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Bicycle Riding

Cardiovascular exercise such as jogging, racket ball, running, swimming and tennis has been associated with decreased prevalence of erectile dysfunction. While bicycle riding is a form of cardiovascular exercise, bicycle riding is associated with an increased prevalence of erectile dysfunction. The primary problem with bicycle riding is the bicycle saddle. While the rider is bearing his weight on the narrow bicycle saddle or its protruding nose, the compressive forces push the contents of Alcock’s canal against the bony surface of the pelvic bone, stopping blood flow to the genital organs and causing numbness and tingling in the penis and scrotum.

As it concerns the artery, chronic compressive forces can cause focal endothelial dysfunction leading to focal atherosclerosis and narrowing of the artery. The reduction in perfusion pressure in this artery leads to erectile dysfunction. In addition, bicycles designed for males often have a bicycle bar or top tube onto which boys and men can crush their perineum.

The relationship between erectile dysfunction and bicycling was demonstrated in the Massachusetts Male Aging Study (MMAS), a cross-sectional survey of 1709 men in their 40’s to 70’s. The random sample is representative of a similar population of men and includes a variety of cyclists, such as recreational and occasional riders, stationary bikers, and serious sport cyclists. A key finding of the MMAS was the relationship between moderate cycling (< 3 hours per week) or sport cycling (=3 hours per week) and the development of ED. Analysis of the data showed that individuals who cycle at least 3 hours per week have an odds ratio for developing moderate or complete ED of 1.72. (Odds ratios < 1.5 are defined as health risks.) That is, at least 3 hours of cycling per week was more likely to caused artery blockage and long-term damage.

Ultimately, men must make their own decisions about the risks and benefits of bicycle riding. Before they begin to ride, however, they should be aware of the need for a properly fitting bicycle and comfortable saddle as well as the potential risks to sexual health presented by long-distance cycling. Finally, supervising children and providing them with properly fitting bicycles and seats, just as we do with protective helmets, is also essential to avoid injury and preserve sexual functioning.

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