Cycling is one of the best aerobic activities for the heart and metabolism. At the same time, it is cyclists who most often have to hear warnings about erection, the prostate and fertility. The editorial team breaks down which of these risks are confirmed, what they depend on and what can be changed in the fit and equipment.
The benefit of cycling for a man
Regular cycling improves the work of the cardiovascular system, lowers blood pressure, improves insulin sensitivity and helps control body weight. For the joints, the bicycle is a gentle load, so it is often recommended to people with excess weight or knee problems.
A large British cohort (Celis-Morales et al., 2017) showed that people who commuted to work by bicycle had a lower risk of cardiovascular diseases, oncological illnesses and death from all causes compared with those who used transport. These are observational data, but they are consistent with the general benefit of aerobic activity.
For men's health this is important, because erectile function is closely connected with the condition of the vessels. Endothelial dysfunction, atherosclerosis, diabetes are the main causes of organic erectile dysfunction, and physical activity reduces the risk of exactly these conditions.
So the question is not whether cycling is harmful in general, but what specific loads it creates on the perineum and how to minimize them in order to preserve all the advantages.
The saddle and the perineum: what happens anatomically
In an ordinary sitting position the body weight falls on the sitting bones. On a bicycle, especially in an aggressive road position, part of the weight is transferred forward — onto the soft tissues of the perineum. Here run the pudendal nerve and artery, which provide sensitivity and blood supply to the penis.
Studies measuring oxygen in the tissues of the penis showed that on a classic narrow saddle with a nose the blood flow in this area is significantly reduced, and on saddles with a cutout or without a nose — to a lesser extent. Thus the design of the saddle and the fit directly affect the compression.
The most common manifestation is numbness of the perineum or the penis after a long ride. It may be temporary, but regular and prolonged numbness is a signal that the pressure is excessive and something in the settings needs to be changed.
The load is affected by the time in the saddle without breaks, the width and shape of the saddle, its angle of inclination and height, the difference between the height of the saddle and the handlebars, and also body weight. The cushioning of the cycling shorts and the quality of the road also matter.
Erection, prostate and fertility: study data
As for erectile dysfunction, the data are contradictory. Early studies, especially among cyclists who spend many hours a week in the saddle, reported a higher frequency of erectile disorders. At the same time, a large survey by Hollingworth and co-authors (2014), which included several thousand amateur cyclists, found no connection between riding volume and erectile dysfunction after accounting for age and other factors.
Another cross-sectional study (Awad et al., 2018) compared cyclists, runners and swimmers: sexual and urinary function in cyclists was not worse, although perineal numbness and urethral strictures occurred more often. The authors emphasize the role of correct bicycle setup.
As for the prostate: prolonged saddle pressure in some studies was associated with a temporary rise in PSA, in others the effect was insignificant. There is no reliable evidence that cycling causes prostate cancer. This is exactly why urologists often advise not to ride for 1–2 days before taking a PSA test — to avoid a false rise.
Data on fertility are limited. Several small studies in trained high-level cyclists described changes in sperm parameters; they are attributed to heating of the scrotum, tight clothing, pressure and a large training volume. For amateurs with a moderate riding volume there is no convincing evidence of harm.
| Problem | What is known | Risk factors |
|---|---|---|
| Perineal numbness | Common, usually reversible | Narrow saddle, aggressive position, long rides |
| Erectile dysfunction | Large studies of amateurs show no connection | Very large volumes, chronic numbness |
| Rise in PSA | A temporary one is possible | Riding before the test |
| Fertility | Limited data for elite athletes | Heating, pressure, large volume |
Bones, hormones and energy deficit
A less obvious aspect is bone tissue. Cycling is not an impact load, so it weakly stimulates bone formation. Several studies in high-level road cyclists found lower bone mineral density than in runners or people who do strength sports.
To this is added the problem of relative energy deficiency in sport (RED-S). Cyclists strive to reduce body weight for a better power-to-weight ratio, and a chronic lack of energy can lower testosterone and worsen the condition of the bones. The consensus of the International Olympic Committee (Mountjoy et al., 2018) emphasizes that RED-S also concerns men.
Large volumes of endurance loads by themselves can also be associated with somewhat lower resting testosterone levels. Hackney and co-authors described this phenomenon as the «hypogonadal state in endurance-trained men». In most cases the indicators remain within the norm or close to it, but in combination with undernutrition and sleep deprivation the effect can become clinically significant.
The practical conclusion: it is useful for cyclists to add strength training and impact loads (jumps, running), to watch energy availability, to get enough calcium, vitamin D and protein.
- 1–3 strength sessions per week with an emphasis on legs, back and core;
- small volumes of jumping and running exercises, if there are no contraindications;
- control of body weight without prolonged harsh deficits;
- in case of symptoms of decreased libido, frequent injuries or fatigue — an examination.
How to reduce the risks: fit, saddle, habits
The first is professional bike fitting. Correct saddle height, its horizontal position, the distance to the handlebars and the height drop reduce the load on the perineum. Too high a saddle forces the pelvis to rock, and an upward tilt of the nose increases compression.
The second is choosing a saddle according to the width of the sitting bones. Models with a central cutout or channel reduce pressure on the perineum. Wide «soft» saddles are not always better: too much foam can press exactly on the sensitive zone. A noseless saddle does not suit everyone, but can be an option in case of persistent numbness.
The third is habits while riding. Periodically rising from the saddle for a few seconds, changing the position of the hands and body, breaks on long rides help restore blood flow. Quality cycling shorts with a chamois and without seams in the contact zone reduce friction.
The fourth is to listen to the body. Numbness that does not pass, pain in the perineum, problems with urination or erection are a reason to reconsider the settings and consult a urologist. These symptoms should not be perceived as «the norm for cyclists».
Editorial conclusions
For most men cycling is a beneficial activity that improves the condition of the heart and vessels, and therefore indirectly supports erectile function as well.
Specific risks are connected with the pressure of the saddle on the perineum, and they can largely be controlled through fit, choice of saddle and habits while riding.
Those who ride a lot should add strength loads for the bones, watch the energy balance and not ride before a PSA test.
Related materials on our blog: «Prostate and Strength Training», «Andrological Examination: What It Includes» and «Is It Harmful to Train Every Day».
References
- Hollingworth M, Harper A, Hamer M. Risk factors for erectile dysfunction in cyclists: cross-sectional study. J Men's Health. 2014.
- Awad MA, Gaither TW, Murphy GP, et al. Cycling, and male sexual and urinary function: results from a large, multinational, cross-sectional study. J Urol. 2018;199(3):798–804.
- Celis-Morales CA, Lyall DM, Welsh P, et al. Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study. BMJ. 2017;357:j1456.
- Mountjoy M, Sundgot-Borgen JK, Burke LM, et al. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Br J Sports Med. 2018;52(11):687–697.
- Sommer F, Goldstein I, Korda JB. Bicycle riding and erectile dysfunction: a review. J Sex Med. 2010;7(7):2346–2358.
- Olmedillas H, González-Agüero A, Moreno LA, et al. Cycling and bone health: a systematic review. BMC Med. 2012;10:168.
- Hackney AC. Hypogonadism in exercising males: dysfunction or adaptive-regulatory adjustment? Front Endocrinol. 2020;11:11.
Andriy Melnyk
A strength-sports coach and author of programs for beginner and intermediate levels. Writes about training planning.
