It is well known how physical activity, even of moderate intensity, contributes to improving all aspects related to the quality of life of the individual. On the contrary, sedentary lifestyles represent one of the main risk factors for the onset of a series of chronic diseases and disorders.
However, can there be a correlation between sport and sexual performance?
Physical activity and sport seem to be able to exert positive and / or negative actions on the hypothalamus-pituitary-gonadal axis and consequently on the sexual health and / or reproductive functions of the individual.
However, these adaptations appear to be dependent on a multitude of variables, linked both to the individual (eg genetics and epigenetics) and to the type of sport or activity performed (type of sport, intensity, volume, use and / or abuse of doping substances, state nutritional, psychological stress, allostatic load ...).
However, if well structured physical activity and sport can have a positive role on the sexual health of the individual.
The researchers analyzing a total of 238 individuals divided between physically active and sedentary, through specific diagnostic tests (the PEDT premature ejaculation diagnostic tool and the IELT intravaginal ejaculatory latency time), found a prevalence of individuals with premature ejaculation significantly higher among sedentary than to those who practiced even a minimum of sport.
In 2016, another study directly evaluated the therapeutic effect of physical activity in subjects with diagnosed premature ejaculation, demonstrating how physical activity can have similar effects to dapoxetine therapy in reducing this problem.
Another aspect in which physical activity seems to have a considerable impact is erectile functions. A meta-analysis published in 2011 reports how aerobic exercise can have a positive effect on erectile function.
Five studies published between 2004 and 2010 demonstrate strong evidence for which aerobic physical activity can represent a valid therapy for subjects suffering from erectile dysfunction.
The adaptations caused by aerobic physical activity on endothelial functions are therefore the basis of these beneficial effects.
The Massacchussets Male Aging Study represents perhaps the study that best highlights this correlation, developed on a population of 1156 individuals and with a follow-up of almost 9 years, and demonstrating that the most physically active individuals were less exposed to the risk of erectile dysfunction. .
At the same time, another predisposing factor for erectile dysfunction and indirectly linked to the level of physical activity is the body mass index (BMI).
Individuals with a higher BMI are exposed to a higher risk of erectile dysfunction, at the same time exercising can certainly allow you to reduce or keep your body weight stable while avoiding increases in BMI.
As mentioned, the hypothalamus-pituitary-gonadal axis is influenced both acutely and chronically by physical activity, be it endurance sport or resistance training, however, the type of "adaptive" response is affected, as already mentioned in the first paragraph, from the type of physical exercise / sport, from individual factors, from the load of stress and obviously from the possible use of doping substances.
The role of testosterone in sexual health is well known, and at the same time it is known that certain activities can stimulate the secretion of endogenous testosterone more than others.
In reality, given the heterogeneity of the factors that regulate hormonal adaptations during physical activity, it is difficult to standardize a protocol in order to verify its correlations with one or another type of activity or sport.
However, the evidence to date suggests that the stimulating effect is more evident in acute, for example single 30-minute activities at sub-maximal intensity (testosterone levels + 30%) or after 30 minutes of exercise at maximum aerobic capacity (testosterone level + 40%).
In the chronic, however, things can change, particularly in endurance sports where reductions in both free and total testosterone are reported.
Several studies over the years have highlighted the possible correlations between resistance training, and in particular strength training, and the increase in testosterone levels. As mentioned, it is difficult to standardize studies of this type and consequently the results are contradictory.
A study published in 2015 suggests that the increase in testosterone found in both "young" subjects (aged 25-30 years) and in elderly subjects (70-75 years) is the increase in circulating testosterone during a resistance training program was mainly due to a reduction in its clearance rate and therefore not to an increase in secretion.
Physical activity or any sporting activity practiced in a habitual way is undoubtedly a practice capable of positively impacting the health of the individual including sexual health. Training continuously can be a way to reduce psychological stress, increase self-esteem and generate physiological adaptations that can improve our hormonal framework.
However, if the activities and the type of training (volume, intensity) capable of having an "inhibitory" impact on the endogenous secretion of testosterone seem to have been identified (sport endurance with chronic adaptations), it is currently difficult to state which type of activity it may be more able to overstimulate its secretion.
At the same time, the same type of activity (aerobic activity) can generate positive effects (capillarization and improvement of endothelial functions and therefore improvement of erectile functions) and sometimes negative effects (reduction of testosterone secretion and increase in cortisolemia).
Carrying out physical activity by managing the various variables related to the type of training (eg: volume, intensity, energy system involved ...) can be an excellent strategy to reap all the beneficial effects resulting from the activity without incurring chronic adaptations.
