Cycling does not damage men’s sexual or urinary functions

Cycling is increasingly popular for transportation, exercise, and leisure, and its impact on sexual health has received a great deal of media attention, especially regarding erectile function. In a new report in The Journal of Urology®, researchers found that contrary to some previous studies, neither recreational nor intense cycling appear to have a negative impact on men’s sexual and urinary function.

“This is the largest comparative study to date, exploring the associations of cycling, bike and road characteristics with sexual and urinary function using validated questionnaires,” explained lead investigator Benjamin Breyer, MD, MAS, of the Department of Urology, University of California–San Francisco.

“We believe the results will be encouraging for cyclists. Cycling provides tremendous cardiovascular benefits and is low impact on joints. We believe the health benefits enjoyed by cyclists who ride safely will far out weight health risks.”

Some studies have suggested that cycling negatively affects erectile function. The hypothesis was that this negative impact is caused by the prolonged perineal pressure and micro-trauma during cycling. However, these studies lacked the use of validated measures or comparison groups, and were limited by small sample sizes.

In this multinational study a cross-section of three athletic groups – cyclists, swimmers, and runners – was surveyed using Facebook ads and outreach to sporting clubs for athletes. Participants included 2,774 cyclists, 539 swimmers, and 789 runners. Participants completed validated questionnaires, including the Sexual Health Inventory for Men (SHIM), International Prostate Symptom Score (I-PSS), and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), as well as questions about urinary tract infections (UTIs), urethral strictures, genital numbness, and saddle sores.

In addition to the comparisons between similar athletic activities with and without perineal pressure, the researchers examined how cycling intensity, bicycle configuration, and even road conditions might impact sexual and urinary functions. Cyclists were asked about their bike type, saddle type, saddle angle, frequency of wearing padded shorts while cycling, percent of time standing out of the saddle, handlebar height, and the type of surface on which they usually ride. Cyclists were divided into a high intensity group (cycling more than two years more than three times per week, and averaging more than 25 miles per day) and a low intensity group meeting none of these criteria. Non-cyclists were defined as those who swim and/or run but do not cycle on a regular basis.

In general, when compared to swimmers and runners, cyclists’ sexual and urinary health was comparable, although some cyclists were more prone to urethral strictures. Interestingly, high intensity cyclists had overall better erectile function scores than low intensity cyclists. Neither bicycle nor road characteristics appeared to have a negative impact on cyclists. Standing more than 20 percent of the time while cycling significantly reduced the odds of genital numbness. Adjusting handlebar height lower than the saddle height did increase the likelihood of genital numbness and saddle sores.

“The comparison across athletes sampled in a similar way with validated instruments is what this study adds to the literature,” said Dr. Breyer. “We’re looking more closely at those who reported numbness to see if this is a predictor for future problems.”

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The article is “Cycling and Male Sexual and Urinary Function: Results from a Large, Multinational, Cross-Sectional Study,” by Mohannad A. Awad, Thomas W. Gaither, Gregory P. Murphy, Thanabhudee Chumnarnsongkhroh, Ian Metzler, Thomas Sanford, Siobhan Sutcliffe, Michael L. Eisenberg, Peter R. Carroll, E. Charles Osterberg, and Benjamin N. Breyer (http://dx.doi.org/10.1016/j.juro.2017.10.017). It appears in advance of The Journal of Urology^®, volume 199, issue 3 (March 2018) published by Elsevier.

The authors of this study received funding from a UCSF Reac Grant and from the Alafi Foundation.

About The Journal of Urology^® 
Established in 1917, The Journal of Urology^® is the official journal of the American Urological Association. It is the most widely read and highly cited journal in the field. It brings to its readership all the clinically relevant information needed to stay at the forefront of this dynamic field. This top-ranking journal presents investigative studies on critical areas of research and practice, survey articles providing short condensations of the best and most important urology literature worldwide and practice-oriented reports on interesting clinical observations. www.jurology.com

About the American Urological Association
Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 22,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy. www.auanet.org

About Elsevier
Elsevier is a global information analytics business that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray’s Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com