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Endurance Exercise Training and Male Sexual Libido
Article in Medicine and Science in Sports and Exercise · February 2017

DOI: 10.1249/MSS.0000000000001235
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. . . Published ahead of Print
Anthony C. Hackney1,2, Amy R. Lane1, Johna Register--Mihalik1

Register-Mihalik
Register 1
1
Department of Exercise & Sport Science and 2Department of Nutrition, Gillings School of
Global Public Health, University of North Carolina, Chapel Hill, NC
Accepted for Publication: 9 February 2017
Medicine & Science in Sports & Exercise® Published ahead of Print contains articles in unedited
manuscript form that have been peer reviewed and accepted for publication. This manuscript will undergo
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Please note that during the production process errors may be discovered that could affect the content.
Copyright © 2017 American College of Sports Medicine

Medicine & Science in Sports & Exercise, Publish Ahead of Print
DOI: 10.1249/MSS.0000000000001235
Anthony C. Hackney1,2, Amy R. Lane1, Johna Register-Mihalik1, and 1
1
Department of Exercise & Sport Science and 2Department of Nutrition, Gillings School of
Global Public Health, University of North Carolina,, Chapel Hill, NC
Running title: Exercise and Libido
Address correspondence to:
A.C. Hackney, Ph.D., D.Sc., University of North Carolina, CB # 8700 Fetzer Hall UNC-CH,
Chapel Hill, NC 27599, USA
Email: ach@email.unc.edu Fax: 919-962-0489

919-962
919- Tel: 919-962-0334
There was no internal or external funding in support of this project. The authors acknowledge
there are not Conflicts of Interests relative to this work. Also, the results are presented clearly,
honestly, and without fabrication, falsification, or inappropriate data manipulation, and the
present study do not constitute endorsement by ACSM.
Copyright © 2017 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
ABSTRACT
Purpose: To study the associations between aspects of endurance exercise training and the sexual
libido in healthy men using a cross-sectional online survey study design. Methods: A developed
online survey questionnaire was utilized. The questionnaire was based upon
upon pre
pre-existing
validated questionnaires and use to assess elements of physical characteristics, exercise training-
training
habits and libido of participants (n=1077). Three evidence-based

based categories were created for the
primary outcome of total libido score and low,

w, normal, and high response categories set. The
high and normal categories were combined to form a high/normal score group and the low
category formed a low score group. Odds ratios (OR) were calculated to examine group
categorization. Results: Age, training intensity, and training duration of pa

participants had
significant (p<0.02) univariate relationships, with libido scores and were thus included in the
multivariate model. In the multivariate model, training intensity (p<0.000

(p<0.0001) and duration
(p<0.002) components were the most significantly associated with libido group designation
(high/normal vs. low). Participants with the lowest (OR: 6.9; 95% CI: 2.6
2.6-17.9) and mid-range
training intensities (OR: 2.8; 95% CI: 1.4

1.4-5.3) had greater odds of high/normal libido state than
those with the highest training intensity. Participant

Participants with the shorter (OR: 4.1; 95% CI: 1.6-
10.0) and mid-

mid-range
mid -range training durations (OR: 2.5; 95% CI: 1.3
1.3-4.8) at their current intensity also
had greater odds of high/normal libido score than those with a greatest duration. Conclusion:
Exposure to higher
higher levels of chronic intense and greater durations of endurance training on a
regular basis are significantly associated with a decreased libido scores in men. Clinicians who
treat male patients for sexual disorders and, or council couples on infertility issues should
consider the degree of endurance exercise training a man is performing as a potential
complicating factor.
Key Words: hypogonadism, testosterone, sex drive, stress, health
Introduction
The Centers for Disease Control and Prevention reports that 1.5 million women in the US
(6%) are infertile (National Survey of Family Growth) and, the American Society for
Reproductive Medicine affirms that infertility affects men and women equally (2,29). Moreover,
in approximately 40% of infertile couples, the male partner is either the sole cause or a key
contributing cause of infertility (2). One of the factors influencing fertility in males is a low
sexual desire; i.e., decreased libido (2). Clinically decreased libido can manifest as Male
Hypoactive Sexual Desire Disorder (MHSDD - Diagnostic and Statistical Manual of Mental
Disorders [DSM-V]); which affects approximately 16-18%

