Cycling and ED: saddle pressure and what studies show

In short: cycling is good exercise, and the question is not whether to ride but whether long hours on a saddle can affect erections. The research gives two kinds of answer. Lab experiments show that sitting on a saddle presses on the area behind the scrotum and cuts blood oxygen in the penis while seated. Studies of real riders disagree about whether that adds up to more erectile dysfunction (ED). This page sets out what each kind of study measured, what it found, and where it falls short.

Can cycling affect erections?

Possibly, for some riders, but the evidence is not settled. A 2021 meta-analysis in Sexual Medicine Reviews pooled 6 studies with 3,330 cyclists and 1,524 non-cyclists that used a validated ED questionnaire. With no adjustment, there was no significant difference in the odds of ED. After adjusting for age and other health conditions, cyclists had about twice the odds of ED (odds ratio 2.00, 95% confidence interval 1.57 to 2.55), and the authors concluded that “limited evidence” supports a link (Gan et al., Sex Med Rev 2021). A large multinational survey, published in The Journal of Urology in 2018, found that cyclists “had no worse sexual or urinary functions than swimmers or runners” (Awad et al., J Urol 2018).

Why would a bike saddle matter?

Sitting on a saddle compresses the perineum, the area behind the scrotum, and the arteries that run through it. A 2010 review in The Journal of Sexual Medicine concluded that this compression is linked to problems in the blood vessels, their lining and the nerves of the area, and to the development of ED (Sommer et al., J Sex Med 2010). Erections depend on blood flow and on nerve signals, which our guide to nerve conditions and ED explains in more detail. The same review called for more research into the underlying mechanisms and into safer saddle design (Sommer et al., 2010).

What did saddle-pressure studies measure?

Mostly short-term blood oxygen in the penis, measured with a skin sensor while men sat or pedaled on a stationary bike. In a 2001 crossover study of 46 healthy men, the average reading fell from 60.5 mmHg standing to 17.9 mmHg once seated upright on the saddle, then returned to normal after 10 minutes of standing. Riding in a reclining (recumbent) position, in which no perineal compression was seen, left the reading close to the starting level (Sommer et al., Eur Urol 2001).

A 2002 study of 20 healthy young men compared four saddles. Oxygen readings dropped by 82.4% on a narrow, heavily padded saddle, 72.4% on a narrow saddle with a groove in the nose, 63.6% on a wide unpadded leather saddle, and 20.3% on a wide saddle with no nose. The authors concluded that saddle width mattered more than the amount of padding (Schwarzer et al., Eur Urol 2002). These experiments show what happens while seated. They do not, on their own, show lasting harm to erections.

What did studies of riders find?

The rider studies point in different directions. The Massachusetts Male Aging Study, which used a random sample of men and adjusted for age, smoking, depression, chronic illness and overall activity, found that cycling less than 3 hours a week was not linked to ED and “may be somewhat protective,” while 3 hours or more “may be associated with ED” (Marceau et al., Int J Impot Res 2001). In a 2004 study of 463 riders with no ED before a long-distance event, 4.2% reported ED 1 week later and 1.8% at 1 month. Riding a mountain bike rather than a road bike, and perineal numbness during the ride, were linked to higher risk (Dettori et al., J Urol 2004).

A study of bicycle police officers, who ride for many hours at work, found less time with an erection during sleep. In this 2002 study by the National Institute for Occupational Safety and Health (NIOSH), 17 officers who rode an average of 5.4 hours a day had an erection recorded during 27.1% of their sleep time, compared with 42.8% in 5 men who did not ride. More hours a day and more days a week of riding went with lower figures. Other erection measures were also lower in the riders, but those differences were not statistically significant (Schrader et al., J Androl 2002). That study was small, and the comparison group had only 5 men.

Why do the cycling studies disagree?

Mostly because they asked different men different questions. The 2021 meta-analysis found that the answer changed depending on whether age and health conditions were taken into account, and it flagged differences between studies, suggesting some groups of riders may be more affected than others (Gan et al., 2021). Most rider studies are surveys, which can show that two things go together but cannot show that one caused the other. Even the details conflict: the 2004 event study linked handlebars level with or higher than the saddle to more ED (Dettori et al., 2004), while the 2018 survey linked that same position to less genital numbness (Awad et al., 2018). Our guide on how to read ED evidence explains what odds ratios and survey designs can and cannot tell you.

Is genital numbness after riding a warning sign?

It may be worth paying attention to. In a 2020 survey of 1,635 male cyclists, 57% reported genital numbness and 22% reported ED. Men with penile numbness had higher odds of reporting ED (odds ratio 1.45). Numbness that came on less than an hour into riding was linked to higher odds of ED than numbness that came on after 5 hours, and genital pain within the first hour was also linked to higher ED risk. The authors note that the direction of cause and effect is uncertain (Balasubramanian et al., J Sex Med 2020). The 2004 event study also found that riders with numbness during the ride were more likely to report ED afterwards (Dettori et al., 2004).

What changes did studies look at?

Researchers tested saddle design, riding position and bike type. These are findings from studies, not a personal plan, and a bike fitter or clinician can help with your own setup.

