ORIGINAL RESEARCH

INTERVENTION

Effect of Sexual Intercourse on Lower Extremity Muscle Force in

Strength-Trained Men
Leah M. Valenti, Claudia Suchil, Gabriel Beltran, Roman C. Rogers, Emily A. Massey, and Todd A. Astorino, PhD

ABSTRACT

Background: Sex has been deemed taboo for athletic performance going back to ancient Rome and Greece, as
the act of sex was thought to promote ease and a sense of relaxation.
Aim: This study examined the effect of sexual intercourse completed 12 hours before a bout of isokinetic
dynamometry on muscle force production in strength-trained men.
Methods: 12 Healthy physically active men (age ¼ 25.6 ± 3.8 years) who were sexually active participated in
this study. After men completed a familiarization session on day 1, muscle force was measured during 5 sets of
maximal unilateral knee extension (KE) and knee flexion exercise at 30 deg/s after men engaged in or abstained
from sexual intercourse within the previous 12 hours. The order of this treatment was randomized across par-
ticipants, and time of day was maintained across all sessions.
Outcomes: Lower extremity muscle strength and endurance were measured.
Results: Data showed no significant effect (P ¼ .34 and P ¼ .39) of sexual intercourse on peak or average KE or knee
flexion torque. For example, after sexual intercourse, KE torque was similar in set 1 (198.9 ± 39.1 ft/lb vs 190.2 ± 28.7
ft/lb) and set 5 (163.2 ± 30.8 ft/lb vs 159.4 ± 35.2 ft/lb) compared to when men abstained from sexual intercourse.
Clinical Translation: Engaging in sexual intercourse on the night before exercise is not detrimental to muscular
strength in active men.
Conclusions: This study is strengthened by use of a homogeneous sample of active men as well as precise
determination of changes in muscle function via isokinetic dynamometry. However, completion of sexual in-
tercourse was confirmed through self-report rather than direct observation, so it is not certain if participants
actually met the requirements of each condition. Results demonstrate that sexual intercourse does not signifi-
cantly impact lower extremity muscle force, which suggests that restricting sexual activity before short-term, high-
force activity is unnecessary. Valenti LM, Suchil C, Beltran G, et al. Effect of Sexual Intercourse on Lower
Extremity Muscle Force in Strength-Trained Men. J Sex Med 2018;15:888e893.
Copyright
2018, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
Key Words: Sexual Intercourse; Isokinetic Dynamometry; Knee Extension/Flexion; Muscle Force; Men

INTRODUCTION
Engagement in sexual intercourse before athletic competition
has been a subject of controversy for many years. It is not un-
common for coaches to recommend that athletes refrain from
sexual intercourse preceding an event in fear that it could harm
their performance. Athletes such as Muhammad Ali and Brian
Bosworth proclaimed that engaging in sexual intercourse prior to
competition was detrimental to their athletic ability.1 It is
Received February 2, 2018. Accepted April 16, 2018.
Department of Kinesiology, California State University, San Marcos, San
Marcos, CA, USA
Copyright ª 2018, International Society for Sexual Medicine. Published by
Elsevier Inc. All rights reserved.
https://doi.org/10.1016/j.jsxm.2018.04.636
suggested that this commonly held belief stems from the idea that
abstaining from sexual intercourse elicits an increase in rage and
aggressive behavior resulting in improved athletic performance.2
Consequently, partaking in sexual intercourse resulting in
orgasm is thought to reduce the positive effects associated with
abstinence and may reduce testosterone levels, which in turn may
be detrimental to athletic performance.2 It is evident that sexual
intercourse leading to orgasm elicits various physiological changes
including reduced testosterone, slower recovery response, and
increased happiness, which may decrease physical function.3 In
addition, there are reports that abstinence may promote a drive to
excel in sports, as a world renowned 5K runner famously said, “Sex
makes you happy, and happy people don’t run a 3:47 mile.”2
Despite these mostly anecdotal reports, literature pertaining to
this topic is relatively limited. In inactive men, Boone and

