Cycling and erectile dysfunction
AbstractAbstract: For many years medical studies have implicated bicycle riding is causing erectile dysfunction (ED) in association with higher perineal pressure. This review focuses upon epidemiological studies assesing the impact of cycling on ED, pathogenesis of ED in cyclists as well as on research considering changes of perineal pressure, hemodynamics, and nerve conduction when cycling. Investigestors were also interested in different saddle sizes, materials and geometry and also in the impact of saddle and riders position on changes to the perineum. Research on female cyclists is very limited but indicates similar genitourinary disorders as in male cyclists. We also review research on preventative and therapeutic options regarding bicycle riding and ED.
Kiilavouri K, Näveri H, Salmi T,Härkönen M. The effect of physical training on sceletal muscle in patients with chronic heart failure. Eur J Heart Fail 2000;2:53-63.
Sundquist K, Qvist J, Sundquist J, Johansson SE. Frequent and occasional physical activity in the elderly: A 12-year follow-up study of mortality. Am J Prev Med 2004;27:22–7.
Lehmann R, Kaplan V, Bingisser R, Bloch KE, Spinas GA. Impact of physical activity on cardiovascular risk factors in IDDM. Diabetes Care 1997;20:1603–11.
Kronisch RL, Pfeiffer RP. Mountain biking injuries: An update. Sports Med 2002;32:523–37.
Pinnock CB, Stapleton AM, Marshall VR. Erectile dysfunction in the community: a prevalence study. Med J Aust. 1999 Oct 4;171(7):353-7.
Wijesinha S, Piterman L, Kirby CN. The male reproductive system - An overview of common problems. Aust Fam Physician. 2013 May;42(5):276-8.
Kubin M, Wagner G, Fugl-Meyer AR. Epidemiology of erectile dysfunction. Int J Impot Res.2003;15:63–71.
Prins J, Blanker MH, Bohnen AM, Thomas S, Bosch JL. Prevalence of erectile dysfunction: a systematic review of population-based studies. Int J Impot Res. 2002;14(6):422–432.
Mock K. Epidemiology and age-related risk factors of erectile dysfunction. Wien Med Wochenschr. 2000;150(1-2):2-3.
Hippocrates. Airs waters places. In: Hippocrates. [English Translation, WHS Jones]. Ch. XXI–XXII, Vol. I. London: William Heinemann; 1923:125–31. Dosegljivo 3. 8. 2013 s spletne strani: http://classics.mit.edu/Hippocrates/airwatpl.mb.txt
Andersen KV, Bovim G. Impotence and nerve entrapment in long distance amateur cyclists. Acta Neurol Scand 1997;95:233–40.
Huang V, Munarriz R, Goldstein I. Bicycle riding and erectile dysfunction: An increase in interest (and concern). J Sex Med 2005;2:596–604.
Sommer F, König D, Graft C, Schwarzer U, Bertram C, Klotz T, Engelmann U. Impotence and genital numbness in cyclists. Int J Sports Med 2001;22:410–3.
Dettori JR, Koepsell TD, Cummings P, Corman JM. Erectile dysfunction after a long-distance cycling event: Associations with bicycle characteristics. J Urol 2004;172:637–41.
Marceau L, Kleinman K, Goldstein I, McKinlay J. Does bicycling contribute to the risk of erectile dysfunction? Results from the Massachusetts Male Aging Study (MMAS). Int J Impot Res 2001;13:298–302.
Sommer F, Goldstein I, Korda JB. Bicycle riding and erectile dysfunction: a review. J Sex Med. 2010;7:2346–2358.
Leibovitch I, Mor Y. The vicious cycling: Bicycling related urogenital disorders. Eur Urol 2005;47:277–86.
Mackinnon SE. Pathophysiology of nerve compression. Hand Clin 2002;18:231–41.
Nanka O, Sedy J, Jarolim L. Sulcus nervi dorsalis penis: Site of origin of Alcock’s syndrome in bicycle riders? Med Hypotheses 2007;69:1040–5.
Goldstein I. Erectile Dysfunction and Bicycling. Center for Sexual Medicine, Boston University School of Medicine; 2003. Dosegljivo 29. 4. 2014 s spletne strani: http://www.bumc.bu.edu/sexualmedicine/publications/erectile-dysfunction-and-bicycling/
Munarriz RM, Yan QR, ZNehra A, Udelson D, Goldstein I. Blunt trauma: the pathophysiology of hemodynamic injury leading to erectile dysfunction. J Urol. 1995 Jun;153(6):1831-40.