8% of the adult male population (8).
(
It is well known women

omen who are involved with high levels of intensive exercise training
have an elevated risk for developing menstrual dysfunctions and potential infertility, especially if
the menorrhea as a result of hypothalamic

hypothalamic-pituitary-gonadal (HPG) axis
disruption (31). Evidence indicates that exercising men develop a similar corollary HPG axis
ypogonadal
ypo gonadal M
Male Condition (EHMC) (16). In the male
condition a quasi-hypogonadotropic
hypogonadotropic hypogonadi
hypogonadism exists as testosterone and luteinizing
hormone levels are both suppressed;

suppressed; and, abnormal sperm characteristics are sometimes
manifested (3,14
(3,14).
3,14).
). Current evidence
eviden links the development of EHMC to the combining effects of
the volume and intensity of endurance exercise training in these men (3,14,16).
Testosterone is associated with many androgenic-anabolic processes in the male, and
while
ile not universally accepted, it is thought to play a key role in male sexual libido (6). Being
more physically active has been shown to be beneficial reproductively for men who are
sedentary (or have a very low physical activity levels) as it results in improved testosterone
levels and libido (11,32). Conversely, there are many reports in the popular literature and on the
internet suggesting that men who participate in large amounts of endurance exercise training
(e.g., marathon running) can have suppressed testosterone and libido (3,5). An examination of
available peer-reviewed research literature, however, reveals the issue of libido status in males
engaged in endurance exercise has not been systematically or empirically studied. To this end,
we studied the associations between aspects of endurance exercise

xercise training and the libido status
in healthy men using a cross-sectional online survey study design.
METHODS
Development of the Survey Instrument
An online survey questionnaire was developed to assess elements of physical
characteristics, exercise training-habits

habits and sexual libido of male participants. The questions
concerning exercise training-habits

ts were based on the International Physical Activity
Questionnaire (IPAQ) and the Baecke Questionnaire; and followed recommendations of the
American Heart Association (1,4,12

(1,4,12). The libido related questions were based on items within
the Androgen Deficiency in the Aging Male Questionnaire (ADAM), Sexual Desire Inventory
(SDI-2) and the Aging Male Symptoms (AMS) Scale (18,19,23,27). The IPAQ, Baecke, ADAM,
SDI-2 questionnaires and the AMS Scale are commonly used in research-clinical settings and the
validity of each has been assessed and reported elsewhere (
10,18,19,20,24,27).
,18,19,20,24,27) The completed online survey was reviewed by an exercise physiologist and a
fertility specialist who were not involved with the study to insure legitimacy of selected question
items (i.e., content validity). The completed questionnaire and procedures for distribution were
reviewed and approved by the University of North Carolina Institutional Review Board.
Participant consent was obtained via their online access to the questionnaire; and, in which they
also indicated they were healthy and free of endocrine-related medical disorders and prescription
medication usage.
Survey Sample - Administration
The completed survey questionnaire was formatted into the Qualtrics (Quatrics, 2014)
online survey platform and made accessible through a specific world-wide web link
(https://jfe.qualtrics.com/form/SV_eWESbBdaONSuUPb).. Subsequent to establishment of the
web link, a series of email notifications were sent to sports clubs, national sports organizations,
university athletic departments, and sporting magazines publicizing the existence of the survey
and the web link site for access (~300 club/organizations were contacted).
contacted) These emails
requested announcement of the survey and encouragement of participation by individuals
associated with the group/organization. The target population was adult males (>18 years old)
involved with sporting activities (e.g., walking, running, bicycling, swimming) on a recreational
and competitive basis in North America. However, clubs and organizations associated with
endurance based activities (e.g., running, triathlons, bicycling) were predominately targeted since
EHMC is more prevalent in men engaged in such activities (3,14,16). The survey administration
period was January 2014 to January 2015. Approximately every four months reminder emails
were sent to prior contacts to encourage them to continue to promote and distribute information
about the survey.
Dependent measures
The survey was constructed in three parts. The first section addressed elements of the
participant involvement (e.g., gender, medical status) and physical
characteristics/demographic information. The second part focused on exercise habits and history
of regular frequency of exercise (days/week), intensity of training effort (number of light,
moderate, hard sessions per week), duration of exercise (hours/session; total hours/week),
primary and secondary types-forms of exercise engagement, endurance sports competition
participation (type and number of events), years in training, stability of training (i.e., our intent
injury, tapering or overreaching),

