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 But does science back this up, or is it merely an outdated myth?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.

A 24-year-old woman died after collapsing just two miles from the finish line of the New York City Marathon. Her death has reportedly been attributed to a rare but life-threatening condition called rhabdomyolysis.

Rachel Apa was running her first-ever New York City Marathon on November 1 when she collapsed in Central Park. A former field hockey player at Bucknell University, she had spent months preparing for the 26.2-mile race.

Apa was running as part of the Parkinson’s Champions team, raising money in memory of her grandfather, who died of Parkinson’s disease in 2022.

According to reports, Apa had been experiencing pain during the race. She texted her father, Steve Apa, at mile 18 saying “Ow”, followed by another message, “Ow, Ow”, at mile 19. Her final message came at mile 23, when she wrote “final stretch”.

She collapsed near mile 24, approximately two miles before the finish line. A spectator who was a hospital social worker rushed to help, while two doctors at the scene performed CPR. Marathon medical personnel later arrived with a defibrillator.

Apa was taken to Mount Sinai Medical Center, where she died at 9:40 p.m. Her father told The New York Times that doctors said that her cause of death was rhabdomyolysis.

He described his daughter as being in “perfect health, perfect shape” and said her death was difficult to comprehend.

What Is Rhabdomyolysis?

Rhabdomyolysis, often called rhabdo, is a rare life-threatening condition in which damaged skeletal muscle tissue breaks down and releases its contents into the bloodstream.

When muscle cells are injured, they release proteins like myoglobin along with enzymes and electrolytes.

Myoglobin is processed by the kidneys normally but large amounts released during extensive muscle damage can injure kidney cells.

The condition can develop following severe physical exertion, muscle injuries, accidents, extreme heat exposure and certain infections.

Intense Exercise May Trigger Rhabdomyolysis

Also read: 90-Year-Old Japanese Bodybuilder Says He Has Never Fallen Sick, Shares How He Maintains Muscle Strength

Prolonged strenuous physical activity can cause extensive muscle damage, which can trigger exertional rhabdomyolysis.

During intense exercise, muscles undergo microscopic damage as they work. The body normally mends this damage during recovery.

However, when the muscle injury becomes excessive, muscle cells can break down and release their contents into the bloodstream.

The risk increases with excessive exercise, exercising in hot conditions and poor recovery.

Dehydration does not directly cause rhabdomyolysis but it can worsen its effects by making it harder for the kidneys to clear substances released from damaged muscles.

Signs Of Rhabdomyolysis

Also read: Exercise Snacking: Short Bursts Of Squats May Build Strength As Effectively As Longer Gym Sessions, Study Finds

The US Centers for Disease Control and Prevention (CDC) lists three important symptoms:

• Muscle aches, cramps or pain that are much more severe than expected after physical activity.
• Urine that looks like tea-coloured or cola-coloured.
• Feeling extremely weak or tired.

Symptoms may develop hours or even days after the initial muscle injury. The symptoms may also resemble dehydration, heat cramps or other similar problems.

Therefore, people should not assume that severe muscle pain or unusual fatigue is simply part of recovery after an intense workout. The CDC advises seeking medical attention immediately if rhabdomyolysis is suspected.

How Can Rhabdomyolysis Become Life-Threatening?

One of the most serious complications is acute kidney injury. Myoglobin released from damaged muscles can accumulate in the kidneys and cause damage which can lead to kidney failure.

Rhabdomyolysis can also cause dangerous changes in electrolyte levels, especially potassium.

High potassium levels can interfere with the heart’s electrical activity and trigger abnormal heart rhythms that could prove to be fatal.

In severe cases, complications can include seizures, organ damage and death.

The severity depends on the extent of muscle damage, the amount of substances released into the bloodstream and how quickly treatment begins.

At 90, Japanese bodybuilder Toshisuke Kanazawa has built an age-defying physique that is a testament to his rigorous training of two hours a day for six days a week. Kanazawa is still able to compete against athletes decades younger than him.

