Introduction

Cycling health benefits are well known; however, concerns have been raised about its effect on the genitourinary tract, due to prolonged perineal pressure. We conducted an international survey of female athletes to determine the impact of cycling on sexual and urinary function.

Methods

Cyclists were recruited to complete a survey through Facebook advertisements and outreach to English speaking sporting clubs across the world. Swimmers and runners were recruited as controls. Participants were queried on their physical activities, sexual function with the Female Sexual Function Inventory (FSFI), urinary symptoms with the International Prostate Symptom Score (I-PSS), history of urinary tract infections (UTI), and perineal numbness. High intensity cycling was defined as cycling for more than 2 years, more than 3 times/week, and with a daily average cycling of more than 25 miles.

Results

Of 4,879 respondents, 2,691 (55%) completed the survey. Of these, we compared cyclists who do not regularly swim or run (658, 39%), and swimmers or runners who do not regularly cycle (1,013, 61%). After adjusting for age, body mass index, history of hypertension, diabetes, ischemic heart disease and/or tobacco use, there were no significant differences between cyclists and non-cyclists in the mean storage and voiding subscores of I-PSS nor the total I-PSS score (6.9 vs 7.4, p=0.12). Cyclists had significantly higher mean total FSFI scores (22.7 vs 21.3, p<0.01) as well as higher mean scores in each FSFI domain, except for satisfaction and pain (Table 1). After adjusting for age, cyclists had higher odds of having a self-reported UTI Odds Ratio (OR) 1.4 (95% 1.1-1.7), and perineal numbness OR 7 (5.3-9.3). High intensity cyclists had no significant differences in the mean I-PSS score (6.8 vs 6.9, p =0.69), nor mean FSFI score (22.9 vs 23.2, p= 0.68) compared to lower intensity cyclists. High intensity cyclists were more likely to develop perineal numbness, OR 1.6 (95% CI 1.3-2), and saddle sores, OR 2.2 (95% CI 1.8-2.8). Bike seat type had no significant effect in any of the above mentioned results.

Conclusions

Contrary to previous literature, we demonstrate that cycling has no appreciable effect on female sexual or urinary function. However; our study suggests that cycling may increase the risk of UTI and perineal numbness.

Funding

none