overreaching) focus of
training (recreation, health, sporting competition), and physical activity requirements at work
(level of activity, minutes/day). Approximate oxygen uptake (VO2) percentages

percentages for respective
recommendations of Bouchard et al. (6). The third part of the survey addressed questions on
libido, targeting such issues as sexual activity, arousal, desire, attraction, fantasy, appetite,
fulfillment, needs for intimacy, and infertility issues or confounders (i.e., concussions
concussions, children
sired).
Parts one and two of the survey allowed participants to cclick on predetermined answer
button options, which provided appropriate ranges for each particular question and parameter
being assessed.. Part three (libido) involved a three category format structure to the answer
options where participants

participants clicked answer buttons of Yes, Maybe, No; and, based on answers
some follow-
follow-up
follow-up questions were
w presented. Answers to part three were scaled and scored in a
Likert- ; answers were assigned plus or minus
values towards final llibido score depending on the nature of the specific question. All libido
questions (15 in total) were scored and an aggregate total libido score computed (i.e., > score = >
libido).
Statistical analysis
All statistical analyses were conducted using IBM® SPSS ® v19 (2010). Frequencies
and missing data checks were conducted to confirm data integrity (i.e., relative to missing data).
Specific variables of interest included age categories, elements of exercise training intensity and
exercise training duration (see above) at the current levels of training;; but all response variables
were included in initial analyses. Additionally, several

everal exercise training variables were computed
in which elements of frequency, intensity and, duration relative to time (hour

(hour per week and years
of training) were integrated into composite scores to estimate overall dose of exercise effects.
effects
Tertiles categories were created for the variables of interest listed above and three evidence-
based categories were created for the primary outcome of total

total libido score (30). The cut-points
representing the libido score categories were as follows: Low 7, normal 88-14, high 15. The
high and normal categories were combined to form a single high/normal score group and the low
category formed the low score group.

group. Combining
Combining high/normal score groups was utilized since
the focus of the study was on the presence and occurrence of low
lower libido in relation to
endurance exercise training.
Demographic, exercise training, and libido characteristics of the participants were
summarized with the use of means, standard deviations, and percentages. Demographic and
exercise training outcomes potentially related to our primary outcome of libido score were
analyzed using univariate statistics (Chi

(Chi-Square analyses and t-tests). Subsequently,
multivariable logistic regression (entry method) was utilized to determine adjusted odds ratios
(OR) and 95% confidence intervals (CI) for libido score (i.e., placement in high/normal vs. low
score group) for the factors with significant univariate relationships to libido score categories.
Alpha level for all analyses was set to 0.05 a priori.
RESULTS
A total of 1366 individuals responded to the survey. Only respondents meeting all study
criteria (n=1077; healthy male and 18 years or older, complete surveys ) were included in
the analyses. The mean (±SD) physical characteristics and demographic outcomes of the
participants are reported in Table 1.
Age, exercise training intensity, and training duration components of participants had
significant univariate relationships (p<0.02; Table 2) with libido scores and were thus included in
the multivariate model. In the multivariate model, training intensity (p<

