Cycling in the hot seat
With bikes linked to impotence in some men, manufacturers created saddles to prevent it. But do they work?
STREAMLINED: Many of the new saddles, such as the Prologo, feature cutouts meant to ease pressure on the nerves.
(Seats courtesy of I. Martin Bicycles
Ten years later, more than two dozen published studies, including several by Goldstein, have confirmed the connection between cycling and sexual dysfunction. Problems can range from impotence -- the complete inability to penetrate -- to an erection that doesn't last as long as desired.
Bike companies have responded by developing new saddle designs, and riders have bought millions of these ergonomic seats in the last 10 years. But whether they will help a rider's sex life is a matter of contention.
Some medical and occupational health researchers say they don't prevent erectile dysfunction, that the modifications don't necessarily ensure adequate blood flow to the penis. They advocate a more radical seat design that some cyclists say is dangerous.
One man in Northern California, looking for more comfort, began using an ergonomic bike saddle last fall. The seat, with a protruding nose, was advertised as "helpful in reducing the risk of cycling-associated genital numbness and sexual dysfunction." But after using the saddle for a few months, the 52-year-old began having trouble maintaining an erection. His doctor advised him to give up the bike. He didn't -- and suffered the consequences. "After a time it didn't work at all," says the man who requested anonymity.
Comfort can be a misleading guide. Some cyclists opt for a big, soft-gel seat. But that can be the worst choice for circulation, some experts say. Riders on large gel seats sink in, and the gel tends to bunch up under the tender bits, cutting off blood flow.
Women can also be affected. A study of 48 young women competitive cyclists and 22 women runners published last year in the Journal of Sexual Medicine found that the cyclists had decreased genital sensation compared with the runners, but that this didn't have any negative effects on their sexual function. Another study found that female competitive cyclists who spent a lot of time on their bicycles had swelling and damage to the lymphatic vessels in the vulva.
"This whole saddle thing is very tricky for the bike industry," says Matt Phillips, test director for Bicycling and Mountain Bike magazines. "We want people to be healthy and comfortable while riding, but we don't want to scare people away from riding."
A small percentage
Not all male riders, or even the majority of male bicyclists, are likely to experience erectile dysfunction, as Goldstein seemed to suggest in 1997. Then a professor at the Boston University School of Medicine, where he headed the Institute for Sexual Medicine, he notably commented: "Riding should be banned and outlawed."
A study presented to the American Urological Assn. in 1997 found that 4.2% of cyclists had moderate to complete ED, compared with 1.1% of runners. That study compared 738 male riders from a Boston cycling club with an age-matched control group of runners.
A second study, presented to the association the following year comparing cyclists and swimmers, found that 4% of cyclists had ED compared with 2% of swimmers. Older bicyclists and those riding long distances tend to have an increased risk.
And yet another study, published in the International Journal of Impotence Research in 2001, found that men who rode for less than three hours a week decreased their risk of ED, compared with noncyclists, possibly because of the benefits to the cardiovascular system. But the same research found that cycling more than three hours a week nearly doubled the risk of ED, compared with noncyclists. To this day, Goldstein says bicycles should come with a warning label, similar to those on cigarette packs, that cycling may cause impotence.
Recreational cyclists aren't the only riders to experience problems.
In 2000, a group of bicycle patrol officers in Long Beach, suspecting that bike-riding was causing sexual problems, contacted Steven Schrader, a reproductive health expert at the National Institute for Occupational Safety and Health in Cincinnati. Schrader studied the bike cops and reported in the Journal of Andrology in 2002 that although none of the men were impotent, they had decreased erectile quality and genital numbness compared with nonbiking officers.
As with many other cyclists' seats, the nose of the officers' bike saddles exerted excessive pressure on the perineum, the region between the anus and the external genitals, "a place that was never designed to support a person's weight," Schrader wrote. Such pressure is widely believed to be the source of some cyclists' erectile problems, damaging the arteries that supply blood to the penis and the nerves that connect to the penis.
Although erectile dysfunction can go away if cyclists stop riding, it can also be permanent. Treatments include sex therapy, hormones, drug injections in the penis, vacuum devices and drugs such as Viagra and Levitra. Goldstein, as a last resort, will recommend bypass surgery to restore blood flow, but the procedure is considered experimental by some urologists.
Doctors agree that prevention is better than any of the treatment options. Schrader, for example, suggested that the officers use a bike saddle that did not have a protruding nose.