Reportedly the largest study of its kind involving bikers, swimmers and runners, the findings buck prior reports that cycling could harm sexual or urinary function due to prolonged pressure on the buttocks and the perineum (the area between the scrotum and the anus).
The results provide some reassurance that cycling doesn't harm the perineum any more than swimming and jogging do, said study author Dr. Benjamin Breyer, a urologic surgeon at the University of California, San Francisco.
"Those athletes [swimmers and runners] also have erectile dysfunction," he explained. "The truth of the matter is, many men develop erectile dysfunction, but I think if you ride safely the health benefits of cycling are tremendous. The benefits to overall health far outweigh other concerns."
Cycling, whether done for leisure or transportation, has become increasingly popular, Breyer said. But the activity has received much attention for its potential effects on sexual and urinary health.
"I think a lot of effort goes into cycling from some men to protect their perineum by wearing padded shorts and using different seat types," he said.
The new research on men surveyed 2,774 cyclists, 539 swimmers and 789 runners. All completed several research-validated questionnaires about sexual health, prostate symptoms, urinary tract infections, genital numbness and saddle sores, among other factors.
Cyclists were also asked about their bike type, saddle (seat) type and angle, frequency of wearing padded shorts, percentage of time spent standing out of the saddle, handlebar type and type of surface on which they usually ride. The cyclists were split into a high-intensity group (cycling more than two years more than three times weekly and averaging more than 25 miles per day) and a low-intensity group.
Notably, high-intensity cyclists logged better erectile function scores than low-intensity cyclists.
Also notably, cyclists did experience more than twice the incidence of scarring or narrowing in the urethra -- a condition known as urethral strictures -- compared to swimmers or runners. The condition can affect the flow of urine from the body. But cyclists' sexual and urinary health was comparable overall to the other athletes.
Among cyclists, those standing more than 20 percent of the time while cycling significantly cut their odds of experiencing any genital numbness. Additionally, having handlebar height lower than seat height increased the odds of genital numbness and saddle sores.
Urethral strictures "are such an uncommon event that I wouldn't keep people from riding," Breyer said. "I would try to avoid riding habits that result in really significant numbness in the perineum for really long periods." Instead, he suggested men adopt more of these practices: getting out of the saddle, wearing protective shorts, using a seat that has a cutout, and getting an appropriate bike fitting.
Other urologists praised the study design, saying the comparison between cyclists and other athletes added strength to the findings.
"In my experience with bicyclists, this really reflects what I see," said Dr. Brian Miles, a urologist at Houston Methodist Hospital in Texas. "Erectile dysfunction, of course, happens to men as they age for various reasons, but with cyclists, their rate seems to be no different in my experience."
Dr. Aaron Katz is chairman of urology at NYU Winthrop Hospital in Mineola, N.Y. He said the findings were a little surprising, "because as a urologist who's been in the field for many years, we've had this notion that prolonged cycling can have an effect on sexual function.
"But those studies were older and didn't use a [similar] cross-sectional analysis," Katz added. "I was really happy to see this study. I think it will allow men who are cycling to continue and not be so worried about it."
The study is published in the March issue of The Journal of Urology.More information
The American Sexual Health Association offers more on men's sexual health.
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