Is cycling bad for men's sexual health?

If you spend a lot of time in the saddle, or if you’ve experienced any numbness from riding your bike, you may be concerned that you’re doing yourself some damage. But is your saddle increasing your risk of developing erectile dysfunction or prostate cancer? We teamed up with one of the UK’s foremost urologists, Dr. Anthony Koupparis, to give solid and practical advice that all male cyclists should listen to.

A quick anatomy lesson

When sitting on a bike, some of your weight will be on your perineum, the soft tissue area between your bum and testicles. In this area, under the skin, you’ve got your urethra, which is the tube that connects your bladder to the outside world, you’ve got some major blood vessels, and your pudendal nerve, which gives sensation to the area and therefore also helps with getting an erection. Above that, you’ve got your prostate. With those important parts put under pressure by your saddle, it seems reasonable to make a link between cycling and erectile dysfunction. Should we be worried?

Numbness

First of all, we asked Dr. Koupparis about the temporary numbness that many of us have experienced on the bike. What’s the cause?

“Basically, because of the pressure that you're exerting directly on the perineum, you're pressing on the nerves and you're pressing on some of the blood vessels, and that's what's causing the numbness,” he explained. “So after a period of time when you've been sitting on a nerve, it will undergo some very minor damage."

So a numb penis is down to pressure on the perineum, but is it going to harm us long-term?

“If you get on your bike for prolonged periods and every single time it's numb in that area and it continues to be numb, then you do the same again and again and again, then inevitably, you will cause some long-term damage.

“But common sense takes over, and if it happens once then just get a proper bike fit and get a proper saddle. A one-off period of numbness will not cause any long-term damage either to the sensation in that area or to anything like erections.’

Whilst the occasional feeling of numbness isn’t something to worry about, if it’s happening repeatedly, you should definitely do something about it. Whether that’s a different saddle or altering your riding position, there should be a straightforward fix to make you more comfortable and avoid any long-term issues.

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Should we worry about spending too much time in the saddle?

Erectile dysfunction

Ok, so common sense says repeated numbness is going to cause damage, but is there a link between cycling, repeated numbness and erectile dysfunction?

“The answer is no,” Dr. Koupparis said. “The more important thing is the significance of erectile dysfunction in the first place. The processes that give you erection problems are exactly the same as the processes that give you cardiovascular disease or a heart attack. If you've got diabetes, or high blood pressure, or you smoke, then you are likely to have erectile dysfunction, but you're also likely to have heart disease.

“The fact is, that most middle-aged blokes will take up cycling, it seems at the moment. Now if you're a cyclist and you're of that particular age and you develop erectile dysfunction, your first thought should not be ‘oh, it's my saddle, it’s just because of the cycling’. It should be, ‘I'm not gonna put my head in the sand about it. This could be a marker for something that's undiagnosed. I need to get this checked’.”

In reality, other health factors are likely the cause of any erectile dysfunction issues.

“The odd bit of numbness affecting your perineum is not going to give you erectile dysfunction,” Dr. Koupparis said. “It doesn't give you erectile dysfunction. [So if you do suffer from erectile dysfunction] go and get it checked out. Firstly, to have a proper MOT from a heart point of view, then why not have some treatment for erection problems? It's gone full circle. It's gone from being this sort of slightly sniggering thing, to a proper health issue which you can get sorted out.”

Prostate cancer

Finally, what about prostate cancer? Is there a link between prostate cancer and cycling?

“Thankfully, cycling has no effect on prostate cancer,” Dr. Koupparis said. “But it's not only the development of prostate cancer, it's also the question of whether you get inappropriately investigated for prostate cancer. One of the things that we use to give an indication of a risk of prostate cancer is by doing a blood test. There is a thought that if you cycle lots, you might irritate your prostate and that might artificially put your blood test up. It’s called a PSA blood test, a prostate-specific antigen blood test.

“[People think that] cycling puts it up, so you have a test, it’s artificially raised, and then you have a whole load of investigations that you never needed all because you were cycling. But actually, that’s not true - there’s a possibility that it might affect it a little bit, but if you look at laboratory-based research on lots and lots of molecular markers for prostate cancer, actually cycling and exercise don't make any difference to any of the indicators.”

So there’s no evidence that cycling heightens your risk of prostate cancer, but that said, men - particularly older men - should be mindful of the symptoms and signs, so that if there is an issue, it can be detected earlier.

“As we get older, we're more likely to get prostate cancer,” Dr. Koupparis said. “The first thing is to be aware of some of the symptoms. The things that we look out for are things like water works symptoms, pain in your back, problems with bleeding in the water, those sorts of things. If you're worried about those things, if you're experiencing those things, then you should go to either a urologist or GP and have a sensible discussion about being assessed.

“What we don't want is blokes just completely ignoring it in the first place. And in most cases we find these things much more early these days and it can be completely sorted.”

What kind of age are we talking about here? When should people be thinking about the possibility of prostate cancer?

“As you get beyond 50, you should be having a think about it. If you've got some worrying symptoms, don't panic, don't put your head in the sand. Have a sensible discussion and assessment about what the problem is, whether there are any red flags to act on, and whether you need some more investigations, rather than not doing anything about it.”

To sum up

Essentially, there isn’t a link between cycling and prostate cancer, nor is there a link between cycling and erectile dysfunction – the results for both issues are skewed because of the demographic of cyclists. A lot of us are in the right age group to be at risk. So, the main thing is to keep on top of your health, take note of any indicators, and take the right steps.

And although there doesn’t appear to be a link between saddle numbness and erectile dysfunction, if your saddle is making you numb every time you ride, you should get a bike fit, or find a saddle that takes pressure off your perineum. It’s going to remove any chance of causing yourself any damage, and it’ll give you the comfort and peace of mind to ride as much as you like.

Simon Richardson

GCN Presenter

Former pro road and mountain biker racer