Bicycling and Erectile Dysfunction
August 18th, 2008 by Patrick KistnerSince there are a lot of avid cyclists in the Athlo community, I thought this would be a great topic to write about. I recently came across a good article by Elizabeth Quinn that this post provides a summary of. The main cause of erectile dysfunction from bicycling is the amount of time and pressure placed on the tissues of the perineum which can eventually damage the blood vessels and nerves that allow men to have an erection. The perineum is the area of the groin between the male reproductive organ and the anus. Continually damaging this area with constant pressure can permanently affect erectile function in men.
Factors that are associated with an increase of risk for erectile dysfunction in cyclists include the weight of the cyclist, saddle design, length of rides or a cyclist’s intensity, and skill of the cyclist. Obviously heavier riders will have an increased pressure on the perineum and certain saddle designs increase these risk factors.
Many cyclists have felt some type of symptom in that area consisting of numbness, tingling, pain, etc. There is some good news though. Most of these symptoms will be felt long before any serious problems do develop and well before erectile dysfunction would be diagnosed.
So, what can you do to prevent erectile dysfunction and continue riding pain free? One of the most important things to do when you ride is to keep the weight of your body on the pedals through your feet instead of on the saddle to reduce the pressure on the perineum. Cyclists need to take breaks on long rides if pain or discomfort is felt in the area. Changes positions frequently during rides will decrease some of this pressure as well. Adjust the saddle height so the knees are slightly bent at the bottom of the pedal stroke and avoid saddles with lots of padding because this will only cause you to sinker lower on the seat, putting more pressure on the perineum. You can also raise the handle bars causing the rider to sit a bit more upright. I also highly recommend wearing cycling shorts that have the proper padding in them.
The last thing to consider is the type of saddle. Most studies show that wider saddles are better than narrow ones because it actually allows more blood flow throughout the groin area and more weight will be distributed to the ischial tuberosity (bottom of the butt). Newer saddles, like the Selle SMP, offer a larger cutout and downward facing nose. It is more advanced than the traditional saddles and allows more blood flow through the perineum. So, for those of you experiencing any types of symptoms, address the issue with some of these solutions and hopefully you will enjoy a new pain free ride.
Tags: Bicycling, Erectile Dysfunction, Perineum
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August 18th, 2008 at 10:34 pm
Great article. I believe posture is key in avoiding excessive or lengthy pressure to the perineum. The first time you sit on a road bike you no doubt feel the firm seat with or without padded bike shorts. I recommend getting comfortable sitting on the bones in your butt to take pressure off of this area. One thing that will help is ensuring your seat is angled downwards from rear to front. I’ve known a few cyclists to have issues with numbness because that had their seat tilted in the opposite direction.
August 18th, 2008 at 11:44 pm
Patrick, I couldn’t have said it any better myself. This is actually what I devote the majority of my physical therapy practice too and I have treated many cyclists with these complaints. In addition to erectile dysfunction, many cyclists feel as though they have pain in their prostate, only to find that when they visit the urologist there is nothing wrong with their prostate. There are many muscles in the pelvis in addition to the pudendal nerve that can result in prostate pain, bladder pain, penile pain, testicular and rectal pain. I have also known cyclists to complain of secreting prostatic fluid when cycling. Not only that, but females suffer from this as well in the way vaginal, labial and clitoral pain and pain inside the sit bones. If anyone you know suffers from these symptoms I highly recommend getting it checked out by a PT knowledgeable in pelvic floor muscle dysfunction. You can check out the website of my clinic at Pelvic Rehab or go directly to information about pelvic pain from cycling.
August 19th, 2008 at 1:31 pm
The type of route a person rides also plays a factor in the stress on the perineum. I have found that long, flat rides are the worst for constant pressure and weight on the perineum. On a flat ride I rarely change posture and most of my weight is squarely on the seat. That’s why I would much rather ride a hilly route.
On the uphill I am often times out of the saddle when I pedal. When I am seated, my weight is shifted more towards my butt. On the downhill, a lot of the weight shifts to my arms and feet. I also lean when going around turns which causes even less weight on my perineum.
If you live in a place with no hills you might want to also consider buying aero bars for your bike. It might help alleviate the problem by allowing you to distribute more body weight to your arms.
August 20th, 2008 at 1:00 am
I have also been learning a lot recently about pelvic torque and leg length discrepancies. It’s important that if you’re going to be on the bike for a considerable amount of time that you get a proper bike fit and maybe even a retul assessment. http://www.retul.com/