(p<0.000
(p<0.0001) and
duration (p<0.002) were significantly associated with libido score group designation
(high/normal vs. low). Total intensity was a computed variable representative oof number of
training sessions at a low, moderate, hard intensity times the hours of each per week (~oxygen
uptake (VO2) percent for respective intensities were; and high
) (see Methods).. Chronic duration was a computed value representative of hours per
week training times the number of years

years training (at
(at current level).
Specifically, participants
articipants with the greatest amount of low intensity training (OR: 6.9;
95% CI: 2.6-17.9)

17.9) and moderate amount training (OR: 2.8; 95% CI: 1.4-5.3) had greater odds of
being in the high/normal libido sscore group than those participants with a greater amounts of
high intensity training (Table

(Table 3).
3)
Likewise, participants with lower duration amounts to their training (OR: 4.1; 95% CI:
1.6-10.0)
10.0) and moderate duration amounts of training (OR: 2.5; 95% CI: 1.3-4.8) also had greater
odds of high/normal libido state than those with a greatest amounts of training duration (Table
3).
Age was also a
OR: 1.9, 95% CI: 1.0-3.9) and those in the mid-age category (41-55 yr; OR: 1.9, 95% CI: 0.9-41)
were more likely to be in the high/normal libido score group than those participants in the oldest
age- 56 yr).
Cronbach alpha values within the current survey ranged from 0.64 to 0.88. These were
slightly lower than the values originally reported from the survey/questionnaires on which the
current one was based (see Methods).
DISCUSSION
In this cross-sectional
sectional survey study we found that an inverse relationship exists
exist between
endurance exercise training factors and male libido scores.

scores Specifically, higher amounts of
intensive training or training involving greater amounts of duration within the endurance
program were associated with lower libido scores

scores. When
When comparing the OR responses among
libido
do score classifications, participants in the low score group were approximately 64.5 to
85.5% ([1-[1/OR]] x 100) more likely to fall in tthat category since they did greater amounts of
higher intensity exercise.

exercise. Also the low libido score group were 60.0 to 75.6% more likely to fall
into that category since they were doing greater amounts of longer duration exercise training
(28). Conversely,
Conversely the
he effect of low - moderate intensity and shorter - moderate duration exercise
training seemed highly comparable in clearly influencing the libido scores of the participants in a
positive fashion which is in support of prior published work (32).
To our knowledge this is the first scientific, research-based study to examine the issue of
male libido and endurance exercise training. Several surveys on sexual habits and exercise
training have been conducted previously by sporting magazines (e.g., Runners World) and
sporting goods manufacturers (e.g., Brooks Sports Inc., Seattle, WA, USA). However, the
constructs of the questions presented in those surveys were not based upon clinical assessment
instruments used in sexual behaviors and fertility research. Furthermore, the statistical
approaches employed with these surveys tended to be descriptive in nature and not analytical-
inferential.
Several recent laboratory studies have examined issues of sexual satisfaction and
and libido
with exercise, but the generalizability applicability (to the current study) of the findings are
hampered by the small sample sizes utilized (n < 20) and a focus on female participants (17,22).
The findings of these latter studies did suggest that an acute exercise session enhances sexual
arousal-desire via activation of the sympathetic nervous system (SNS)

(SNS), enhanced SNS activity is
a common response to a single bout of exercise (9)

