Cycling has become increasingly popular, both for pleasure and for convenience. For men in particular, it is worth knowing that adjusting your bike correctly, taking intermittent rests and wearing the correct clothing can prevent some of the more common complaints.
This article on cycling and impotence is written by Vinod Nargund, Consultant Urological Surgeon, St Bartholomew’s and Homerton Hospitals, London.
With the lack of availability of spaces for parking their cars, more and more people who work in the cities resort to alternate forms of transportation. Amongst them bicycle riding is an appealing one as it is a good form of recreation, a means of fitness and transportation worldwide. Saddle related injuries are important in men because of the presence of male sexual and reproductive organs between the thighs.
The saddle abuts directly onto the perineum behind the scrotum where the nerves and blood vessels are entering the penis. This area is sensitive and has hair follicles, sweat and sebaceous glands. Abrasions, chafing, folliculitis in the perineum, lacerations and bruises of the skin are the most common traumatic injuries. Other problems include perineal soreness and groin skin problems due to sweating.
Cyclists may also complain of genital numbness and even of impotence. The main reasons cited for these problems include impaired blood supply and pressure on the nerves of the penis as studies on volunteers have shown that cycling in a standing position does not alter penile blood supply after exercise and remain the same as before exercise. Numbness of the genital region is reported by more than 60% of the cyclists. There is a higher incidence of numbness and erectile problems in men who cycle regularly on longer training distances. Penile blood flow is affected due to the compression of vessels by sitting on the saddle.
This may be accentuated by the hard surface of the saddle which could be a reason for penile numbness and impotence in long-distance cyclists. It is important, therefore, to take rests intermittently during prolonged and vigorous bicycle riding and to restrict the training distance.
Know your bicycle well. The modern bicycle consists of a frame with various components, including handlebars, brakes, wheels, pedals, and gears, in various configurations for the various modes of cycling. For high-performance cycling, the proper fit of the bicycle is critical. This can be achieved with bike fit kit. Make sure that a proper frame selection and adjustment is made for your posture, height and balance by following simple guidelines for frame size, seat height, fore and aft saddle position, saddle angle, reach and handlebar height. The human body functions well with a narrow range of pedal resistance to effort. Riding at too much pedal resistance is a major cause of overuse problems in cyclists.
Managing saddle-related injuries or irritations may also involve adjusting seat height, angle and fore and aft position in addition to changing the saddle. Padding in the saddle and shorts play an important part in preventing saddle-related problems. There are different kinds of saddles available in the market. There are no details about their scientific validation.
Other less common symptoms include priapism (constant erection of penis), penile vein thrombosis, haematuria (blood in the urine), prostatitis (inflammation of prostate) and elevated serum PSA (prostate specific antigen - one of the blood tests used for prostate cancer).
Bicycles and male infertility
Prolonged cycling causes considerable generation of heat in the pelvic area which may affect sperm function, but there is no direct link between cycling and male infertility. Major direct injuries of the testis might cause testicular damage and impaired function of that side. Mountain bikers have a higher incidence of abnormal scrotal findings. Torsion of spermatic cord (twisting of testis and its cord), microcalcification of testis, haematoma (bleeding in the scrotal sac around the testis) and hydrocele (collection of fluid) are other testicular problems. Torsion of the testis is an emergency condition and immediate medical attention is required. It is worthwhile remembering that clothing around the scrotum should not be too tight as this affects the sperm count.