For centuries, the notion that abstaining from sex increases physical performance has been widely debated. From ancient Greek athletes to modern-day boxing legends such as Muhammad Ali and Mike Tyson, have practiced sexual restraint in the expectation of increasing strength, stamina, and hope. The famous scene in Rocky where trainer Mickey Goldmill tells Rocky Balboa to "lay off that pet shop dame", “women weaken legs,” further fueled this belief, reinforcing the belief that sex before competition weakens the body. But does science back this up, or is it merely an outdated myth?

The theory that sex saps energy and impairs performance goes back almost 2,000 years. Abstaining, ancient Greek athletes believed, would enhance aggression and concentration, leading them to become stronger competitors. Even today in the world of sports, people stick to this hypothesis despite the changing scientific findings. But during the Rio 2016 Olympics, officials gave away a staggering half a million condoms to participants—far from a indication that sex was being thought of as a performance-sapping activity.

Although some continue to abstain prior to major events, the real effect of sex on sports performance is still controversial. Is there any basis to the belief that sex inhibits strength and endurance, or is it merely an old wives' tale?

Role of Testosterone in Athletic Performance

Testosterone is an essential hormone that is essential for muscle growth, power, and overall athletic performance. Although men naturally produce more than women, both sexes need testosterone for energy and recovery. Some athletes think not having sex maintains their testosterone levels, providing them with an advantage in the gym or on the field. But is this statement scientifically accurate?

Studies indicate that testosterone levels are not consistent throughout the day but are constantly being produced in the body. Unlike glycogen, which can be stored and used as energy, testosterone is controlled according to the needs of the body. Research does not indicate that having sex depletes testosterone levels significantly—if anything, it can increase them slightly through endorphin and dopamine release.

Does Abstinence Make One Stronger and More Enduring?

Some fitness enthusiasts skip sex before hard workouts because they think it takes away their energy. Although intense physical exercise (including sex) can cause temporary tiredness, there is no scientific evidence to support that sex deteriorates long-term strength or endurance.

A 2016 review article in Frontiers in Physiology reviewed nine studies of sex and performance in sports, and concluded there was no basis to believe sexual activity prior to competition would cause the body to be weakened. Another study, published in 2019 in the Journal of Sexual Medicine, found no statistically significant effect of sex on performance.

Whereas sex shortly before intense exercise may make you momentarily lethargic, it will not impair general performance, stamina, or muscular power. As an alternative, taking sufficient rest, eating appropriately, and exercising with a standard program are many more significant variables.

Can Men 'Save' Their Testosterone Through Abstinence?

It is long believed by some men that ejaculation abstinence will result in a dramatic increase in testosterone. In 2003, researchers from China claimed that men who did not ejaculate for seven days experienced a short-term 45% rise in testosterone. Yet this response was not found to last past the seventh day, and subsequent experiments have been unable to duplicate this effect regularly.

Conversely, some studies show that testosterone levels actually increase slightly after sex, undermining the idea that abstinence is required for optimal performance. The bottom line? The body has a fine balance of hormone production, and sex abstinence is not likely to give any real athletic benefit.

Even though there is no scientific basis, most athletes still feel that sex impacts their performance. It may be because of the placebo effect—if a player believes that not having sex makes him or her stronger, he or she will be more confident and play better. Some players may also feel relaxed and more alert after sex, and this clears their minds for the competition.

Finally, the psychological effect of sexual activity can differ from individual to individual. Sports persons who believe abstinence allows them to remain aggressive may decide to abstain from sex prior to a big event. There are others who believe that sex helps in reducing stress and enhancing sleep and may gain from intimacy pre-competition.

So, Should You Avoid Sex to Enhance your Performance at Gym?

Although the concept of forgoing sex to enhance gym performance has been around for generations, new research indicates that it does not have any noticeable effect on physical ability. Strength, stamina, and overall performance are more affected by training, nutrition, recovery, and psychological readiness than by sex.

If you think that abstinence makes you more aggressive and focused, you can do so without any ill effects. If sex makes you sleep better and relax, you might be increasing your performance rather than diminishing it. The message here is that there's no one-size-fits-all principle—players have to listen to their bodies and play in whatever way best suits them.

Ultimately, there is no scientific rationale for not having sex before you go to the gym or to compete. Whether you abstain or not, therefore, the outcome of your workout will come down to the effort you make, not the activity in the bedroom.

Most of us know exercise is good for the heart. It makes the muscle stronger and brings the resting heart rate down. But new research from the University of Bristol suggests there is another layer. Regular exercise may also change the nerves that tell the heart how fast to beat.

What The Researchers Did

The heart is partly run by the autonomic nervous system, the body’s autopilot. It handles heartbeat, breathing and digestion without you thinking about it. According to a University of Bristol statement, the team studied rats that did 10 weeks of moderate treadmill running. They then examined the stellate ganglia, two small clusters of nerve cells on either side of the lower neck and upper chest. These clusters send the “go faster” signals to the heart.