(9). Itt is unclear if these aforementioned studies
used habitual exercisers (such as within the current study)

study). This last point is an important
consideration as it is well established that exercise training improves the sensitivity of tissue
responses to the SNS via enhanced receptor actions, resulting in substantially lower overall
sympathetic autonomic neural tone following chronic training (9,15).
Our focus was to establish whether an association between libido

libi and endurance training
characteristics exists. As
As noted an
a inverse relationship between the duration/intensity
characteristics of endurance training and libido was identified. However, why increasing
duration and,
and, or intensity
intensity of exercise training reduces a male s libido score cannot be ascertained
from the data obtained in this study. This study was not designed to explore a potential
mechanism. As mentioned earlier, the presence of EHMC is more prevalent in endurance-trained
men and the condition is associated with lowered basal testosterone, which can be linked to
reduced libido. But, currently the only means of detecting the existence of EHMC is through
measurement of reproductive hormonal levels within the blood or saliva. The present study did
not ascertain hormonal profiles of the respondents. Hence, we cannot state whether EHMC was a
direct factor in our participants with lower libido scores. Likewise, select medication use (e.g.,
performance enhancing drugs [PED]), existing psychological disorders (i.e., depression), and/or
chronic low caloric intakes are well established factors associated with suppression of
testosterone and reduced libido (13,14,26). For participation, we asked our males if they were
healthy and not under medical supervision, thus we feel the likelihood of these facto
factors
confounding our outcomes is unlikely -
adherence and must acknowledge these were potential confounders

confounder in our data.
data.
Increased
ncreased volumes of intensive exercise training may also result in greater levels of
physical and mental fatigue in an individual, which could
motivation towards sex. In the current survey, we

we did not ask participants to report on their
overall level of general fatigue or lethargy.

lethargy TTypically
ypically with excessive physical fatigue,
experienced exercising individuals reduce their training loads to allo

allow recovery (25). Our
participants reported they were in a stable period of consistent training for a number of months at
the time of the survey.

survey This last fact also suggests that they were not overreaching / overtraining
which is associated with the development of the Overtraining Syndrome, which is linked to
sexual dysfunction ((15).

15)). Nonetheless, the influential aspects of general exercise fatigue from
15
chronic exercise training as a possible causative mediator of reduced libido scores seems a
logical likelihood and needs to be pursued in future research.
It was expected the age of the participants would be associated with libido score
categorization. We found the two younger age groups participants had a greater likelihood of
placement in the high/normal libido score group than the oldest age group. Evidence indicates
that male libido does decrease with aging (13), and one could argue this was a factor influencing
membership in the low libido score group. However, Lindau and Gavrilova (21) report that
medically healthy men of this age group (i.e., 56 yr) have active sexual desires and not until
70-85 years of age may there be sizable declines; being ~50-80% less than that observed 20-40
years earlier in life. Relative to this last point, the odds ratio observed for the influence of
exercise training intensity and duration were of a significantly larger magnitude than that of age
alone.
We acknowledge our
ur sample was one of convenience, with potential response bias and
hence is a limitation. We also asked our subjects to complete the questionnaire only once, but
with multiple reminded notices sent to organizations it is possible some duplication occurred.
Another aspect of our study which limits the interpretation and general
gen
generalizability of the findings is
our reliance upon self-reports and recall from our respondents. As a result of these factors, our
findings should be viewed as preliminary in nature and more work on this topic is needed.
To conclude,, this systematic study using an online survey approach suggests men
engaged in higher
igher intensities and greater durations of endurance training on a chronic basis (i.e.,
years) are significantly associated

associated with decreased libido scores. Although our findings are
preliminary, the results suggest that clinicians

clinic who treat male patients with regard to Male
Hypoactive
poactive Sexual Desire Disorder and/or council couples on infertility issues should take into
account the degree of endurance exercise training a man is performing as a potential
complicating factor.
Acknowledgements
There was no internal or external funding in support of this project. The authors acknowledge
there are not Conflicts of Interests relative to this work. Also, the results are presented clearly,
honestly, and without fabrication, falsification, or inappropriate data manipulation, and the
present study do not constitute endorsement by ACSM. The authors wish to acknowledge the
support of all the different sports clubs and organizations that aided in the distribution of our
questionnaire.
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Table 1. The physical and exercise training characteristics of the participants. *Mean and SD for
categorical rating of measurement (Age: 1: < 18 years = not included in analysis; 2: 18-25; 3: 26-
40; 4: 41-
Measurement Minimum Maximum Mean SD