The 19-time national champion recently appeared at the International Fitness and Bodybuilding Federation (IFBB) World Fitness and Bodybuilding Championships in Santa Susanna, Spain, on October 30, 2026.

Although he did not finish on the podium, Kanazawa remains committed to bodybuilding and hopes to compete once more at 93.

“I like to try doing things that nobody else has done, and more than anything I want to pursue bodybuilding for the rest of my life,” he told Reuters.

In interviews with Reuters and The Guardian, Kanazawa has described how he has modified his exercise routine, diet and prioritised recovery to maintain muscle strength as he grows older.

Toshisuke Kanazawa Still Strength Trains For Two Hours A Day

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Kanazawa trains for approximately two hours a day, six days a week, at his gym in Hiroshima, Japan. However, his routine has changed with age. He no longer performs heavy exercises, including squats and bench presses, and prefers using weight-training machines instead of free weights.

He said machines allow him to control movements and adjust resistance according to his physical capabilities. “I do what’s best for me and my body at this age,” he told The Guardian.

His approach speaks about the importance of recovery when it comes to strength training in older adults. It also reinforces that exercise needs to be adapted to changing strength, mobility and recovery capacity rather than maintaining the same intensity throughout life.

Kanazawa Prioritises Muscle Recovery

Kanazawa says recovery takes longer than it did when he was younger. “It takes longer to recover from weights sessions than it used to, so I make sure I rest properly between sets and get around seven hours’ sleep a night,” he told The Guardian.

Adequate recovery is important because resistance exercise creates stress on muscles, which need time to repair and adapt. Older adults may also experience age related stress when it comes to muscle recovery and the ability to build muscle.

Also read: Why Is Excess Belly Fat A Health Concern, Even In People Who Appear To Have A Normal Body Weight?

Kanazawa's Diet For Muscle Building

Kanazawa attributes his physical conditioning to a traditional Japanese diet that he has followed since turning 50. His regular meals include:

• Brown rice: A source of carbohydrates and dietary fibre.
• Natto: Fermented soybeans that provide plant-based protein.
• Miso soup: A traditional fermented soybean-based soup.
• Raw eggs: He has also described adding a couple of raw eggs to his miso soup.

“This is something I’ve been researching and want to learn more about. But ever since I turned 50, I’ve been building muscle by eating a purely Japanese diet which includes brown rice, natto, and miso soup,” he said.

He also revealed that he has reduced his protein shake intake with age. “I used to have six protein shakes a day but now I have three. As I get older, it’s harder to stomach that much liquid,” he said.

Kanazawa has also given up meat and fish and says he has never smoked or consumed alcohol.

Also read: Leading Gastroenterologist Padma Bhushan Dr S K Sarin Shares Dos & Don’ts For Healthy Liver At Times Health Summit 2026

He Adjusted His Training Instead Of Stopping

Kanazawa’s return to competitive bodybuilding at 50 came after he had retired from the sport in his mid-30s. He said he wanted to encourage his wife, who had a chronic illness, and realised that he had lost some of his own strength after retiring.

He eventually returned to competition and went on to win several masters championships. He believes older people should not automatically give up activities they enjoyed when they were younger.

“I worry that too many of them give up on the things they did when they were younger,” he said. He added, “I want to be a bodybuilder until the day I die.”

Strength Training Tips For Older Adults

Muscle mass and strength naturally decline with age due to a process called sarcopenia. This can affect mobility, balance and the ability to perform everyday activities.

The World Health Organization recommends that adults aged 65 and older undertake muscle strengthening exercises involving major muscle groups at least twice a week.

Older adults should also include varied physical activity that emphasises functional balance and strength on three or more days a week. Exercise intensity and type should be adjusted to individual health, fitness and mobility.

India is facing a significant metabolic health challenge, with millions of people living with diabetes or prediabetes. The ICMR-INDIAB study estimated that 101 million Indians have diabetes and 136 million have prediabetes.

What is particularly concerning is that many people at risk may not appear overweight. They may have a normal Body Mass Index (BMI) but carry excess body fat, particularly around the abdomen, putting them at risk of metabolic disorders.

