The surprising links between cycling and the prostate

There has been a lot of talk lately about the higher incidence of prostate cancer, erectile dysfunction and enlarged prostate among cyclists, which makes you wonder whether cycling really causes health risks in men.

Men's Health

Sonia Chartier

02 May 2016

If you ask me, your sofa is probably a lot more dangerous! While you’ll need to take a few precautions, cycling is still good for you!


So what is it that makes cycling so controversial?

For men who ride their bikes occasionally, there really is no problem. For those who cycle more than eight hours a week, a traditional saddle can cause pain in the perineum, put pressure on the pudendal nerve and possibly on the prostate. The pudendal nerve passes through the perineum, the spot between the base of the penis and the anus. Prolonged compression of the nerve by the saddle can cause the scrotum to swell and cause erectile problems lasting up to a few hours after the ride.

Eventually, repeated friction of the perineum on the saddle can lead to the formation of a “third testicle,” which is actually a (sometimes painful) fibrous cyst, a condition that requires medical attention. Other conditions such as a damaged urethra, perineal contusion or a congested prostate may also cause discomfort. Men already suffering from an enlarged prostate or erection problems should avoid putting undue pressure on the area.

In any case, the “damage” is temporary and reversible and is caused by a bicycle saddle whose shape is not compatible with the cyclist’s body. The following precautions can help you avoid a range of problems:

  • A slotted saddle with a downwardly curved nose will reduce pressure on the perineum and pudendal nerve while avoiding compression of the urogenital area.
  • Wearing padded cycling shorts will improve comfort.
  • Don’t tilt the saddle upward so as to avoid putting additional pressure on the perineum.
  • Adjust the height of the saddle so that your legs come just short of extending completely when the pedal is at the lowest point.
  • Raise the handlebars to keep your torso in a more upright position.
  • To minimize the risk of injuring yourself when you fall or when the chain jumps off the chainring, make sure your bike frame is sized to leave at least 5 cm of space between the cross bar and your crotch.
  • Wear a helmet! No, this has nothing to do with your prostate, but if your brain is damaged, who cares about the prostate, right?

In addition to “mechanical” problems, what about the risk of prostate cancer? Intensive cycling has been linked to a higher level of prostate-specific antigen (PSA), which can signal the presence of cancer. However, the presence of PSA may also be explained by the prostate’s being irritated or slightly inflamed as a result of friction against the saddle. Before going for a prostate exam, avoid cycling so as not to skew the results. The seemingly higher incidence of prostate cancer in die-hard cyclists might simply owe to the fact that cyclists are more aware of their health and visit the doctor more often, so any conditions they have are more likely to be diagnosed.

The benefits of cycling far outweigh the potential problems caused by a poorly adjusted bike. Cycling or practicing any sport for more than five hours a week reduces the risk of an enlarged prostate by 30–50% compared with those who exercise less than two hours a week. Men whose jobs are physically demanding, such as farmers and construction workers, have a 30–40% lower risk of suffering from an enlarged prostate than those with desk jobs.

Your sofa is a much greater cause for concern

Men who spend a lot of time watching TV or playing video games (around five hours a day) have twice the risk of an enlarged prostate than those who spend less than five hours a week doing so. What’s even more alarming is that if you spend a lot of time on the couch, your risks go up regardless of the amount of time you practice sports.3

Your best bet is to go for a bike ride or find a pastime that’s more active than watching TV! Your family surely has a number of ideas for things you can do that are good for your prostate. Even renovating the basement can be good for you!

References – Your bike seat and your health

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