Age Group 2.0 5.0 3.39* 0.96
(category)
Weight 51.8 159.0 76.4 12.3
(kg)
Height 1.42 2.29 1.79 0.08
(m)
BMI* 16.0 35.0 23.63 3.06
(kg/m2)
Table 2. Summary of key responses from survey on aspects of exercise training characteristics
and elements. Associations * = statistically significant association with libido groups (Low vs.
Normal/High). Abbreviations: Med = medium (tertile), yr = year, IS = intensity sessions/week (#
low, # moderate, # high), T = tertile, hr = hour, hr/wk = hours per week, VO2% = approximated
VO2%/ IS (# low [ 35%], # moderate [50%], # high [ 70%]) (7). = rounding of numbers to
0.1 decimal (i.e., affects overall percentage totals).
Libido Score Group Total X2 p

Characteristic Low Normal/High
% (count) % (count) % (count)
Age* 18 25 33.3 (20) 18.8 (191) 19.6 (211) 0.000 0.000
(year) 26 40 13.3 (8) 38.5 (392) 37.1 (400)
41 55 25.0 (15) 28.8 (293) 28.6 (308)
> 56 28.3 (17) 13.9 (141) 14.7 (158)
Frequency 1 3 1.7 (1) 9.3 (94) 8.9 (95) 0.000 0.000
exercise (per 4 6 21.7 (13) 58.3 (589) 56.2 (602)
week)* 7 10 30.0 (18) 25.8 (261) 26.1 (279)
> 10 46.7 (28) 6.6 (67) 8.9 (95)
Hours of exercise 1 3 1.7 (1) 9.6 (98) 9.2 (99) 0.000 0.000
(per week)* 4 6 10.0 (6) 33.1 (336) 31.8 (342)
7 10 23.3 (14) 35.0 (356) 34.4 (370)
> 10 65.0 (39) 22.2 (226) 24.6 (265)
Primary exercise Walking 1.7 (1) 1.9 (19) 1.9 (20) 0.711 0.711
mode Running 88.3 (53) 79.9 (812) 80.4 (865)
Biking 5.0 (3) 9.4 (95) 9.1 (98)
Swimming 0.0 (0) 1.0 (11) 1.0 (11)
Weightlifting 3.3 (2) 5.5 (56) 5.4 (58)
Other 1.7 (1) 2.3 (23) 2.2 (24)
Other exercise Walking no 63.3 (38) 70.8 (720) 70.4 (758) 0.219 0.219
modes regularly Walking yes 36.7 (22) 29.2 (297) 29.6 (319)
performed* Running no 81.7 (49) 73.3 (745) 73.7 (794) 0.150 0.150
Running yes 18.3 (11) 26.7 (272) 26.3 (283)
Biking no 71.7 (43) 68.1 (693) 68.3 (736) 0.568 0.568
Biking yes 28.3 (17) 31.9 (324) 31.7 (341)
Swimming no 90.0 (54) 85.2 (866) 85.4 (920) 0.301 0.301
Swimming yes 10.0 (6) 14.8 (151) 14.6 (157)
*Wt. Lift no 80.0 (48) 57.6 (586) 58.9 (634) 0.001 0.001
*Wt. Lift yes 20.0 (12) 42.4 (431) 41.1 (443)
Other no 81.7 (49) 72.4 (736) 72.9 (785) 0.115 0.115
Other yes 18.3 (11) 27.6 (281) 27.1 (292)
Compete No 28.3 (17) 47.8 (485) 46.7 (502) 0.003 0.003
regularly* Yes 71.7 (43) 52.2 (529) 53.3 (572)
Reason for *Wt. Loss no 63.3 (38) 39.0 (397) 40.4 (435) 0.000 0.000
exercise training *Wt. Loss yes 36.7 (22) 61.0 (620) 59.6 (642)
Stress Relief no 40.0 (24) 30.1 (306) 30.6 (330) 0.106 0.106
Stress Relief yes 60.0 (36) 69.9 (711) 69.4 (747)
*Enjoyment no 50.0 (30) 14.5 (147) 16.4 (177) 0.000 0.000