888 J Sex Med 2018;15:888e893

Sexual Intercourse and Muscle Force
Gilmore4 showed that sex, which was defined as sexual inter-
course finishing in orgasm, led to no change in maximal oxygen
uptake, heart rate, or blood pressure compared to a trial preceded
by abstinence from sex. Almost 30 years earlier, Johnson5 re-
ported no change in grip strength in former men athletes who
engaged in sexual intercourse. Nevertheless, there are reports that
sexual intercourse between a man and a woman is correlated with
improved psychological and physiological function. For example,
participants who partook in penile-vaginal intercourse demon-
strated an improved response to stress and increased emotional
awareness,6 which may potentially enhance exercise performance.
Additionally, there is evidence demonstrating a relationship be-
tween frequency of orgasm via sexual intercourse and risk for
mortality. Smith et al7 reported that individuals who experienced
more frequent orgasms had 50% lower all-cause mortality vs
individuals with less frequent orgasms, which may improve
health status in men. More recently, Corona et al8 demonstrated
reduced risk of major cardiovascular events with higher frequency
of sexual intercourse in men with erectile dysfunction. While
much of the current literature focuses on changes in hormone
levels or aerobic performance in response to sexual intercourse,
no studies have examined changes in lower extremity muscle
force after sexual intercourse.9 This omission is unfortunate
considering that performance in many sports is highly dependent
on muscle strength.
The aim of this study was to examine the effects of sexual
intercourse resulting in orgasm on lower extremity muscle force
in strength-trained men. It was hypothesized that sexual inter-
course would diminish lower extremity force production
compared to abstention. This line of inquiry applies to health
care professionals who may treat athletes who are recovering from
injury or preparing for competition.
METHODS
Experimental Design
Participants completed 3 sessions held at the same time of day
within subjects (8:30e11:30 AM). They refrained from physical
activity for 24 hours before all sessions and maintained their
dietary intake, which were confirmed with a written log. They
underwent testing of lower extremity muscle force after partaking
in or abstaining from sexual intercourse the night before. After
baseline testing, the investigators informed each participant that
2 additional sessions would be required, 1 held after completion
of sexual intercourse the night before, or alternatively, absten-
tion. The order of condition was randomized across subjects
using a Latin squares design.
Subjects
12 Healthy active men participated in the study. Their de-
mographic traits are shown in Table 1. They were recruited from
the surrounding areas through word of mouth. Inclusion criteria
included absence of current or previous knee injuries and not
J Sex Med 2018;15:888e893
889
Table 1. Participant demographic characteristics (N ¼ 12)
Parameter Mean ± SD
Age, y 25.6 ± 3.8
Height, cm 177.8 ± 10.4
Body mass, kg 84.9 ± 11.5
Frequency of men who engaged 4/8
in sexual intercourse for >/<30 min
ingesting any medications or supplements that might alter the
study outcomes. 2 Additional inclusion criteria were that all must
undergo strength training a minimum of 2 d/wk in the preceding
year and be currently engaged in a relationship with a consenting
sexual partner. Exclusion criteria included men with diagnosed
disease and knee injury as well as those who do not regularly
perform strength training and who do not have a regular sexual
partner. Prior to providing written informed consent, all par-
ticipants filled out a health-history questionnaire to ensure that
they met our inclusion criteria. All procedures were approved by
the university institutional review board.
Experimental Procedures
The 3 testing sessions were separated by 3e7 days and were
held within a 3-week period. Participants were asked to complete
muscle force testing after abstaining from sexual intercourse or
engaging in sexual intercourse within the past 12 hours, which
were verified through surveys as well as verbal confirmation on
each day. On day 1, participants reported to the laboratory
dressed in exercise attire, and completed a 5-minute warm-up of
light cycling (Monark 894e, Vansbro, Sweden). Subsequently,
they completed a familiarization session of muscle force testing
on the isokinetic dynamometer (Biodex System 3, Shirley, NY)
to reduce learning effects. Straps were placed over the exercising
leg, trunk, and hips to restrict work to the exercising limb, and
settings for the chair height and seat angle were recorded. Then,
knee extension (KE) and knee flexion (KF) range of motion was
determined for each participant. Participants were instructed to
exert maximal effort during 5 sets of 4 repetitions of unilateral
KE and KF exercise at a contraction velocity equal to 30 deg/s.
There was a 30-second recovery between each set. From each set,
peak and average KE and KF torque was determined. Verbal
encouragement was not provided during the sessions. In
strength-trained men, our laboratory’s coefficient of variation for
KE and KF torque is between 5% and 6%.
Participants returned a minimum of 72 hours later to a
maximum of 7 days later at the same time of day within subjects,
following the aforementioned pre-test guidelines, which were
confirmed with a written survey. In addition, participants filled
out a Fatigue Inventory Scale (R. Kreider, personal communi-
cation, June 2010) consisting of various questions (0e10 Likert
scale) pertaining to general feelings of fatigue, and a brief survey
to confirm that each subject satisfied the sexual activity criterion
for that session, ie, they had abstained or participated in sexual
890 Valenti et al

activity leading to orgasm in the preceding 12 hours. They were

also asked if the duration of sexual intercourse lasted less than or
greater than 30 minutes.

