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Enjoy sex like you used to
Whether you played a sport in high school, college or even at the professional level, chances are you heard someone in a locker room talking about sex before the big game. But is this just superstition? Does sex increase testosterone and thus athletic performance?
As you probably know, hormones like testosterone are deeply linked to how our bodies function. Beyond sexual performance and sex drive, testosterone can affect everything from your mood to your hair.
But exactly what increases or decreases those sex hormone levels can sometimes be a little more vague.
Sex’s impact on your testosterone levels isn’t terribly complicated, thankfully. However, the implications of those effects can mean a lot for your health, your athleticism and plenty of other elements of your life.
Does having sex increase testosterone levels? Let’s break this down into simple parts, starting with the relationship between sex and hormones.
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Before we examine how testosterone production and sexual behavior affect each other, it’s important to understand how hormones like testosterone actually work.
Hormones do many things for our bodies. They’re essentially molecules that affect certain biochemical processes of cellular function. An even more compact way of stating this is that they’re sort of like command prompts for your cells, organs and other bodily functions.
Hormones regulate how your body grows. They regulate your production of vital chemicals like insulin. They affect your libido, hair, muscles, skin — you get the picture.
If you’re reproducing, metabolizing, fighting, sprinting or even sleeping, there’s a good chance a hormone told your body to complete the task.
Hormones also help regulate blood levels. It takes a nearly imperceptible volume of these molecular messengers to keep an organ or tissue functioning — or to shut it down completely.
In the case of sexual function, testosterone is a key player in your libido. It regulates phosphodiesterase type 5 enzymes (PDE5s) necessary for the actual “arousal” part of sexual intercourse.
Research suggests that when things veer outside of normal testosterone levels, it can affect your sexual performance. Studies have shown that high testosterone levels are associated with premature ejaculation, while lower levels of testosterone are associated with sexual dysfunction — both delayed ejaculation and reduced ejaculatory volume.
So, yes, there is a strong relationship between sex and testosterone. But these relationships don’t always work the way we expect them to.
Just because hormone levels can affect sex doesn’t mean sex can affect your hormone levels. And the science we have pretty clearly backs this up.
For instance, while research shows a close connection between testosterone and your ability to achieve an erection during sexual intercourse, there’s actually no relationship between having an erection and the presence of testosterone.
It gets even more confusing when you understand that a 1993 study of 60 men looked at the relationship between sexual activity and testosterone levels across various ages, marital status and other variables.
The research concluded that there’s actually no relationship between testosterone levels and sexual activity. In other words, men with high testosterone levels aren’t having more or less sex.
Is this an open-and-shut case against sex increasing your testosterone? Not exactly.
To understand what’s going on, we need to take a more nuanced look at testosterone and sex.
A 2003 study examined serum testosterone levels in 28 volunteers during periods of abstinence after ejaculation.
What the researchers found was interesting. The first few days after ejaculation, hormone levels didn’t fluctuate significantly, but by day seven, serum testosterone levels reached nearly 150 percent of the baseline levels.
These fluctuations weren’t permanent, nor were they substantial in the long term. But they did prove a critical point: testosterone levels could be more influenced by a lack of sex than by sex itself.
A 2021 review suggested a more nuanced relationship between testosterone levels and sexual activity. Short-term increases from watching erotic movies (aka porn) or participating in sex can occur, and limited results show the same could be true for masturbation.
In other words, sex can increase testosterone levels. But so can abstinence in some cases, depending on masturbation frequency.
And before the abstinence fans gloat, there’s one more thing we have to point out. Though the seven-day study did show serum increases, previous studies have shown that reduced sexual activity due to ED lowers testosterone. And resuming sexual activity restores equilibrium from that drop in testosterone levels, regardless of whether the ED was treated.
This tells us is sex can have an impact on testosterone levels, but the scope of that impact is unclear — and potentially temporary.
For the most part, claims about abstinence and testosterone are usually a reach. Testosterone levels have more to do with healthy endocrine function and age than your weekly, monthly or annual average.
Sex and fluctuations in sexual desire don’t seem to have a meaningful effect on testosterone. But testosterone itself, as well as testosterone therapy or testosterone replacement therapy, can certainly affect your sexual activity in major ways.
The first thing you need to understand is that testosterone levels decrease as we age. It’s just a part of life and the changes that occur as you get older.
It’s generally understood that low testosterone levels are one of the major causes of endocrine erectile dysfunction (ED) as men get older.
Hypogonadotropic Hypogonadism (when your pituitary gland doesn’t produce enough sex hormones) is an established ED cause. Treating it with hormone therapy has been shown to improve the signs and symptoms of erectile dysfunction in men suffering from ED due to endocrine issues.
Hypogonadotropic Hypogonadism is generally considered the least common cause of erectile dysfunction. It’s kind of morbid to think of it this way, but the causes of ED are a bit like the potential causes of death.
According to the CDC, the number one cause of death is heart disease. According to the National Library of Medicine, the same is true of erectile dysfunction.
So rather than treat erectile dysfunction with more sex or testosterone injections, it’s best to consider whether health conditions like cardiovascular disease are at fault.
You can check out our guide to the causes of erectile dysfunction for more information. And if you’re interested in treatment for ED, we can walk you through your options.
Your sex life probably isn’t the primary cause of any positive or negative effects on your testosterone levels. The amount of sexual intercourse you’d have to have to make serious or long-term changes to your testosterone levels is too epic to calculate.
If you’re trying to crank your testosterone up ahead of your club softball playoffs, abstaining for at least seven days might increase your testosterone levels — but that seems like a heavy price to pay.
In the bigger picture, testosterone is only important when it rises or falls outside the normal range. If you’re seeing problems that might be associated with out-of-balance T levels, it’s time to get off the internet and in front of a healthcare professional.
A healthcare provider brings you numerous benefits. They can aid you with health tips and recommendations for problems like erectile dysfunction, low libido, hair loss and whatever else you might be worried about. And they can diagnose other potential causes of these problems.
As for competitive sports, do whatever you think gives you the best edge. Just don’t deprive yourself for too long, and don’t hesitate to reach out for a professional opinion.
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Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.
She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.
Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.
Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.
Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.
Education & Training
Andrology Fellowship, Medical College of Wisconsin
Urology Residency, University of California San Francisco
M.D. Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill
Published as Kelly Walker
Cowan, B, Walker, K., Rodgers, K., Agyemang, J. (2023). Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. https://www.sciencedirect.com/journal/fertility-and-sterility/vol/120/issue/1/suppl/S
Walker, K., Gogoj, A., Honig, S., Sandlow, J. (2021). What’s New in Male Contraception? AUA Update Series, Volume 40. https://auau.auanet.org/content/update-series-2021-lesson-27-what%E2%80%99s-new-male-contraception
Walker, K., Shindel, A. (2019). AUA Erectile Dysfunction Guideline. AUA Update Series, Volume 38. https://auau.auanet.org/content/course-307
Walker, K., Ramstein, J., & Smith, J. (2019). Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients. The Journal of Urology, 201(Supplement 4), e680-e681. https://www.auajournals.org/doi/10.1097/01.JU.0000556300.18991.8e
Walker, K., & Smith, J. (2019). Feasibility Study of Video Telehealth Clinic Visits in Urology. The Journal of Urology, 201(Supplement 4), e545-e545. https://www.auajournals.org/doi/10.1097/01.JU.0000556071.60611.37