*Enjoyment yes 50.0 (30) 85.5 (870) 83.6 (900)
*Strength/Fit no 70.0 (42) 34.9 (355) 36.9 (397) 0.000 0.000
*Strength/Fit yes 30.0 (18) 65.1 (662) 63.1 (680)
*Competition no 20.0 (12) 35.8 (364) 34.9 (376) 0.013 0.013
*Competition yes 80.0 (48) 64.2 (653) 65.1 (701)
Physical activity < 30 minutes 58.3 (35) 66.9 (679) 66.4 (714) 0.121 0.121
at work (per day) 30 60 minutes 28.3 (17) 16.7 (170) 17.4 (187)
1 2 hours 10.0 (6) 10.0 (102) 10.0 (108)
> 3 hours 3.3 (2) 6.3 (64) 6.1 (66)
Completed a No 31.7 (19) 45.6 (463) 44.8 (482) 0.035 0.035
marathon* Yes 68.3 (41) 54.4 (553) 55.2 (594)
Number of 1 3 19.5 (8) 43.8 (242) 42.1 (250) 0.001 0.001
marathons 4 5 7.3 (3) 12.1 (67) 11.8 (70)
completed* 6+ 73.2 (30) 44.1 (244) 46.1 (274)
Completed a No 61.7 (37) 75.6 (769) 74.8 (806) 0.016 0.016
triathlon* Yes 38.3 (23) 24.4 (248) 25.2 (271)
Number of 1 3 52.2 (12) 48.6 (120) 48.9 (132) 0.799 0.799
triathlons 4 5 13.0 (3) 10.1 (25) 10.4 (28)
completed 6+ 34.8 (8) 41.3 (102) 40.7 (110)
Concussions No 76.7 (46) 75.1 (763) 75.2 (809) 0.785 0.785
Yes 23.3 (14) 24.9 (253) 24.8 (267)
Number of 1 84.6 (11) 50.2 (127) 51.9 (138) 0.044 0.044
Concussions* 2 15.4 (2) 31.6 (80) 30.8 (82)
3+ 0.0 (0) 18.2 (46) 17.3 (46)
Years exercise <1 3.3 (2) 6.4 (65) 6.2 (67) 0.002 0.002
training at 1 2 8.3 (5) 20.6 (210) 20.0 (215)
current level 3 5 20.0 (12) 31.0 (315) 30.4 (327)
(year)* 6 10 20.0 (12) 14.9 (152) 15.2 (164)
> 10 48.3 (29) 27.0 (275) 28.2 (304)
Chronic intensity Low (0- 1100) 13.8 (8) 34.9 (324) 33.7 (332) 0.000 0.000
(T; IS x yr)* Med (1140 2480) 19.0 (11) 33.2 (308) 32.4 (319)
High (2500 10000) 67.2 (39) 31.9 (296) 34.0 (335)
Exercise at Low (< 1 2) 11.7 (7) 27.0 (275) 26.2 (282) 0.001 0.001
current level (T; Med (3 10) 40.0 (24) 45.9 (467) 45.6 (491)
year)* High (> 10) 48.3 (29) 27.0 (275) 28.2 (304)
Training hours Low (1 - 6) 11.7 (7) 42.7 (434) 41.0 (441) 0.000 0.000
per week (T; hr)* Med (7 - 10) 23.3 (14) 35.0 (356) 34.4 (370)
High (> 10) 65.0 (39) 22.2 (226) 24.6 (265)
Total intensity Low (0 305) 8.6 (5) 33.9 (315) 32.5 (320) 0.000 0.000
(T; IS x hr/wk x Med (310 405) 22.4 (13) 33.0 (306) 32.4 (319)
VO2%)* High (410 1000) 69.0 (40) 33.1 (307) 35.2 (347)
Chronic Duration Low (1 16) 11.7 (7) 31.0 (315) 29.9 (322) 0.000 0.000
(T; hr/wk x yr)* Med (20 40) 21.7 (13) 34.9 (355) 34.2 (368)
High (50 100) 66.7 (40) 34.1 (346) 35.9 (386)
View publication stats
Table 3. Multivariate (logistic regression) model with adjusted odds ratios for libido score
group. Only significant clinical and biological factors noted.
Investigative Variable Comparison Odds Ratio CI (95%)

