Uneasy Riders
For years, the Palos Verdes professor was bicycling’s version of the hard-working weekend warrior, venturing out Sunday mornings for a huff-and-puff along the coast and a first-hand look at the spectacular scenery right there beyond his own backyard.
Still, with each 30-mile ride came the nagging tingle and numbness in his groin--troubling symptoms he rationalized away as the devil’s due for a middle-aged man pedaling hard to stay in shape.
Soon, however, his problems moved from the bicycle to the bedroom. After his wife made gentle comments about his performance, the 59-year-old finally confronted a no-win choice: sex or cycling.
“I was fairly depressed about the whole thing,” said the veteran educator, who asked that his name not be used. “I thought, ‘Here I am, trying to stay healthy, and now I have to deal with this little side effect.’ After so many years, bicycling had become an addictive part of my life, and suddenly I was at a point where I had to choose.
“I certainly wasn’t going to give up my sex life, but I also sure hated to give up bicycling.”
He temporarily quit cycling and consulted a specialist. A year later, with new biking equipment and regular doses of Viagra, he’s back at both pastimes with gusto.
The professor is one of a growing number of enthusiasts to experience a medical condition that for years has been secreted away in the closet of the bicycling community--the possibility that riding a bike can cause sexual impotence in men.
Two years ago, noted Boston urologist Irwin Goldstein shook the cycling world with new--and immediately challenged--claims of the sport’s ill-effects. Regular riding placed undue weight on the arteries and nerves that feed the male reproductive system, he said--restricting critical blood vessels and causing possibly permanent damage.
His conclusions were no-nonsense: More than 100,000 American men had been left permanently impotent from cycling, which Goldstein called the most irrational form of exercise. And the phenomenon troubled more than just cycling’s “Tour de France crowd”--the dedicated habitual road rider--but affected mountain bikers, stationary bike riders, even young novices.
The trouble, Goldstein said, wasn’t so much the perilous support bar on men’s bikes as the innocuous seat--especially those narrow racing saddles with the elongated nose that he claims put dangerous pressure where it was never intended.
Furthermore, the doctor said, there were but two types of cyclists--those who were already impotent and those who would eventually become so.
Two years later, Goldstein has given little ground.
“Every single day I sit in a chair and I face people who were made impotent, whose only crime in life is that they rode one of these objects--I won’t dignify them any more than that. They’re men in their 20s and 30s, and their lives have now been made miserable. They say, ‘Doctor, it’s all in my head. I must not love my wife.’ ” Goldstein said.
Not All Doctors Are in Accord With Goldstein
Goldstein’s warnings have been both heralded and dismissed across all corners of the bicycling and medical communities. The bicycle seat industry has invested millions designing and manufacturing ergonomically correct saddles that the companies say solve the problem.
But many doctors question whether that’s necessary.
“I’m unconvinced that bicycling, for the vast majority of men, is an important cause of impotence or erectile dysfunction,” said Dr. Harin Padma-Nathan, director of the Male Clinic in Beverly Hills.
“Will biking cause impotence for the average cyclist, and does that risk outweigh the sport’s cardiovascular benefits?” he asked. “I think the answer is no on both counts.”
Nevertheless, some dealers say the issue has already driven newcomers from the sport and has caused advocates to think twice about their pedaling pursuits. “People are beginning to avoid the sport--they’re saying, ‘Gee, maybe I should try golf or bowling instead,’ ” said Alan Goldsmith, owner of Supergo Bike stores of Santa Monica and Fountain Valley, which are among the largest cycling retailers in California.
The impotence scare--coming at a time of declining bike sales-- has hit hardest in California, the sport’s unchallenged economic center and cultural soul, insiders say.
An estimated 20% of the 50 million adult bicyclists nationwide live in California--where the warm climate allows year-round cycling and the challenging terrain draws riders ranging from beginners to professionals training for worldwide events.
“There’s no doubt that that California market is the most important part of the entire cycling industry,” said Ted Costantino, editor of VeloBusiness, an industry trade magazine.
“With any trend--even negative ones like the male impotence thing--it’s felt first, and hits hardest, in California.”
A Petaluma Doctor Sought a Solution
Like so many others, Dr. Roger Minkow saw the August 1997 issue of Bicycling magazine detailing the connection between cycling and impotence.
But the 52-year-old Petaluma cyclist did something about it.
The doctor and product designer began drawing up plans for a new type of bicycle seat that would relieve the pressure on nerves and blood vessels during extended rides.
His finished product, called the Minkow Wedge, is a Y-shaped saddle with the rear portion removed to reduce pressure on critical arteries.
“The solution, ergonomically, wasn’t that complicated,” said Minkow, who also designed a seat for airline pilots to relieve back pressure on long flights. “You just cut out the part of the seat that presses on the troubled area.”
