From the Guidelines
Cycling does not typically cause male infertility or erectile dysfunction for most cyclists, though prolonged pressure on the perineum can potentially lead to temporary numbness or discomfort in some riders. The current evidence suggests that the relationship between cycling and male infertility or erectile dysfunction is not well-established, with most studies focusing on the effects of heat exposure on semen parameters and fertility outcomes 1. However, it is essential to note that prolonged pressure on the perineum can temporarily compress nerves and blood vessels that supply the genital area, leading to potential issues. To minimize any potential risk, cyclists can take several precautions, including:
- Using a properly fitted bicycle with a comfortable saddle designed to reduce perineal pressure
- Wearing padded cycling shorts
- Adjusting their riding position to shift weight to their sit bones rather than soft tissue
- Taking regular breaks during long rides
- Occasionally standing on the pedals to relieve pressure
These issues are generally preventable and reversible with proper equipment and riding techniques. For those who experience persistent numbness or discomfort lasting more than a week, it's advisable to consult a healthcare provider. Most recreational cyclists who follow these guidelines can enjoy biking without concerns about reproductive health or sexual function. Additionally, recent guidelines on survivorship and sexual function in cancer survivors provide valuable insights into the treatment of sexual dysfunction, including the use of PDE5 inhibitors, testosterone therapy, and lifestyle modifications 1. However, these guidelines are not directly applicable to the general population of cyclists, and the primary concern for cyclists remains the prevention of temporary numbness or discomfort due to prolonged perineal pressure.
From the Research
Cycling and Male Infertility or Erectile Dysfunction
- There is limited evidence to suggest a direct link between cycling and male infertility or erectile dysfunction 2.
- However, a systematic review and meta-analysis found that when controlling for age and comorbidities, cyclists had significantly higher odds of having erectile dysfunction (odds ratio: 2.00; 95% confidence interval: 1.57,2.55) 2.
- Other studies have investigated the relationship between physical activity, erectile dysfunction, and male infertility, but not specifically cycling 3, 4, 5, 6.
- These studies suggest that regular physical exercise, including aerobic and anaerobic protocols, can improve erectile function and may have a positive effect on semen parameters 3, 5.
- Additionally, sildenafil citrate has been shown to be effective in treating erectile dysfunction and may have a beneficial effect on semen parameters, particularly in men undergoing infertility treatments 4, 5, 6.
Mechanisms and Risk Factors
- Erectile dysfunction can be an early sign of endothelial dysfunction and cardiovascular disease, with which it shares many risk factors, including physical inactivity 3.
- Regular physical exercise has been shown to improve erectile function through different mechanisms, including glucose and lipid metabolism, regulation of arterial pressure, production of nitric oxide, and hormonal modulation 3.
- Stress and psychological factors can also contribute to erectile dysfunction and male infertility, particularly in men undergoing infertility treatments 4, 6.