Statistical Analyses
Data were analyzed using software (SPSS, Version 22.0; IBM
Corp, Armonk, NY) and are reported as mean ± SD. The
Shapiro-Wilks test was used to assess normality. 2-Way repeated
measures analysis of variance was used to examine changes in
peak and average KE and KF torque between the conditions. If a
significant F ratio was obtained, Tukey post hoc test was used to
identify differences between means. If the sphericity assumption
was not met, the Greenhouse-Geisser correction was used. Paired
t test was used to identify differences in various indices of fatigue
between conditions. At a statistical power equal to 0.80 and
expected difference in muscle torque between conditions equal to
5%, the minimum total sample size was determined to be 10
individuals.10 Statistical significance was set at P < .05.

RESULTS
Figure 1. Change in peak muscle torque produced during unilateral
Sexual Intercourse Duration knee extension (A) and flexion (B) with and without sexual inter-
All participants complied with the requirement to perform course. All values are mean ± SD.
sexual intercourse or abstain from it in the 12 hours preceding
each session. Data show that 4 of 12 participants reported in-
1.4 ± 1.7 and 2.1 ± 2.0 before the sexual intercourse trial and
tercourse lasting longer than 30 minutes; whereas, the remaining
2.7 ± 2.2 and 2.9 ± 3.1 before the abstinence trial, and they did
8 reported sexual intercourse lasting less than 30 minutes. The
not differ (P ¼ .08 and P ¼ .37) across conditions. Participants
amount of sleep completed by each participant on the night
reported similar leg fatigue (P ¼ .50) before the trial requiring
before each session was not different in the sex or abstinence
sexual intercourse (1.7 ± 1.6) compared to abstention
conditions (6.4 ± 1.0 and 6.6 ± 0.8 hours, respectively).

Changes in KE and KF Torque

2-Way repeated measures analysis of variance showed no main
effect (P ¼ .34) or conditionXset interaction (P ¼ .89) for peak
KE torque, although it did decline across sets (P < .001). Across
participants, 6 showed little difference (<10 ft/lb change) in KE
torque across conditions; whereas 3 showed higher KE torque
after partaking in sexual intercourse, and 3 displayed higher KE
torque after abstention. Similar results were demonstrated for
peak KF torque as there was no main effect (P ¼ .39) or
interaction (P ¼ .24), although it declined across sets (P ¼ .001)
(Figure 1). Additional data revealed no effect (P ¼ .28) of sexual
intercourse or interaction (P ¼ .80) on average KE torque
although it declined across sets by 15% (P < .001) in both
conditions. Average KF torque revealed similar findings as no
main effect (P ¼ .40) or interaction (P ¼ .66) were shown.
These results are demonstrated in Figure 2.

Changes in Fatigue
Results demonstrate similar levels of mental and physical fa-
tigue prior to both sessions. Participants rated mental and
physical fatigue on a scale from 0e10, with 10 representing the
highest fatigue. Mental and physical fatigue were equal to
Figure 2. Change in average muscle torque produced during
unilateral knee extension (A) and flexion (B) with and without
sexual intercourse. All values are mean ± SD.

