Back in the Saddle

Posted on by Paul Turek, MD

Autumn has arrived. Majestic colors, windy roads and a nip in the air all make for great cycling. All good, but my reason for getting back on the bicycle is much more practical: I am tired of commuting to work by car. So I parked it and bought a fixie. The question is: will my ride hurt my pride?

Sex and the Cyclist

Yes, there is reason to be concerned about your sex life as a cyclist. When riding, a big chunk of weight and pressure is on the perineum, the indescribable area between the scrotum and anus. At the edges of the perineum are the sit bones, and inside of them are the nerves and arteries that feed the penis. Since most bike seats are too narrow to support the sit bones, these thready little vessels and nerves organs receive the brunt of the pressure when you fly by the seat of your pants. And when this happens, my friends, your wood can suffer and, along with it, your mojo and your pride.

What’s a Guy to Do?

Here are some ways to protect your sex life when cycling:

  • Cycling is not a common cause of erectile dysfunction (<5%). It is more likely to be due to heart disease and so bicycling (exercise) likely helps more than hurts erections.
  • Men at risk are those who are riding more than 3 hours weekly or 100 miles, whichever comes first.
  • Competitive cyclists are at higher risk than casual cyclists (more seat time, harder seats, forward sitting position).
  • The earliest warning signs of a developing problem are pelvic numbness or tingling while riding (endearingly termed “numb nuts” in the cycling world).
  • Ways to prevent erectile dysfunction from cycling include:
    • Maintain an upright posture
    • Shift position and stand on the pedals frequently while riding
    • Get a properly fitted bicycle
    • Get a properly fitted bicycle seat (noseless is best but a central cutout helps)
    • Use gel pads instead of foam on the seat
    • Tip the nose of the seat down a couple of degrees
    • Change seats if numbness develops despite thee precautions
    • Use padded bicycle shorts

I respect this problem and will continue to take steps to avoid it, and you should too. Remember, a good cyclist always rises to the occasion.