Minkow’s seat is among a host of new products designed to offer protection to male cyclists. There are gel-filled seats and seats with cutout holes, odd geriatric-looking saddles with support bars that run perpendicular to the bike, and protective biking shorts.
The rush of new products is part of an entire new market in the industry--ergonomic equipment. “At first I thought the impotence thing was overrated, but I’m seeing the positive fallout,” said Geoff Drake, editor of Santa Cruz-based Bicycling magazine. “Now it’s incumbent on every saddle-maker to consider the human anatomy when designing their product.”
Dealers say discomfort in men or women can be corrected not only by changing seats, but also lowering the saddle, tilting it slightly downward and moving it forward on the bike.
But Padma-Nathan of the Male Clinic says the reactions are “way overblown.”
“It’s a knee-jerk reaction by an industry . . . and its solution has been these so-called ergonomic seats,” he said.
A Correlation Noted in Studies Since ’74
Goldstein’s studies are not the first look at the connection between cycling and impotence. Since 1974, numerous case reports and small published studies worldwide have suggested a relationship between bicycle seats and restricted blood flow to male sexual organs.
But once Goldstein--a nationally recognized authority on male impotence--began making such dire predictions, people began to take notice, Minkow said.
“As a result, most people have come to the conclusion that there is a problem,” Minkow said. “But most physicians believe the trouble is mostly pain and numbness and, to some small degree, impotence.”
“Goldstein has gone in the other direction, saying all these tens of thousands of men are already impotent. Those high numbers of impotent men--that’s where the controversy lies.”
Minkow and Stanford University urologist Robert Kessler recently studied 25 men--ages 27 to 62--who suffer from bicycle-related medical problems. Of those men, nine complained of erectile dysfunction that lasted anywhere from one month to more than a year.
The male sexual plumbing--the nerves and blood vessels that feed the penis--is funneled through the perineum, the area that lies between the sit bones, doctors say.
While a cyclist is riding a bike, his weight is focused between these pelvic bones. When pressed against the bone, the arteries are compressed, cutting blood flow, resulting in the tell-tale tingling and numbness.
Over time--like a straw repeatedly flattened that eventually fails to return to its circular shape--the blood vessels can become scarred and disfigured, resulting in reduced blood flow to the penis. The result is often an inability to achieve or maintain an erection.
Doctors say the pressure on critical arteries can also affect women, temporarily leaving them with reduced sensation.
While Kessler disagrees with Goldstein’s estimate of the number of U.S. men suffering from bicycling-induced impotence, he acknowledged that a small percentage of cyclists do progress to full-blown erectile dysfunction.
For the rest, it’s more of a minor discomfort.
“As many as 20% of men who ride more than six hours a week suffer some numbness--and some doctors predict as many as 50%,” Kessler said. “The problem occurs not only after greater number of hours ridden weekly, but also after longer single rides.”
Yet Padma-Nathan says occasional numbness is not necessarily a precursor to impotence.
“When a cyclist has numbness, it means there is pressure on the nerves, not necessarily the arteries, but both travel in the same pathways,” he said. “Usually, it’s just a message that you need more padding on your seat.”
Padma-Nathan found that cycling was the cause of erectile dysfunction in only five of 100 patients he examined. In the rest, impotence is caused by emotional or other physical factors, he said.
“Is biking and impotence a major problem?” he asked. “Only time will tell.”
He Believed Numbness Was Par for the Course
At age 55, San Francisco television producer John Motroni thought his chronic genital numbness was just another hellish hazard of the road.
“I thought, ‘This is what happens when you ride a bike 100 miles a week’--your Achilles’ heel throbs and your shoulders hurt--I figured it all just came with the territory.”
Like many riders, Motroni never broached the subject with cycling friends and only learned numbness was common among riders from articles in the cycling magazines.
Drake, the Bicycling magazine editor, says numbness complaints for years went unspoken among cyclists. “The problem hasn’t been traditionally talked about,” he said. “But now everyone’s admitting to the sensation.”
A new candor among cyclists, riders say, is good for the sport.
“We know now numbness is not good,” Drake said. “You just don’t want to cut off blood supply to any piece of your anatomy. That’s a bad idea.”
Goldstein, the Boston urologist, plans to continue his campaign to alert cyclists that their beloved sport could be hurting them.
He plans to publish the results of several recently completed studies linking bicycling and impotence--studies he says have already been presented at international conferences.
One review of 100 impotent men showed that men riding on a bicycle seat experienced only 5% or 10% of the normal levels of blood flow to the penis than men who were lying flat. Another study shows that four times as many people who ride bikes have self-reported complaints of impotence as compared with runners. With a new seat, Motroni’s groin tingling is history. But he’s not still sure his symptoms were worth all the uproar.
“Is this impotence scare for real? Or have all these new precautions been a cure in search of a disease, created in the imaginations of people who read something in a magazine?” he asked.
“I think it’s somewhere in between. Some cyclists have real symptoms, but others, I think it’s just in their mind.”