The study appeared in the journal Autonomic Neuroscience, with researchers from University College London and two Brazilian universities.

In untrained rats, the left and right clusters looked fairly similar. In trained rats, they did not. Healthline, reporting on the paper, said the right cluster held about four times as many neurons as the left. The nerve cells also changed size in opposite directions. Those on the left grew to nearly twice their size, while those on the right became slightly smaller.

The trained rats also had a lower heart rate, around 280 beats a minute against 314 in untrained rats, while their blood pressure stayed about the same, according to Healthline’s report on the study.

Why It Matters

Doctors already target these nerve clusters in some patients. Nerve blocks and denervation procedures calm them down to treat irregular heartbeats, angina (chest pain from poor blood flow to the heart) and stress-induced “broken-heart” syndrome.

Dr. Augusto Coppi, the study’s lead author, said in the University of Bristol’s statement that the clusters work like the heart’s “dimmer switch.” He said that knowing how they differ on each side could one day help doctors pick the side most likely to benefit.

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This was a rat study. Dr. Coppi himself said in the same statement that the findings are early-stage and that clinical studies would need to follow. The team still has to show how these changes affect the way the heart actually works. They plan to test larger animals and eventually people, using noninvasive markers so no surgery is needed.

So this is not a new reason to change anyone’s treatment. It is a clue, not a cure.

The advice itself is old and well proven. The World Health Organization recommends that adults aged 18 to 64 do at least 150 to 300 minutes of moderate aerobic activity a week, or 75 to 150 minutes of vigorous activity. Brisk walking, swimming and cycling all count. WHO data also shows that about a third of adults worldwide still don’t do enough.

If you have a heart condition, get chest pain, or take heart medicines, check with your doctor before starting a new routine. For everyone else, the message is simple. Your heart is not the only thing that changes when you work out. The nerves that control it may change too.

For someone living with obesity today, the treatment conversation has become more complex and, in many ways, far more hopeful. With newer weight-loss pharmacotherapies offering significant results, patients and clinicians now have more options than ever before. The key question is no longer whether medication or surgery is better, but rather which approach or combination of therapies is most appropriate for a particular patient.

Obesity is a chronic, relapsing disease that can affect much more than body weight. It is closely linked to severe metabolic comorbidities, including type 2 diabetes, hypertension, obstructive sleep apnoea, fatty liver disease, joint problems and reduced quality of life. Treatment must therefore focus not merely on short-term weight loss, but on long-term metabolic health and sustained weight maintenance.

How Newer Weight-Loss Medicines Are Changing Treatment

Newer anti-obesity medicines, including GLP-1-based and related therapies, have significantly expanded the options available to patients. They can support meaningful weight loss and improve metabolic health when combined with appropriate nutrition, physical activity and behavioural support. They may be particularly useful for patients who are not ready for surgery, those who need to improve their health before an operation, or those who experience weight recurrence after previous treatment.

However, these medicines do not work in the same way for everyone. Long-term treatment may be required, while side effects, affordability, access and adherence can influence outcomes. Some patients may also regain weight after stopping treatment. In India, the cost and continued access to these therapies are therefore important considerations when planning long-term care.

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Why Bariatric Surgery Remains An Important Option

For patients with severe obesity, particularly those with established metabolic complications, metabolic and bariatric surgery remains an important treatment option. Procedures such as sleeve gastrectomy, Roux-en-Y gastric bypass and one-anastomosis gastric bypass can influence appetite, gut hormones and glucose metabolism, in addition to reducing stomach capacity. This can result in substantial weight loss and improvement in conditions such as diabetes and sleep apnoea.

The decision to undergo surgery should be based on factors such as the severity of obesity, associated illnesses, previous treatment attempts and the patient's readiness for an operation and long-term follow-up. Surgery is not an endpoint; nutritional care, lifestyle changes and regular monitoring remain important afterwards.

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Combining Medication, Surgery And Lifestyle Changes

Weight regain also needs to be viewed in the context of obesity as a chronic disease. Treatment may need to evolve over time, with medicines, surgery and lifestyle interventions playing different roles at different stages. A patient may use medication before surgery to improve metabolic health, while another may require medication later to manage weight recurrence. This approach allows treatment to adapt to the patient's changing needs rather than treating weight loss as a one-time goal.

Technology is also influencing how bariatric surgery is performed. Technology has fundamentally elevated precision in minimally invasive bariatric procedures. Robotic-assisted surgical systems, such as the da Vinci Surgical System provide three-dimensional visualisation and wristed instruments that flex and rotate with dexterity far exceeding the human hand.

