I’ve always loved cycling. As a teenager in Connecticut, I spent my summers at a bicycle shop working on European models, and I adored the movie Breaking Away, a coming-of-age film filled with dreamy Italian bicycles. So, I know what a rush cycling can be – but as a doctor who treats men for sexual dysfunction, I also know that the rush can come with risk.
When riding, a big chunk of weight and pressure is on the perineum, that area between the scrotum and anus. At the edges of the perineum are the “sit bones,” and inside of them are the nerves and arteries that feed the penis. Since most bike seats are too narrow for the sit bones, and the pressure when sitting on a seat can be 7 times as intense as that of sitting in a chair, these delicate vessels are vulnerable to pressure damage when you ride.
When researchers started digging into the potential link between cycling and erection problems decades ago, things looked pretty bleak. Studies suggested that that adult men who rode a road bike for more than 3 hours a week or 100 miles/weekly were facing a 70% increased risk of having erections issues. Newer research, though, seems to offer hope to the avid cyclist: the risk of erectile dysfunction in cyclists appears to be not measurably different than that of runners or swimmers. Why the change? It seems the cycling industry – and cyclists themselves – heeded that early research and have since made changes to their products and habits to reduce the risk. All good!
To keep your risk low, here are ways you can protect yourself while cycling:
- Get a properly fitted bicycle seat and tip the nose of the seat down a couple of degrees from the level.
- Use a noseless saddle if possible. Gel padding is better than foam. Cushion is king here.
- Use split rail or cutout saddles, which have a depression or gap down the middle of the seat.
- Maintain an upright posture as much as possible while bicycling.
- Shift position often and stand on the pedals frequently while riding.
- Use padded bicycle shorts
- Watch for pelvic numbness or tingling while riding (endearingly termed “numb nuts” in the cycling world), which can be early warning signs of a developing problem.
- Keep in mind that competitive cyclists are at higher risk than casual cyclists (more seat time, harder seats, forward sitting position).
