In September 1997, Ed Pavelka, a columnist with Bicycling magazine, made a startling revelation: He had erectile dysfunction from riding his bike. He wrote at the time: "...tests revealed that the blood flow to my penis had become so restricted that I was incapable of an erection firm enough for sexual intercourse."
Pavelka's conviction that biking had led to his problem was soon backed up by medical authority. Irwin Goldstein, MD, a specialist of erectile dysfunction with the Boston University Medical Center, was widely quoted in the press saying that all male cyclists risked erectile dysfunction, and that they should consider giving up the sport if they enjoyed sex.
Alarmist Advice or Scientific Proof?
Goldstein, whose patients included a number of cyclists with sexual dysfunction, performed a study at Boston University Medical Center to investigate the connection. His 1997 study showed that cyclists experienced more sexual dysfunction than athletes who didn't bike. Cyclists' complaints included erectile dysfunction, groin and penile numbness, and problems urinating.
But what was it about cycling that led particularly to erectile dysfunction? Goldstein's study hadn't uncovered a cause, but another study done at the University of California, San Diego, offered an explanation. The study -- done in conjunction with Serfas, a bicycle accessory company in Lake Forest, Calif. -- found that the rub lies not in cycling itself but in the seats.
"Men can develop erectile dysfunction after sitting on a hard bicycle seat for many hours because they compress an area of the anatomy known as the perineum," explains Ken Taylor, MD, a former assistant clinical professor of family medicine at UCSD and a co-researcher in the 1999 cycling-impotence study. The perineum is the area between the anus and the scrotum.
Tim Roddy, M.D., a urologist in Edmonds, Wash., agrees that the pressure of sitting on a bike seat can cause the problem: "A man can squeeze off some of the vital arteries and nerves necessary for normal sexual functioning by sitting on a hard bicycle seat too long," he says.
If the Seat Fits
Serfas, a manufacturer of biking accessories, set out to design a seat that would shift the rider's weight off the perineum. The result, called "the Eliminator," has a long groove down its middle and is hollowed out in front. In April 1999, researchers tested the newly designed seat on 15 regular cyclists, most of whom pedaled between 150 and 300 miles weekly.
The results? Though 80% of those using a conventional seat suffered numbness, only 14% of those using the new seat did. Serfas now offers several seat models for street and mountain bikes.
More Studies, More Seats
Specialized Bicycle Components, Inc., of Morgan Hill, Calif., also offers seats designed to help men ride safely. Medical designer Roger Minkow, MD, helped develop the Body Geometry Saddle seat with input from urologists and police bicycle divisions. The Specialized seat is very narrow and has a V-shaped wedge cut from the rear.
To test the seat, the firm consulted with Robert Kessler, MD, professor of urology at Stanford University Medical Center in Palo Alto, Calif. In March 1999, Kessler recruited 25 cyclists. Each one regularly rode at least six hours weekly, and all had suffered from perineal pain, numbness, and erectile dysfunction. The cyclists used the new seat for a month and then shared their results.
"Fourteen had complete relief, nine had almost complete relief of their symptoms, one had partial relief, and one indicated no change," says Kessler. Kessler presented his findings at the 1999 annual meeting of the American Urological Association.
Diamondback and Avocet Inc. also manufacture seats designed not to compress the perineum.
A Little Padding Helps, Too
A study presented at the same AUA meeting found that unpadded seats reduce penile blood flow more than padded seats. The width of the padded seats wasn't a factor.
"Of course, not every bicycle rider develops erectile dysfunction, just as not every smoker develops lung cancer," says Taylor. "But a standard seat is a risk factor."
Other risks, according to Taylor, include being overweight, having wider than average hips, and leaning forward over the handlebars while riding -- all of which put extra pressure on the perineum.