Ideally, when a cyclist straddles the bicycle and bears her weight on a bicycle saddle, the weight is supported directly on the pelvic sit bones (ischial tuberosities). If the bicycle saddle has a narrow seat alone, if the bicycle saddle has a narrow protruding nose, or if the bicycle saddle has both a narrow seat and a narrow protruding nose, there may be situations where the cyclist bears her weight directly on the groin. Bearing weight on the groin has been shown in multiple studies to compress the pudendal nerve and or its branches and the pudendal artery and or its branches. The pudendal nerves and branches, and the pudendal artery and its branches run through the groin are the primary sources of sensation and arterial blood inflow to the genitals. Pressure on these nerves and arteries over time may lead to a loss of sensation and a decrease in arterial blood supply to the genitals. These reductions in sensation and/or arterial blood flow can contribute to the sexual health problems that have been widely reported in the peer review medical literature associated with bicycle-riding sexual dysfunction. Some cyclists erroneously believe it is normal and a useful sign of the intensity of the workout, that genital sensation is reduced. The fact is numbness is a warning that excessive pressure is applied to the groin and this should not be ignored and that dismounting from the bicycle is recommended.
Men and women ride bicycles either for transportation, exercise or for their occupation. In particular, police officers who patrol by bicycle and have prolonged use of a bicycle saddle in their work, have reported groin/genital numbness and sexual problems. Women cyclists are also at risk for a decrease in sensation of their genitals from use of a narrow nosed bicycle saddle. Other studies have shown altered clitoral ultrasound studies in women cyclists.
To help prevent bicycle riding sensation and/or sexual changes, it is recommended that cyclists use a no-nose saddle. A no-nose bicycle saddle is designed to support the weight of the cyclist on the sit bones. A no-nose bicycle saddle does not have a narrow nose protruding forward under the groin region. A no-nose bicycle saddle is designed so that the important pudendal nerves and pudendal arteries serving genital sensation and genital blood flow are not compressed against any part of the saddle surface. Recent studies have demonstrated the effectiveness of no-nose bicycle saddles in decreasing groin pressure and improving the sexual health. Other efforts to avoid bicycle riding sensation and/or sexual changes, involve obtaining guidance from a trained bicycle specialist who can provide information concerning saddle height and angle adjustments. It would be wise to get off the bicycle saddle when possible.
If consistent and persistent sexual problems have already resulted from bicycle riding, and the sexual problems result in distress, detailed evaluation of psychologic and biologic causes should be sought.
San Diego Sexual Medicine is conveniently located on the campus of Alvarado Hospital just ten miles from downtown San Diego, and is easily access by car or public transportation. For the fastest appointment with Dr. Goldstein, Dr. Yee or our nurse practitioners, please call us directly.