original research Sexual intercourse before exercise has a detrimental effect on lower extremity muscle strength in men Sinan Levent Kirecci, 1 Ahmet Tevfk Albayrak , 1 Abdullah Hizir Yavuzsan, 1 Cumhur Yesildal, 2 Musab Ilgi, 3 Cemil Kutsal 1 To cite: Kirecci SL, Albayrak AT, Yavuzsan AH, et al. Postgrad Med J 2022;98:e11. 1 Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey 2 Urology, University of Health Sciences Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey 3 Urology, KMG Klinikum Luckenwalde, Berlin, Germany Correspondence to Dr Ahmet Tevfk Albayrak, Urology, University of Health Sciences Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey; atevfkalbayrak@gmail.com Received 15 September 2020 Revised 6 February 2021 Accepted 12 February 2021 Published Online First 1 April 2021 © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. ABSTRACT Introduction The question of whether sexual intercourse can harm athletic performance is a long- debated topic since frst sport competitions were invented. Therefore, due to the lack of solid evidence, we aimed to evaluate the effects of sexual intercourse on muscle training performance. Materials and methods Physically and sexually active, 50 men (age=29.3±1.14 years) were enrolled in the study. Participants completed three weight training sessions and all sessions were at the same time of the day. The maximum weight was adjusted in the frst session. In the second and third sessions, they performed fve repetitions of the squat with their maximum weight for each set with a total of fve sets after participating in and abstaining from sexual intercourse the night before, respectively. The duration of sexual intercourse was measured with a stopwatch. Results The mean duration of sex was measured to be 13.8±3.61 min. Furthermore, the mean lifted weight before sex was calculated to be 109.4±11.41 kg and the mean lifted weight after sex was calculated to be 107±11.05 kg. According to obtained data, sexual intercourse has a signifcant detrimental effect on maximum weight in squat training (p=0001). Conclusion Results demonstrate that sexual intercourse within 24 hours before exercise have detrimental effect on lower extremity muscle force, which suggests that restricting sexual activity before a short- term activity may be necessary. INTRODUCTION In sport industry, sexual intercourse is infamous about its believed detrimental effects on athletic abili- ties. 1 2 Many coaches and trainers advise their athletes to stay away from sex before a competition. Even the famous boxer Muhammad Ali said in one of his inter- views that sexual fasting was helping him to become more aggressive and therefore improve his athletic performance. 3 Like Muhammad Ali, the vast majority of athletes believe abstaining from sex preserves their strength and prepare them to get the right mental state. 4 5 Although it is an essential topic for sports and sexual medicine, literature is very limited and confusing. Therefore, some athletes and coaches are not sure of the effect of sex on athletic performance. 6 Although there are various reports about the effect of sexual activity on athletic performance, none of these studies provide any reliable data but assump- tions. 4 7 8 However, the first reliable report was published by Johnson. 9 The author evaluated the grip strength on the following day of sexual intercourse by using a hand grip dynamometer. No significant difference was reported compared with the absti- nence. This result was also supported by two rela- tively more recent studies. 10 11 Furthermore, three studies were published in last year. The first study was conducted by Valenti et al, 12 who evaluated the nega- tive effect of sexual intercourse on lower extremity muscle force 12 healthy young men. In that study, the authors did not report any significant differences in lower extremity muscle force between the abstinence and partaking sexual intercourse occurred a night before. The second and third studies were published by Zavorsky et al. 13 14 The authors evaluated some parameters of physical exercise performance such as; strength, balance, agility, reaction time, anaerobic power and maximal oxygen uptake in 10 young and healthy males. The authors did not report any signif- icant differences in any of the measured parameters between the abstinence and partaking sexual inter- course occurred a night before. 13 14 In the light of the available data and due to the lack of a consensus about this topic, we decided to evaluate the potential effects of sexual intercourse resulting in an orgasm on lower extremity strength in physically active men. MATERIALS AND METHODS Participants Fifty physically and sexually active men agreed to participate in the study. The mean age of partic- ipants was 29.3±1.14, and the mean body mass index was 22.86±0.76. Participants were semi- professional athletes (including basketball, foot- ball, squash and tennis players) who exercised at least 3 days a week in their normal routines. All participants had a steady and active (two to three times a week) sexual relationship with their part- ners. Participants were non-smokers and drank alcohol occasionally. The demographic data of the participants are presented in table 1. Inclusion criteria were determined to be the absence of knee injury history and absence of any medications or supplements that might enhance physical perfor- mance. Men with chronic diseases or knee injuries were excluded. Those with irregular sexual part- ners and irregular strength training routines were also excluded. A health history questionnaire was completed by all participants. Study design Participants completed three sessions, 7 days apart (figure 1). All sessions were conducted at the same time of day. They avoided excessive Downloaded from https://academic.oup.com/pmj/article/98/1161/e11/6959260 by guest on 10 January 2023