Recently, a patient shared a very private and personal health concern. I believe it’s an important issue for many active men. A few weeks ago a young man came into my office and was complaining about getting an erection. I found it extremely odd since he was young and in the best shape of his life. After going over his medical history and lifestyle, I discovered that he spent long hours on a new racing bike every weekend.
If you are a cyclist or you know someone who is, then you need to be aware of how this exercise can have hidden risks to your sex life.
The Connection between Cycling and Erectile Dysfunction
The two leading causes of erectile dysfunction (ED) are usually diabetes and hypertension. But with my patient who was in excellent health, I knew the cause of his erectile dysfunction must be hiding elsewhere—and I discovered it could easily be from cycling.
In recent years, several studies have been conducted to determine why biking is sometimes responsible for ED. The trouble starts when pressure is exerted on the perineum for prolonged periods.
The arteries and nerves leading to the penis pass along this area between the scrotum and anus. The typical posture of a cyclist—leaning over the handle bars and distributing most of one’s weight on the perineum—can damage these nerves over time, putting men at risk for pain, numbness and ED.
Unfortunately, competitive racers and Olympians are not the only ones who suffer from cycling-related ED. If you spend over 3 hours in the saddle every week, you may be at risk too. Early signs of erectile problems include tingling and numbness. Not all men who do a lot of riding will suffer from ED, and most doctors do not recommend giving up cycling for good. If you think you’re at risk, there are steps you can take to prevent and reverse cycling-related ED.
Getting Back in the Saddle
The most effective way to prevent ED is to replace a standard racing saddle with the “no-nose” style saddle. These wider saddles make it easier to distribute body weight more evenly, taking pressure off the perineum and shifting it to the sit bones. Competitive riders believe the nose helps them gain greater control, but recreational cyclists should sacrifice a small amount of power for healthier sexual function. One study showed just a 20% reduction in blood flow to the penis in men using no-nose saddles compared with an 80% reduction for riders in traditional seats.
If you have to ride a bike with a regular seat, make sure it is positioned parallel to the ground or tilted slightly downward. This can take some pressure off the perineum, along with sitting up straight rather than leaning your body forward. For optimal comfort, you should also be sure to adjust the handle bar and seat heights to fit your body.
Finally, remember to spend some time hovering above the saddle during long rides. This shift in position will get blood flowing while taking pressure off the perineum. Plus, it is a great way to tone the muscles in your lower body. If you love cycling as much as my patient, giving up your favorite hobby would be an unpleasant decision. If you take a few simple precautions, you will be able to enjoy your rides without the worry of erectile dysfunction.
Mark Rosenberg, M.D.