The no-nose saddle study, run by NIOSH with bicycle police officers, found that only 3 of the men went back to a traditional saddle, and the share who reported no genital numbness while riding rose from 27% to 82% (Schrader et al., J Sex Med 2008). A 2021 review of 22 studies concluded that the evidence supports no-nose saddles for reducing the impact of cycling on the perineum, but at the cost of worse stability and more pressure toward the back of the seat, and that a recumbent bike appears to protect the perineum but several concerns limit its wider use (Litwinowicz et al., Sports Med 2021). Saddle cutouts gave mixed results: in the 2004 event study they went with higher ED risk among riders who felt numb, and the reverse among those who did not (Dettori et al., 2004). NIOSH itself said its 2004 stationary-bike saddle study “does not conclusively answer the question” of whether men face a risk of sexual problems from riding a bicycle at work (NIOSH, 2004).

Should I stop cycling?

None of these studies told riders to stop. The 2020 survey authors stressed that cycling for travel and exercise “confers numerous health benefits” (Balasubramanian et al., 2020), and in a UK survey of 6,949 regular cyclists, more cycling went with lower odds of diagnosed high blood pressure (Hollingworth et al., J Hum Hypertens 2015). A 2023 meta-analysis of 11 randomized trials found that aerobic exercise improved erectile function scores on average compared with no exercise (Khera et al., J Sex Med 2023), which our guide to exercise and ED covers. Cycling sits alongside smoking, alcohol and weight in our wider guide to lifestyle and ED.

The bottom line

Sitting on a saddle presses on the area behind the scrotum and lowers penile oxygen while seated, and narrow saddles do this more than wide or no-nose ones. Studies of real riders disagree: a meta-analysis found about twice the odds of ED in cyclists once age and health were accounted for, while a large survey found cyclists no worse off than swimmers or runners. Long weekly riding and genital numbness were each linked to ED in more than one of these studies. Saddle shape and riding position changed saddle pressure or penile oxygen, standing more on the pedals went with less numbness, and cycling itself brings real health benefits.

Sources

Every clinical statement on this page traces to a primary or government source:

• Gan ZS, et al. Systematic Review and Meta-Analysis of Cycling and Erectile Dysfunction (Sex Med Rev, 2021): 6 studies, 3,330 cyclists and 1,524 controls; no unadjusted difference; adjusted odds ratio 2.00 (95% CI 1.57 to 2.55); “limited evidence”; heterogeneity between studies.
• Awad MA, et al. Cycling, and Male Sexual and Urinary Function: Results from a Large, Multinational, Cross-Sectional Study (J Urol, 2018): 3,932 men; cyclists no worse than swimmers or runners; standing more than 20% of the time and handlebar height linked to less numbness.
• Marceau L, et al. Does bicycling contribute to the risk of erectile dysfunction? Results from the Massachusetts Male Aging Study (Int J Impot Res, 2001): under 3 hours a week not linked to ED; 3 hours or more may be associated with ED.
• Dettori JR, et al. Erectile dysfunction after a long-distance cycling event: associations with bicycle characteristics (J Urol, 2004): 463 riders; 4.2% and 1.8% ED at 1 week and 1 month; mountain bike, handlebar height, numbness and cutout findings.
• Balasubramanian A, et al. The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists (J Sex Med, 2020): 1,635 cyclists; 57% numbness, 22% ED; penile numbness odds ratio 1.45 for ED; causality uncertain.
• Schwarzer U, et al. Cycling and penile oxygen pressure: the type of saddle matters (Eur Urol, 2002): 20 men, four saddles; oxygen drops of 82.4%, 72.4%, 63.6% and 20.3%; width mattered more than padding.
• Sommer F, et al. Erectile dysfunction in cyclists: upright versus reclining position (Eur Urol, 2001): 46 men; 60.5 to 17.9 mmHg when seated upright; recovery after 10 minutes standing; recumbent riding near baseline.
• Schrader SM, et al. Nocturnal penile tumescence and rigidity testing in bicycling patrol officers (J Androl, 2002): 17 police cyclists versus 5 non-riders; erections during 27.1% versus 42.8% of sleep; lower figures with more riding hours and days; other erection measures not significantly different.
• Schrader SM, et al. Cutting off the nose to save the penis (J Sex Med, 2008): 90 police officers on no-nose saddles for 6 months; 66% less perineal pressure; improved sensation and IIEF; no RigiScan change; no-numbness share from 27% to 82%.
• Litwinowicz K, et al. Strategies for Reducing the Impact of Cycling on the Perineum in Healthy Males: Systematic Review and Meta-analysis (Sports Med, 2021): 22 studies; no-nose saddle and recumbent bike reduce perineal pressure; indirect evidence that standing every 10 minutes might help; trade-offs in stability and rear seat pressure.
• Sommer F, Goldstein I, Korda JB. Bicycle riding and erectile dysfunction: a review (J Sex Med, 2010): perineal compression linked to vascular, endothelial and nerve problems; fit, position and seat as preventive measures; more research needed.
• Hollingworth M, et al. Dose-response associations between cycling activity and risk of hypertension in regular cyclists: The UK Cycling for Health Study (J Hum Hypertens, 2015): 6,949 cyclists; more cycling linked to lower odds of diagnosed high blood pressure.
• Khera M, Bhattacharyya S, Miller LE. Effect of aerobic exercise on erectile function: systematic review and meta-analysis of randomized controlled trials (J Sex Med, 2023): 11 randomized trials; aerobic exercise improved IIEF erectile function scores compared with controls.
• NIDDK, Symptoms and Causes of Erectile Dysfunction: causes include diabetes, heart and blood vessel diseases, and certain medicines.
• NIOSH, Bicycle Saddles Without Protruding Noses Reduce Pressure Associated With Erectile Dysfunction Measure (June 30, 2004): no-nose saddles reduced perineal pressure in 33 riders on stationary bikes; the study “does not conclusively answer the question.”