What does sex have to do with winning at sports?
Does Sex Improve Athletic Performance?

For decades, athletes have been advised to abstain from sex before an athletic performance. Now that advice is being challenged if not reversed thanks to a new study by Laura Stefani, M.D., an assistant professor of sports medicine at the University of Florence, Italy, and lead author of this report. She says the opposite may be true. The study she headed suggests that having sex before a sporting event can boost athletic performance. However, the benefits can only be seen if sex is avoided for two hours before the athletic activity.
So much for folklore. The researchers shuffled through reports on hundreds of studies of the topic, eventually whittling them down to the nine most responsible reports. Nevertheless the study conclusions varied. One of the studies reported that the strength of female former athletes did not differ if they had sex the night before. Another study suggested that sexual activity improved marathon runner’s performance. They found that male athletes were more frequently investigated than were females and that there were few or no studies that measured results across gender lines.
Stefani and her colleagues were disappointed (but not surprised) by the lack of existing research on the subject. “We clearly show that this topic has not been well investigated and only anecdotal stories have been reported, ” she said.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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