Bike Riding and Infertility

Bike riding has been blamed for low sperm count, erectile dysfunction, and even testicular cancer, but what does the research say? Can bike riding really lead to infertility, fertility issues, and erectile dysfunction? Like many questions involving health, the answer lies in the details.

First, let’s be clear: exercise and bike riding is good for your health, can decrease your risk of developing certain diseases, and can even improve your fertility. If your bike fits you properly, if your seat is comfortable, if you wear loose-fitting clothing when riding, and you haven’t experienced any numbness around your genital area when riding, you are probably okay. And in many cases, simple adjustments, like changing the type of clothing you wear, finding a well-fitting bike, and finding a softer seat can make an immense difference.

However, bike riding can become problematic when bicyclists ride for long distances (over 300 kilometers a week or 186 miles a week as has been noted in the Open Reproductive Science Journal). If bike riding causes excessive heat to build up around your testicles, this can also temporarily reduce your sperm count (an important factor to consider if you are planning to start an I.V.F. cycle or if your doctor has noted that your sperm counts are low). The good news is that many of the issues linked to bike riding can be remedied by either cutting back how much you ride (by varying your workouts), by wearing loosely fitting clothing, or by finding a better bike seat or better-fitting bike.

Let’s take a closer look at what the research says about bike riding, infertility, and disease:

Bike Riding and Low Sperm Count

Bike riding has been linked to lower sperm counts in men undergoing I.V.F.. According to researchers at Boston University’s School of Public Health, lower sperm counts and lower sperm motility (ability of the sperm to move) was found in men who rode bike for five or more hours a week. While there have been studies linking competitive cycling to lower sperm count and lower semen quality, the Boston University study was the first to find links between non-competitive cyclists and lower sperm count and poorer sperm quality. The study, published in Fertility and Sterility, gave questionnaires to men undergoing their first I.V.F. treatment. The men were asked about their physical activity to determine if there might be a link between exercise and sperm counts. While exercise generally was found to have no impact on sperm count, biking more than five hours a week was associated with lower sperm count and sperm quality. It is important to note that the study focused on men undergoing I.V.F. treatment. But, a smaller study published in the Clinical Journal of Sport Medicine looking at 24 healthy male road cyclists also found similar results. After 16 weeks of low-to-intensive cycling training, sperm counts and sperm quality decreased.

It isn’t entirely clear why bike riding could be leading to lower sperm counts, but in a fascinating essay titled: “Great Balls of Fire and the Vicious Cycle: A Study of the Effects of Cycling on Male Fertility,” Tom Southorn looked at the different ways that cycling could impact the male reproductive system. Higher scrotal temperatures have been linked to lower sperm count in men. The testicles need to remain cool to properly produce sperm (it is why the testicles are anatomically separated from the body). Bike riding has been linked to higher scrotal temperature, but it isn’t clear whether this can be attributed to the bike riding activity itself, or to the “close-fitting Lycra outfits that bikers wear.” The British Journal of Urology International notes that bike riding can lead to higher temperatures around the scrotum, though there has been no direct link found between bike riding and infertility.

What’s the takeaway? If you ride, consider wearing loose-fitting clothing. If you are having trouble conceiving and bike heavily, consider getting your sperm counts checked and consider cutting back your biking. And if you are undergoing I.V.F., you may want to cut back on the heavy biking at least two to three months before your sperm retrieval procedure (sperm develop in cycles, and preparing for retrieval early can help).

Bike Riding and Erectile Dysfunction

Bike riding has been linked to a rare condition known as “nerve entrapment syndrome” or “pudendal neuralgia.” This condition occurs when the pudendal nerve, a nerve that runs from the pelvis to the base of the penis gets damaged or compressed during bike riding. One of the symptoms of nerve entrapment syndrome is erectile dysfunction. Bike riding can cause this rare condition when excessive riding leads to chronic microtrauma around the scrotum and penis, according to an article on the condition entitled “Pudendal Nerve Entrapment Syndrome.” Patients can experience pain and numbness, and one of the symptoms of the condition is sexual dysfunction, including male impotence. The British Journal of Urology International notes that the saddle of the bicycle can compress the perineum, the area behind the scrotum where the nerves and blood vessels enter the penis. Impaired blood supply to the penis and pressure on these nerves can lead to genital numbness and erectile dysfunction. Men who cycle longer distances or who train regularly are more likely to experience numbness and these men may be more at risk of erectile dysfunction.

