Cycling and Erectile Function: Saddle Pressure, Numbness, and What Helps

Cycling is good for the heart and blood vessels, and the blood vessels of the penis benefit along with the rest. It also puts body weight on a small area between the legs, directly over the nerves and arteries that serve the penis. Which effect dominates depends on how a man rides.

The anatomy under the saddle

The perineum is the area between the scrotum and the anus. The pudendal nerve and pudendal artery run through it on each side. The nerve carries sensation from the penis and part of the signal for erection. The artery supplies much of the blood that fills the erectile tissue.

Ideally a cyclist's weight rests on the sit bones, the two bony points at the base of the pelvis. A traditional saddle has a narrow nose that sits under the perineum. Leaning forward into a racing position moves more weight onto that nose, and onto the nerve and artery beneath it.

Research by the US National Institute for Occupational Safety and Health found that a traditional sport saddle produced more than twice the pressure on the perineum of saddles without a protruding nose.

What the large study found

A 2018 study published in the Journal of Urology compared 2,774 male cyclists with 539 swimmers and 789 runners, using validated questionnaires for erectile and urinary function.

• Cyclists had no worse erectile function than swimmers or runners. High-intensity cyclists had slightly better scores than the others.
• Cyclists were more likely to report a narrowing of the urethra, called a urethral stricture.
• Standing on the pedals for more than 20% of riding time reduced the odds of genital numbness.
• Handlebars set level with or higher than the saddle were associated with less numbness and fewer saddle sores.

The average recreational cyclist in this study was not worse off for erectile function than swimmers or runners. It was a survey of men who were still riding, though, so men who had stopped because of problems would not appear in it.

Numbness is a warning sign

Genital numbness or tingling during or after a ride means the pudendal nerve, and probably the artery beside it, is being compressed. Brief numbness that resolves quickly is common. Numbness that lasts for hours, recurs on every ride, or comes with changes in erections needs attention.

A study of bicycle police officers, who spent an average of 24 hours a week on their bikes, tested a change of saddle. After six months on saddles with no nose, perineal pressure was 66% lower, penile sensation had improved, and scores on an erectile function questionnaire had improved. Measurements of erections during sleep had not changed, which the authors suggested might need a longer recovery period.

What helps

• Saddle choice. Saddles with a cut-out channel, a wider rear, or no nose reduce perineal pressure. The saddle should support the sit bones.
• Saddle angle. A level saddle or one tilted slightly nose-down usually reduces pressure. A nose tilted upward increases it.
• Handlebar height. Setting the bars level with or above the saddle shifts weight back onto the sit bones.
• Standing. Standing on the pedals regularly, particularly on long rides, relieves pressure and restores blood flow.
• Breaks. On long rides, stopping and getting off the bike periodically helps.
• Professional fitting. A bike fit adjusts saddle height, setback and reach together. Poor fit is a common cause of persistent numbness.

Padded shorts improve comfort but do not relieve pressure on their own if the saddle and position are wrong.

When to see a doctor

See a doctor if numbness persists after rides, if erections have changed since you started riding more, or if you notice a weaker urine stream or straining to urinate. The last of these can signal a urethral stricture, which the 2018 study found more often in cyclists.

If you have erectile problems and you cycle, do not assume the bike is responsible. The same vascular risk factors that affect every man still apply, and erectile dysfunction can be an early sign of cardiovascular disease. Our article on erectile dysfunction and cardiovascular risk explains the connection.

For most men, adjust the bike rather than give up cycling. The cardiovascular benefit of regular riding is large, and poor vascular health is a far more common cause of erectile dysfunction than saddle pressure.

Related reading

• The Link Between Erectile Dysfunction and Cardiovascular Risk
• Pelvic Floor Training for Venous Leak: What the Trials Show and How to Do It
• Smoking, Vaping, and Erectile Function: What the Dose-Response Evidence Shows

References

• Awad MA, et al. Cycling and male sexual and urinary function: results from a large, multinational, cross-sectional study. Journal of Urology. 2018;199(3). https://doi.org/10.1016/j.juro.2017.10.017
• Schrader SM, Breitenstein MJ, Lowe BD. Cutting off the nose to save the penis. Journal of Sexual Medicine. 2008;5(8):1932-1940. https://pubmed.ncbi.nlm.nih.gov/18466268/
• National Institute for Occupational Safety and Health. Using no-nose bicycle saddles to prevent genital numbness and sexual dysfunction. NIOSH Science Blog. https://blogs.cdc.gov/niosh-science-blog/2009/04/22/bicycle

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