Between Tertiles (placement in
high/normal
Vs. low)
Chronic Duration Low Low vs. High 4.0 1.6 10.0
Medium Medium vs. High 2.5 1.3 4.8
High
Total Intensity Low Low vs. High 6.9 2.6 17.9
Medium Medium vs. High 2.8 1.4 5.3
High
Age Low vs. High 1.9 1.0 3.9
(years) Medium (41 55) Medium vs. High 1.9 0.9 4.1

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Endurance Exercise Training and Male Sexual Libido

Article in Medicine and Science in Sports and Exercise · February 2017

Anthony C. Hackney Amy Lane

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Endurance Exercise Training and Male Sexual Libido

Anthony C. Hackney1,2, Amy R. Lane1, Johna Register--Mihalik1

Accepted for Publication: 9 February 2017

Copyright © 2017 American College of Sports Medicine

Endurance Exercise Training and Male Sexual Libido

Anthony C. Hackney1,2, Amy R. Lane1, Johna Register-Mihalik1, and 1

Global Public Health, University of North Carolina,, Chapel Hill, NC

Running title: Exercise and Libido

Address correspondence to:

Chapel Hill, NC 27599, USA

Email: ach@email.unc.edu Fax: 919-962-0489

present study do not constitute endorsement by ACSM.

habits and libido of participants (n=1077). Three evidence-based

primary outcome of total libido score and low,

categorization. Results: Age, training intensity, and training duration of pa

multivariate model. In the multivariate model, training intensity (p<0.000

training intensities (OR: 2.8; 95% CI: 1.4

those with the highest training intensity. Participant

10.0) and mid-

Key Words: hypogonadism, testosterone, sex drive, stress, health

Disorders [DSM-V]); which affects approximately 16-18%

It is well known women

the menorrhea as a result of hypothalamic

hormone levels are both suppressed;

Testosterone is associated with many androgenic-anabolic processes in the male, and

we studied the associations between aspects of endurance exercise

in healthy men using a cross-sectional online survey study design.

Development of the Survey Instrument

An online survey questionnaire was developed to assess elements of physical

characteristics, exercise training-habits

concerning exercise training-habits

American Heart Association (1,4,12

validity of each has been assessed and reported elsewhere (

Survey Sample - Administration

(https://jfe.qualtrics.com/form/SV_eWESbBdaONSuUPb).. Subsequent to establishment of the

requested announcement of the survey and encouragement of participation by individuals

about the survey.

participant involvement (e.g., gender, medical status) and physical

of regular frequency of exercise (days/week), intensity of training effort (number of light,

primary and secondary types-forms of exercise engagement, endurance sports competition

injury, tapering or overreaching),

(level of activity, minutes/day). Approximate oxygen uptake (VO2) percentages

options where participants

Likert- ; answers were assigned plus or minus

were included in initial analyses. Additionally, several

in which elements of frequency, intensity and, duration relative to time (hour

based categories were created for the primary outcome of total

category formed the low score group.

endurance exercise training.

Demographic, exercise training, and libido characteristics of the participants were

analyzed using univariate statistics (Chi

Alpha level for all analyses was set to 0.05 a priori.

participants are reported in Table 1.

the multivariate model. In the multivariate model, training intensity (p<

uptake (VO2) percent for respective intensities were; and high

week training times the number of years