The good news is that impotence in cyclists is rare. The bad news is that impotence in cyclists was noted as being higher than the general population. The reasons for this include the fact that cycling can compress the nerves around the penis and compress arteries around the penis, disrupting blood flow. In rare cases, riders can experience torsion of the testicles, which is a condition where the testicle rotates leading to reduced blood flow and potential risks to the testicle. According to Research and Reports in Urology, testicular trauma associated with bike riding is rare, but it was listed as a cause of testicular injury and trauma.

So what’s the takeaway? Ultimately, if you experience numbness in your genital region when riding or after riding, this might mean you need a better fitting bike or seat. It could also mean that you need to rest between longer bike rides, or need to reduce the amount of time you spend on the saddle. Numbness in your genital region could be the first sign of pudendal nerve entrapment syndrome. If you experience this symptom, consider finding a better bike, better seat, or taking a break.

Bike Riding and Cancer

Because two prominent professional cyclists, Ivan Basso and Lance Armstrong both had testicular cancer, some believe that bike riding can cause testicular cancer. But, doctors have repeatedly noted that the more likely common factor between these two men is their age and not their intensive bike riding. There is no scientific link between bike riding and the development of testicular cancer.

Some studies have linked bike riding with testicular cancer and prostate cancer, but some of these studies are old, only focus on elite mountain bike riders, and have been critiqued for being observational in nature. A study dating back to 1982 published in the British Journal of Cancer linked horseback riding and bike riding to testicular cancer risk, but a more recent study in the journal of Cancer Causes & Control found no link between horseback riding and bike riding and increased testicular cancer risk. An article published in the Lancet did note a higher prevalence of testicular disorders among mountain bikers, and this was believed to be caused by repeated microtrauma to the scrotum caused by elite training regimens.

Another study published in the Journal of Men’s Health found a slight link between bike riding and prostate cancer in an observational study of 5,282 men. But the research has been critiqued in Trends in Urology and Men’s Health for only looking at men over 50 and not at men under 50 and for failing to compare the cancer rates in men who cycle to the cancer rates in men who don’t cycle.

When it comes to bike riding, while there might be a small risk of testicular trauma, testicular torsion, and nerve compression, there doesn’t seem to be a robust link between bike riding and cancer. Riders should monitor themselves when riding for signs of numbness and pain to prevent more common riding injuries.

 What Can You Do to Prevent Testicular Injury, Erectile Dysfunction, and Other Issues When Bike Riding?

Harvard Health Publishing noted some of the ways you can adjust your bike and riding habits to prevent injury. Here are a few simple changes you can make to your bike and habits to avoid injury:

• Get a properly fitted bike; when handlebars were lower than the saddle, the risk of erectile dysfunction decreased, according to Harvard Health. Getting fitted to a bike that places as little pressure as possible on your perineum is important.
• Choose the right seat. Narrow seats and V-shaped seats reduced oxygen flow to the penis. Padded seats, gel seats, and seats with a nose no longer than 6 centimeters were best. Seats tilted downward were also better. Padded shorts can also help.
• Wear loose-fitting clothing to increase airflow around the scrotum and decrease heat around the testicles.
• Take breaks after long rides. Men at highest risk for injuries and low sperm count were those who biked more than 186 miles a week. If you experience numbness or pain after riding, consider varying your workout, taking a break, or reducing your time on the bike.
• Consider biking less than three hours a week. A study published in International Journal of Impotence Research noted that men who biked less than three hours each week were protected from erectile dysfunction while those who rode more than three hours a week had a higher probability of experiencing erectile dysfunction.

 While there is some research linking bike riding to certain conditions, including low sperm count, it is important to remember that exercise in moderation is good for your health and may improve your health. For the recreational bike rider, issues with low sperm count or testicular injury shouldn’t be a major factor. But if you train intensively, ride hard or long distances, and are trying I.V.F. or are having trouble conceiving, then talking with your doctor about whether your bike riding could be impacting your fertility, sperm counts, and health might be a good idea.

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