J Sex Med 2018;15:888e893

Sexual Intercourse and Muscle Force
(2.5 ± 3.0). General tiredness was also similar (P ¼ .77) across
conditions (2.1 ± 2.4 vs 2.0 ± 2.4 for sexual intercourse and
abstinence, respectively).
DISCUSSION
The purpose of this study was to determine the effects of a
single bout of sexual intercourse resulting in orgasm on quadri-
ceps and hamstring torque in healthy, strength-trained men. The
findings showed that sexual intercourse completed within 12
hours of muscle force testing has no detrimental effect on the
maximal or average torque achieved. Results of the present study
corroborate prior findings showing no effect of sexual intercourse
on athletic performance, and suggest that abstention from sexual
intercourse prior to brief bouts of high-force activity is not
warranted.
To our knowledge, only a few studies have examined the ef-
fects of a single session of sexual activity on exercise performance.
2 Studies4,11 consisted of laboratory-based graded exercise tests
during which cardiac parameters were measured. Their results
showed no change in performance between sessions following
sexual intercourse vs abstention from intercourse. In a sample of
active and inactive men and women, Vouyoukas12 reported no
change in grip strength, vertical jump, or sub-maximal exercise
performance between conditions. Johnson5 tested potential
changes in grip strength in former men athletes ages 24e49 years
old, and there was no effect of sexual intercourse performed the
previous evening on this parameter compared to when sex was
completed at least 6 days prior. Lastly, cross-sectional data in
marathon runners13 showed no relationship between running
performance and sexual activity in the 48 hours before the race.
Overall, there are no data that support the long-held belief that
sexual intercourse is detrimental for athletic performance,
although existing studies are characterized by small and hetero-
geneous samples, use of laboratory-based exercise tests rather
than protocols mirroring the demands of sport, and minimal use
of elite athletes as participants, where small changes in perfor-
mance are potentially detrimental or beneficial. Further study is
merited to clarify this issue as it has great application to the
preparation of competitive athletes as well as weekend warriors
who seek to optimize performance in competition.
Previous findings12 may potentially explain why our results
showed no significant effect of sexual intercourse on muscle
force. Sexual intercourse activates both the sympathetic and para-
sympathetic nervous system similar to exercise. Immediately
following orgasm, release of neuro-transmitters such as dopamine
and serotonin provide a sense of relaxation and calmness yet
shortly after, neuro-transmitter levels begin to return to baseline
values.12 However, little is known regarding the duration of this
state of relaxation, called the refractory period, as existing studies
have focused on animals.14e16 1 Study suggests the refractory
period lasts less than 30 minutes,17 which would explain why
performance is not impaired when morning exercise is preceded
J Sex Med 2018;15:888e893
891
by sexual intercourse on the night before. Furthermore, a lack of
effect could be due to the duration of sexual intercourse, which
was not standardized in our participants and may have led to
different capacity for exercise testing on the following morning.
For example, 25% of men showed meaningful increases in
muscle torque after abstaining from sex, whereas an additional
25% demonstrated higher torque when tested the morning after
sexual intercourse. Individual responses to acute18 and chronic19
exercise training have been demonstrated, and it is likely that a
single session of sexual intercourse affects men differently. This is
an area of future study considering the desire to personalize ex-
ercise training to maximize the benefits of regular physical
activity.20
Past studies have associated plasma testosterone levels with
changes in muscle mass, strength, and skeletal muscle tissue
modification,21 which have the potential to affect long-term
exercise performance.22 Previously, sexual intercourse was
thought to be linked to a decrease in testosterone levels.3
However, Phoenix et al16 reported that Rhesus monkeys
showed no significant change in blood testosterone before and
50, 80, and 140 minutes after ejaculation. In contrast, Dabbs
and Mohammed23 showed increased testosterone levels in both
men and women before and after sexual intercourse with a
partner, and levels decreased when they abstained from sexual
intercourse. Nevertheless, these data may be of limited impact
since results from only 4 couples were examined. In a cross-
sectional study,24 men with erectile dysfunction showed signifi-
cantly lower concentration of total and free testosterone vs
healthy men who served as controls. When these men completed
therapy resulting in resumption of normal sexual activity, marked
increases in testosterone levels were demonstrated. However, data
from a recent study25 showed that in men who completed 12
weeks of resistance training, resultant increases in strength and
muscle mass were unrelated to changes in anabolic hormones
including testosterone. This potentially suggests that any change
in testosterone induced by sexual intercourse may not have any
effect upon the force-generating ability of the muscle. This belief
is further supported as muscle strength exerted during a single
exercise bout is determined by phosphocreatine content, muscle
