Does Bicycling Cause Erectile Dysfunction and Impotence in Men?

The answer to this question has received a lot of media attention over the past several years and has also been the topic of heated debate. The answer seems to be that prolonged cycling on a poorly fitting bicycle saddle may be associated with erectile dysfunction (ED), more commonly in older men. But the risk depends upon many factors including the hours of cycling per week, the weight of the cyclist, the skill of the cyclist and the bicycle fit.

What is Impotence and Erectile Dysfunction?

According to the National Kidney and Urologic Diseases, "Erectile dysfunction, sometimes called 'impotence,' is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word 'impotence' may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved."

What Causes Erectile Dysfunction?

There are many causes of erectile dysfunction and impotence. The physical causes include damage to nerves, arteries, muscles, and tissues responsible for an erection. However, 70% of ED is caused by diseases such as diabetes, kidney disease, chronic alcoholism, atherosclerosis, vascular disease, and neurologic disease.
The most common lifestyle-related causes of erectile dysfunction are:
• Smoking
• Obesity
• Inactivity

Cycling and Erectile Dysfunction

So how can bicycling lead erectile dysfunction? Prolonged pressure on the tissues of the perineum (the area of the groin between the penis and anus) can damage blood vessels and nerves responsible for an erection, and spending excessive amounts of time in the same position on the saddle may cause temporary erectile dysfunction. This damage may become permanent if the tissues are continually damaged and not allowed to recover.
Many factors increase the risk of developing erectile dysfunction in cyclists. Some of these include the weight of the cyclist (heavier riders put more pressure on the perineum), the saddle design (some saddles increase pressure on the perineum), and even the cycling intensity. Studies have found that racing cyclists offset much of the weight on the saddle by keeping so much of their body weight on the pedals. This, in turn, reduces the pressure on the perineum.

Symptoms of Erectile Dysfunction in Cyclists

The good news is that nearly every cyclist who experiences erectile dysfunction or impotence will have symptoms before the problem becomes serious. Reduced blood flow to the perineum causes pain, numbness or tingling in the perineum long before men develop ED. If you don't have problems with pain, numbness or tingling, stop worrying and enjoy your ride. If you do have pain, address the problem before it gets worse.
Preventing Erectile Dysfunction
If you do feel groin discomfort, pain or numbness when you bike take the following actions:
• If you are on a long ride, take a break, stand up on the pedals, stretch and "adjust yourself" until normal sensation returns.
• During rides, change your position frequently by shifting forward and backward and standing.
• Consider adjusting your bike seat to reduce pressure points.
• Use a seat with a cutout to reduce pressure on the perineum.
• Avoid seats with a lot of padding. Although it sounds comfortable, you'll actually sink deeper into the saddle and feel more pressure and numbness.
• Keep the seat level or angled slightly downward; never tilt the saddle upward.
• Raise your handlebars slightly so you are a bit more upright.
• Change positions often during your rides.
• Wear good cycling shorts with a comfortable pad.
• Adjust your saddle height so that your knee is just slightly bent at the bottom of the pedal cycle.
• See: Proper Bike Fit Can Prevent Pain and Injury

Bicycle Saddle Choice

Bicycle saddle design has changed dramatically over the years and there are many options. Saddles now offer a cutout down the middle to relieve pressure on the perineum and reduce pressure on the soft tissues. Some research supports this theory and many cyclists find that the cutouts are more comfortable than traditional saddles. Newer saddles, such as the Selle SMP, offer a large cutout and downward facing nose. One study found this design superior in allowing penile blood flow compared with standard saddle shapes.
Another study on saddle shape and penile blood flow found that narrow saddles result in less blood flow than a wider saddle. Computer analysis of pressures showed that a wide saddle allowed more weight to be distributed to the sit bones (ischial tuberosity) and put less pressure less on the perineum than narrow saddles.
So if you don't have symptoms, don't worry about impotence and enjoy cycling!