Nehra A, Goldstein I, Pabby A, Nugent M, Huang YH, de las Morenas A, et al. Mechanisms of venous leakage: a prospective clinicopathological correlation of corporeal function and structure. J Urol. 1996 Oct;156(4):1320-9.
Nayal W, Schwarzer U, Klotz T, Heidenreich A, Engelmann U. Transcutaneous penile oxygen pressure during bicycling. BJU Int 1999;83:623–5.
Schrader SM, Breitenstein MJ, Clark JC, Lowe BD, Turner TW. Nocturnal penile tumescence and rigidity testing in bicycling patrol officers. J Androl 2002;23:927–34.
Schrader SM, Breitenstein MJ, Lowe BD. Cutting off the nose to save the penis. J Sex Med 2008;5:1932–40.
Potter JJ, Sauer JL, Weisshaar CL, Thelen DG, Ploeg HL. Gender differences in bicycle saddle pressure distribution during seated cycling. Med Sci Sports Exerc 2008;40:1126–34.
Schwarzer U, Sommer F, Klotz T, Cremer C, Engelmann U. Cycling and penile oxygen pressure: The type of saddle matters. Eur Urol 2002;41:139–43.
Sommer F. Type of saddle and sitting position influence penile oxygen pressure while cycling. Cologne, March 2003. Dosegljivo 27. 10. 2013 s spletne strani: http://www.yumpu.com/en/document/view/3337876/type-of-saddle-and-sitting-position-influence-penile-selle-royal
Jeong SJ, Park K, Moon JD, Ryu SB. Bicycle saddle shape affects penile blood flow. Int J Impot Res 2002;14:513–7.
Munarriz R, Huang V, Uberoi J, Maitland S, Payton T, Goldstein I. Only the nose knows. Penile hemodynamic study of the perineum-saddle interface utilizing saddle/seats with and without nose extensions. J Sex Med 2005;2:612–9.
Lowe BD, Schrader SM, Breitenstein MJ. Effect of bicycle saddle designs on the pressure to the perineum of the bicyclist. Med Sci Sports Exerc 2004;36:1055–62.
Spears IR, Cummins NK, Brenchley Z, Donohue C, Turnbull C, Burton S, et al. The effects of saddle design on stresses in the perineum during cycling. Med Sci Sports Exerc 2003;35:1620–5.
Gemery JM, Nangia AK, Mamourian AC, Reid SK. Digital three-dimensional modelling of the male pelvis and bicycle seats: Impact of rider position and seat design on potential penile hypoxia and erectile dysfunction. BJU Int 2007;99:135–40.
Taylor KS, Richburg A, Wallis D, Bracker M. Using an experimental bicycle seat to reduce perineal numbness. Phys Sportsmed 2002;30:27–30,32,34.
Bressel E, Bliss S, Cronin J. A field-based approach for examining bicycle seat design effects on seat pressure and perceived stability. Appl Ergon 2009;40:472–6.
Guess MK, Connell K, Schrader S, Reutman S, Wang A, LaCombe J, et al. Genital sensation and sexual function in women bicyclists and runners: Are your feet safer than your seat? J Sex Med 2006;3:1018–27.
Battaglia C, Nappi RE, Mancini F, Cianciosi A, Persico N, Busacchi P. Ultrasonographic and Doppler findings of subclinical clitoral microtraumatisms in mountain bikers and horseback riders. J Sex Med 2009;6:464–8.
Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. No-nose saddles for preventing genital numbness and sexual dysfunction from occupational bicycling. Doseglijvo 3. 8. 2013 s spletne strani: http://www.cdc.gov/niosh/docs/wp-solutions/2009-131/pdfs/2009-131.pdf
Sommer F, Schwarzer U, Klotz T, Caspers HP, Haupt G, Engelmann U. Erectile dysfunction in cyclists. Is there any difference in penile blood flow during cycling in an upright versus a reclining position? Eur Urol 2001;39:720–3.
Hutson M., Speed C (eds). Sports Injuries. Oxford: Oxford University Press; 2011.
Longman J. New suspect in sports doping is, no joke, viagra. The New York Times 2008; November 22:A1
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.