Introduction

Cycling provides many health benefits. Previously, concerns have been raised about cycling's impact on sexual and urinary health due to prolonged perineal pressure. We conducted an international survey of male athletes to determine the impact of cycling on urinary and sexual health.

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 about their physical activity and answered validated questionnaires including: The Sexual Health Inventory for Men (SHIM), International Prostate Symptom Score (I-PSS), and the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI). High intensity cycling was defined as cycling for more than 2 years, more than 3 times/week, and a daily average of more than 25 miles.

Results

Of the 5,851 respondents, 3,919 (67%) completed the survey. Of these, we included cyclists who do not regularly swim or run 1,642 (63%), and swimmers or runners who do not regularly cycle 975 (37%). After adjusting for age, body mass index, hypertension, diabetes, ischemic heart disease and tobacco use, cyclists had a higher mean SHIM score (20.1 vs 18.9) p<0.01, compared to non-cyclists. There were no statistically significant differences in I-PSS or NIH-CPSI scores between the two groups. High intensity cyclists had a significantly higher mean SHIM score compared to lower intensity cyclists (20.6 vs 19.5) p<0.01, but no significant differences were found in I-PSS and NIH-CPSI scores. After adjusting for age, cyclists had significantly higher odds of perineal numbness compared to non-cyclists, odds ratio=10.6 (95% confidence interval 8.3-13.7). Bike seat type had no significant effect in any of the above mentioned results.

Conclusions

Contrary to prior studies suggesting that cycling may cause ED, our study shows that cyclists have no worse erectile function than non-cyclists. We also showed that cycling does not affect LUTS. Further research is warranted to gain insight into these results, but this study suggests that cardiovascular benefits of exercise may outweigh any theoretical deterrent of cycling.

Funding

none