May 19, 2017
Bicycling does not have significant deleterious effects on either sexual or urinary function in men or women, according to results from two large, population-based surveys presented here the American Urological Association 2017 Annual Meeting.
"Bicycle riding is a very healthy, low-impact, aerobic kind of exercise and it has established health benefits. However, recently some concerns have been raised about its impact on sexual and urinary function due to prolonged perineal compression," said Mohannad Awad, MD, from the University of California, San Francisco.
Dr Awad and his colleagues used Facebook ads and outreach to English-speaking sporting clubs around the world to recruit casual and serious cyclists for their surveys on sexual function and urinary symptoms. Swimmers and runners were recruited to serve as the control group.
Men were asked about physical activity and completed three validated questionnaires: the Sexual Health Inventory for Men, the International Prostate Symptom Score, and the National Institute of Health Chronic Prostatitis Symptom Index.
Women were assessed with the Female Sexual Function Inventory and the International Prostate Symptom Score for urinary symptoms.
Participants were also asked about demographic characteristics; clinical history; cycling, swimming, and running intensity; bicycle and road characteristics; and history of urinary tract infection, genital and perineal numbness, and saddle sores.
In the study cohort, 46.0% of the 8400 men were athletes, as were 53.3% of the 5853 women.
Participants were considered to be high-intensity cyclists if they had been cycling for at least 2 years, rode at least three times a week, and rode at least 25 miles a day, on average.
Numbness and Saddle Sores in Men
For men, sexual and urinary health were no different in cyclists than in noncyclists, although the data hinted that prolonged perineal compression could be related to scarring and a narrowing of the urethra, the investigators point out.
Some degree of numbness, mostly in the penis, was reported by 44% of cyclists. However, that numbness lasted more than 1 day in only 2% of the men; most often it lasted less than 1 hour.
Saddle sores were reported by 31% of the men, and 46% of those occurred in the perineum.
Increasing the amount of time spent standing on the pedals while cycling and adjusting the height of the handles bars to either above or level with the top of the saddle can reduce the risk for numbness and saddle sores, Dr Awad said.
Urinary Tract Infections in Women
For women, sexual and urinary functioning were no different between the cyclists and noncyclists, although there was a trend toward more urinary tract infections in cyclists.
Some degree of numbness was reported by 39% of the women, primarily in the labia and/or vagina. That numbness lasted more than 1 day in only 2% of the women; most often it lasted less than 1 hour.
Saddle sores were reported by 40% of women cyclists; 54% of these were in the labia and/or vagina. Off-road biking increased the risk for saddle sores.
Again, standing on the pedals more often during cycling could reduce this risk, Dr Awad explained.
The type of bicycle (road, off-road, or stationary) and type of bike seat (wide or narrow, padded or not) had no effect on any of the parameters measured in either men or women.
These data are reassuring, said Kevin McVary, MD, professor and chair of urology at Southern Illinois University School of Medicine, who is himself a cyclist.
When talking with patients who present with sexual or urinary dysfunction, "I wouldn't say that I isolate cycling, but for sexual and urinary symptoms, that is a good question to ask our patients," he told Medscape Medical News.
"Essentially, a heart-healthy diet is a prostate-healthy, erection-healthy diet," he said.
This research was internally supported. Dr Awad and Dr McVary have disclosed no relevant financial relationships.