There are many cause of impotence or ED but one of the most common in younger men is bike riding. This blog will discuss the relationship of bike riding to ED and what can be done to prevent problems with bikers erections.
Bicycle seat neuropathy is one of the more common injuries reported by cyclists. The injuries and symptoms are due to the cyclist supporting his or her body weight on a narrow seat, and they are believed to be related to either vascular and\or neurologic injury to the pudendal nerve.
A wide frequency range has been reported for bicycle seat neuropathy, but it is believed to be underreported.
A study of cyclists who ride for long period of time noted that 22% reported symptoms of either numbness or pain in the pudendal area. 21% reported penile numbness, with 6% cyclists reporting symptoms that lasted longer than 1 week. In addition, 13% reported symptoms of impotence, some men having experienced symptoms for longer than 1 week, and a smaller number reported impotence lasting longer than 1 month.
The cause of bicycle seat neuropathy has been attributed to several different events. One study hypothesized that compression of the pudendal nerve as it passes through the Alcock canal causes the condition. The Alcock canal is enclosed laterally by the ischial bone and medially by the fascial layer of the obturator internus muscle. The pudendal nerve exits the canal ventrally, below the symphysis pubis, and innervates the penis and perineal regions.
Long-distance cycling results in the indirect transmission of pressure onto the perineal nerve within the Alcock canal. Bicycle seat neuropathy is due to temporary and transient injury to the dorsal branch of the pudendal nerve secondary to compression of the nerve between the bicycle seat and the symphysis pubis.
Bicycle seat design (eg, shape) may be the major extrinsic factor for the development of bicycle seat neuropathy. Results of computer modeling showed that wider bicycle seats that support the ischial tuberosities or sit bones decrease pressure on the perineal area. Other studies have also demonstrated the effect bicycle seat design has on penile blood flow.
A recreational or elite cyclist who complains of numbness or impotence after cycling is the typical presentation of bicycle seat neuropathy. The amount of time the athlete spent cycling before the onset of symptoms is variable; however, studies have focused upon longer distance, multiday rides. Use of a stationary bicycle has also been reported as a cause of bicycle seat neuropathy.
Medical issues and complications include continued injury or insult to the area, resulting in continuation of the neuropathy and long-term sequelae such as impotence. Reevaluate the patient after making changes to the bicycle or riding style or after decreasing the training volume to ensure that improvement in symptoms is occurring. Continued symptoms despite changes in the bicycle seat position and training volume may indicate a different source of the symptoms and should warrant reevaluation by the physician.
The mainstay of treatment of bicycle seat neuropathy is the adjustment of the bike seat and bike position, such as tilting the nose of the seat down or lowering the seat height to relieve pressure off the perineum. Other recommendations include having the rider change the style of riding (eg, change positions more frequently or stop riding more frequently).
Newer bicycle seats with a split nose or a center cutout may also help to reduce the prevalence of neuropathy by limiting compression on the perineal area (see below). Some of the newer seats reduced perineal pressure by approximately 50%.
Bottom Line: Bike riding is a very popular form of exercise and recreation. However, long rides can affect a man’s potency and increase the risk of ED. I suggest that if you experience numbness after a long bike ride that you check your seat and speak to someone at the bike shop about a new seat that takes the pressure off of your sit bones so there is less compression of your nerves and blood supply to the penis.