Operating at a dedicated console, the surgeon maintains full control throughout the procedure, as the system translates hand movements in real time with built-in tremor filtration. These capabilities are particularly advantageous during complex reconstructive procedures such as gastric bypass, where precise suturing, micro-dissection, and delicate tissue handling are paramount.

The technology, however, works within a broader surgical ecosystem. Patient selection, surgical expertise, standardised protocols, anaesthesia and postoperative care remain central to achieving good outcomes.

What Real-World Experience With Robotic Bariatric Surgery Shows

Our real-world experience of 545 patients undergoing robotic bariatric surgery with the da Vinci Surgical System showed consistent outcomes across procedures, including in patients with severe obesity. There were no conversions to open or laparoscopic surgery, the 30-day post-discharge complication rate was 2.02%, and no mortality was reported during follow-up.

At one year, mean BMI reduced from 44.55 to 32.68 kg/m², while outcomes in patients with BMI ≥50 kg/m² remained broadly comparable with the overall cohort. For patients, this translates into predictable perioperative outcomes and meaningful weight reduction, while for surgeons, the experience demonstrates how robotic assistance can be integrated into bariatric practice, including the management of technically challenging cases.

The changing obesity landscape ultimately calls for a comprehensive, personalized approach to treatment. Anti-obesity medications have expanded the options available to patients, while metabolic and bariatric surgery remains the cornerstone intervention for those who require substantial, durable weight loss and metabolic improvement. Neither approach should be viewed in isolation from nutrition, physical activity, behavioral health, and long-term follow-up.

High-intensity interval training (HIIT) has gained popularity among those who wish to achieve a good workout in a short amount of time. But for those with high blood pressure, the challenge is an important one: Can they attempt HIIT, or is it too much for the heart?

The answer, in short, lies with the individual. Having high blood pressure does not mean that a person has to avoid vigorous exercise, but the intensity has to be suitable considering the blood-pressure control and cardiovascular risk, fitness levels and other medical issues.

In India, where hypertension has become a growing public health concern, an ICMR-INDIAB study which looked at more than 113,000 people across the country, put the overall prevalence of high BP at 35.5 per cent among adults aged 20 years and above. It was higher among men and the urban population.

Blood-pressure control remains a concern in India as the WHO-India estimates that around 220 million people live with hypertension but only about 12 per cent have their BP under control.

So where does HIIT come in?

HIIT, which involves alternating short periods of high-intensity workout followed by recovery periods, can actually be beneficial. HIIT is not forbidden among those with high blood pressure, but the individual has to take stock of several factors before starting such exercises.

Those who are physically active, have good blood-pressure control, and no other concerns can probably take on HIIT workouts. But those who are sedentary and/or have poor blood-pressure control may have to work their way up. This is an important point to consider as HIIT might offer a good workout, but a hard-hitting workout is not always good for your blood pressure.

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Start with assessment, not max intensity

Among those who are new to exercise and have hypertension, jumping into an intense HIIT workout may not be the best move. A doctor would look at blood pressure, age, exercise history, cardiovascular risk and symptoms before advising on the most appropriate way forward.

A sedentary person should start with brisk walking, for example, before working their way up to cycling or jogging, and then adding higher intensity workouts, or interval training. It is about pace and control, and not going all out right at the start. Not only is that risky for those with hypertension, it could also lead to severe injuries.

Pay attention to exercises that help you warm up and cool down, and avoid stopping abruptly immediately after a vigorous round of exercise. While doing strength-based HIIT, people should avoid holding their breath, as this can cause blood pressure to spike. Make sure you train with a qualified trainer who can guide you through your workouts safely, and with the right advice.

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What about people with uncontrolled BP?

This is the point where exercising caution is important. People with high blood pressure who have persistently high or poorly controlled readings should not assume that every form of exercise is a good idea for them just because it is termed healthy.

Unexplained chest pain or discomfort, breathlessness or dizziness, fainting or unusual palpitations during exercise are signs that a person should stop their workout and get to a doctor rather than powering through the routine.

Those on antihypertensive medication will also need to take stock of their medication, how their blood pressure is behaving, and how their body is responding before deciding on the best approach to exercise.

The goal is sustainable cardiovascular fitness

For Indians looking to get into intense workouts, HIIT can be a part of a physically active lifestyle, but the aim should be cardiovascular fitness, not necessarily high-intensity workouts. Physical activity continues to be an important pillar in the management of blood pressure, alongside a balanced diet, weight control, adequate sleep, reduced salt intake, medication when needed and regular health check-ups.

So the right question for a person with hypertension is not: ‘Can I push myself as hard as possible’, but ‘What intensity is appropriate for my heart and blood pressure?’

By Dr. Debdatta Majumdar, Senior Consultant - Interventional Cardiology, Narayana RN Tagore Hospital, Mukundapur, Kolkata