fiber type, muscle mass, and neuro-muscular attributes rather
than changes in various hormones such as testosterone.26
Completion of sexual intercourse has long been thought to be
detrimental to exercise performance, so many coaches or team
physicians may tell athletes to abstain from it prior to competi-
tion. Our results obtained in strength-trained men refute this
long-held belief as they show no change in lower extremity
muscle force when exercise is preceded by sexual intercourse
performed the night before compared to abstention. Neverthe-
less, our sample was relatively small which may limit the appli-
cability of our findings. In addition, the study has several
limitations that need to be addressed. First, participants included
young, healthy men who participate in strength training, which
reduces the application of our findings to different populations
892
including women and inactive individuals. It is apparent that
men and women respond differently to sexual activity, in which
frequency of orgasm and the duration of the refractory period
between genders vary.10 Another limitation was an inability to
standardize the exact time and duration of sexual intercourse
across subjects, although men came to the laboratory well-rested
and sleep duration did not differ between conditions. Of the 4
men who engaged in sex for more than 30 minutes, 2 showed
negligible differences (<10 ft/lb) in torque between conditions,
whereas the other 2 demonstrated marked increases in torque
(18.2 and 51.3 ft/lb) after completing vs abstaining from sexual
intercourse. In addition, energy expenditure of only 25 kilojoules
has been reported27 in response to sex, so it is unlikely that this
has any detrimental effect upon subsequent exercise capacity.
Furthermore, our exercise protocol only involved the knee joint,
and it is unknown if whole-body exercise mirroring the demands
of sport, such as a cycling time trial, running test, resistance
training performance, or performance in sports requiring
cognitive processing (eg, soccer, volleyball, tennis) would also be
affected by a single session of sexual intercourse performed the
previous evening. We did not measure androgen levels, so we do
not know if testosterone concentration differed across conditions.
Moreover, participants were free to select various modalities of
sexual intercourse and were not questioned about the gender of
their partner. It is plausible that different levels of leg fatigue
would occur in response to different positions, such as kneeling
behind a partner vs lying supine on top, which may alter sub-
sequent performance differently. Lastly, we required men to
engage in sexual intercourse within a 12-hour period of muscle
force testing, and it is possible that sexual intercourse leading to
orgasm completed directly before testing could elicit different
results.
Due to a lack of empirical evidence, high-quality, randomized
studies are still needed to further test the impact of sexual in-
tercourse on athletic performance. In addition, data pertaining to
the effect of sexual intercourse on performance in athletes
competing in individual and team sports are limited.27 Further
investigation into this topic may include comparing the effects of
sexual intercourse on athletic performance of men athletes vs
women athletes of the same sport, as a majority of the studies
were conducted in men. Additionally, future analysis is needed
comparing the effects of masturbation vs sexual intercourse on
performance.27 Aside from these areas of future investigation,
additional studies should consider the psychological factors
associated with sexual intercourse.
CONCLUSION
Our data demonstrate that partaking in sexual intercourse
12 hours prior did not affect KE or KF torque. These findings
support past studies,2,4,10 which conclude that sexual intercourse
the day before exercise does not impact athletic performance.
Coaches often prefer for athletes to abstain from sexual inter-
course prior to competition in fear that it may negatively impact
Valenti et al
their subsequent performance. As Casey Stengel, past New York
Yankees manager, mentioned, it may not be the act of per-
forming sexual intercourse affecting the athletes, but rather a
result of depriving themselves of sleep looking for sex.2 The
impact of sexual intercourse on sports performance is still un-
clear, and future studies are needed to clarify the misconceptions
surrounding this controversial topic.
Corresponding Author: Todd A. Astorino, PhD, Department
of Kinesiology, California State University, San Marcos, 333
South Twin Oaks Valley Road, UNIV 320, San Marcos, CA
92096-0001, USA. Tel: 760-750-7351; Fax: 760-750-3237;
E-mail: astorino@csusm.edu
Conflict of Interest: The authors report no conflicts of interest.
Funding: None.
STATEMENT OF AUTHORSHIP
Category 1
(a) Conception and Design
Roman C. Rogers; Todd A. Astorino
(b) Acquisition of Data
Leah M. Valenti; Claudia Suchil; Gabriel Beltran; Roman C.
Rogers; Emily A. Massey
(c) Analysis and Interpretation of Data
Claudia Suchil; Todd A. Astorino
Category 2
(a) Drafting the Article
Leah M. Valenti; Claudia Suchil; Gabriel Beltran; Roman C.
Rogers; Emily A. Massey; Todd A. Astorino
(b) Revising It for Intellectual Content
Leah M. Valenti; Claudia Suchil; Gabriel Beltran; Roman C.
Rogers; Emily A. Massey; Todd A. Astorino
Category 3
(a) Final Approval of the Completed Article
Leah M. Valenti; Claudia Suchil; Gabriel Beltran; Roman C.
Rogers; Emily A. Massey; Todd A. Astorino
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