The ‘Thin-Fat Indian’ Phenotype: What Does It Mean?

This is especially relevant to Indians because of differences in body composition and a greater susceptibility to metabolic complications at relatively lower body weights. Research suggests that Asian Indians tend to have a higher body fat percentage, greater abdominal fat accumulation and relatively lower skeletal muscle mass than several other populations with a similar BMI.

This pattern is commonly described as the ‘thin-fat Indian phenotype’, also known as TOFI, or ‘Thin Outside, Fat Inside’. Genetic predisposition, early-life nutritional influences, physical inactivity and dietary habits can all contribute to this phenomenon. As a result, a person who appears slim may still have excess body fat, reduced muscle mass and an increased risk of metabolic disease.

Also read: Exercise Snacking: Short Bursts Of Squats May Build Strength As Effectively As Longer Gym Sessions, Study Finds

Why BMI Alone Cannot Reveal Excess Body Fat

BMI is a useful screening tool, but it measures weight in relation to height and cannot distinguish between fat and muscle. Body fat percentage offers additional information by indicating the proportion of body weight made up of fat. According to clinical guidelines from the Endocrine Society of India, body fat levels exceeding approximately 25% in men and 30% in women may be considered excessive in Indian adults when measured using Dual-Energy X-ray Absorptiometry (DXA).

However, these thresholds should be interpreted alongside age, fat distribution, muscle mass and other metabolic parameters. A normal BMI alone cannot rule out excess body fat or an underlying metabolic risk.

Visceral Fat: How Belly Fat Affects Metabolic Health

The location of fat accumulation is equally important. Subcutaneous fat lies beneath the skin, while visceral fat accumulates deep within the abdomen, surrounding internal organs. Excess visceral fat can release free fatty acids and inflammatory substances that contribute to insulin resistance, abnormal cholesterol metabolism and chronic low-grade inflammation.

Over time, these changes can increase the risk of type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, hypertension and cardiovascular disease. In Indian adults, a waist circumference of 90 cm or more in men and 80 cm or more in women indicates increased abdominal adiposity and warrants further metabolic risk assessment.

Also read: The Changing Obesity Treatment Landscape: Where Does Bariatric Surgery Fit in the Age of Weight-Loss Drugs?

Can Dietary Changes Help Reduce Metabolic Risk?

Addressing this risk requires a shift in how we approach everyday nutrition and physical activity. Traditional Indian meals can sometimes be disproportionately high in carbohydrates, with rice, rotis and potatoes taking up much of the plate while protein-rich foods receive less attention.

Including adequate protein through dal, pulses, dairy, paneer, soy, eggs, fish or lean meat can help preserve muscle mass and support metabolic health. Carbohydrates do not need to be eliminated; instead, the focus should be on balanced portions, fibre-rich foods and overall dietary quality.

Resistance Training For Metabolic Health

Physical activity is equally important, particularly resistance training, which helps maintain skeletal muscle and supports glucose metabolism and insulin sensitivity.

While walking and other aerobic activities are beneficial, adults should also incorporate muscle-strengthening exercises at least twice a week. A combination of aerobic exercise and resistance training can help improve body composition and reduce metabolic risk.

Festive Eating And Metabolic Health

Festive seasons and weddings often involve frequent consumption of sweets, fried foods and calorie-dense meals. Occasional indulgence is not the primary concern; rather, repeated overeating combined with reduced physical activity can affect long-term metabolic health. Mindful portions, balanced meals and regular exercise can help people enjoy celebrations without consistently compromising their health.

Ultimately, the weighing scale tells only part of the story. BMI, waist circumference, body fat percentage, muscle mass and metabolic markers such as blood glucose and cholesterol should be considered together to obtain a more complete picture of health. India's fight against diabetes must go beyond weight loss and focus on improving body composition, preserving muscle and reducing excess fat. Looking thin does not necessarily mean being metabolically healthy, and recognising this distinction is an important step towards preventing diabetes and other metabolic disorders.

By Dr. Aparna Govil Bhasker, Consultant Bariatric and Metabolic Surgeon, Saifee Hospital, Mumbai