Prostatitis, or inflammation of the prostate gland, ranges from an annoying dull ache to a chronically painful nightmare. Diagnosis is challenging because its symptoms overlap with those of other pelvic and prostate conditions. The four main prostatitis symptoms are pain, difficulty urinating, sexual dysfunction, and general health concerns such as fatigue and flu-like feelings.
Roughly 50% of men will experience some type of prostatitis. In fact, certain activities can create pressure on the pelvic floor and affect the prostate gland. According to an article on prostate.net, heavy lifting, jogging, horseback riding, structural abnormalities of the urinary tract, muscle spasm in pelvic muscles, and jobs that expose the prostate area to strong vibrations such as driving a truck or operating certain machinery can irritate the prostate gland and even lead to prostatitis.
What about cycling?
Riding a bike is a great form of exercise. When cycling is strenuous, it avoids impact on the joints while offering aerobic benefits. Even relaxed bike riding is an enjoyable way to get a gentle workout.
With specific regard to cycling and prostatitis, there are two sides to the matter: what research says, and what cyclists report. Research tells us there are definite genital and pelvic “hazards” for men who spend a lot of time on a bike seat or saddle. A comparison of male swimmers/runners vs. male cyclists (either low or high intensity) used male health questionnaires for all 3,932 study participants:
- SHIM (Sexual Health Inventory for Men)
- I-PSS (International Prostate Symptom Score)
- NIH-CPSI (National Institutes of Health Chronic Prostatitis Symptom Index)
The results showed that cyclists had no worse sexual or urinary functions than swimmers or runners, but were more prone to urethral stricture (narrowing of the urine passage).[i]
Another research-based source, Harvard Health Publishing, weighs in with this opinion:
…there does not appear to be any solid evidence that bicycling worsens the symptoms of an enlarged prostate, such as urinary frequency or urgency. In addition, bicyclists are not at greater risk for future prostate problems such as prostatitis or prostate cancer…[ii]
However, a review of the literature suggests that cycling can cause prostatitis in some cases, though other problems are far more common:
The reported incidence of bicycling related urogenital symptoms varies considerably. The most common bicycling associated urogenital problems are nerve entrapment syndromes presenting as genitalia numbness, which is reported in 50-91% of the cyclists, followed by erectile dysfunction reported in 13-24%. Other less common symptoms include priapism, penile thrombosis, infertility, hematuria, torsion of spermatic cord, prostatitis, perineal nodular induration and elevated serum PSA, which are reported only sporadically.[iii]
What patients report
While the “solid evidence” viewpoint appears to be that bike riding rarely causes prostatitis, there is ample opinion from riders who already have prostatitis that cycling can makes it worse. For example, “I gave up bike riding, and so do most other people with prostatitis, from what I can tell… Your prostate (sometimes called the ‘seat of masculinity’) is fairly close to the surface of the area that touches the seat of the average road bike. So every bump and pothole you go over is transmitted to that region.”[iv]
Protecting your prostate
Yet there are also those with prostatitis who choose to continue cycling by taking steps to protect the gland: “I’m a 100-mile-a-week bicyclist who also has prostatitis. Biking can make your prostatitis worse if you don’t have your clothing and your seat configured properly.”[v] Suggestions for correct configuration include wearing padded biking shorts, and the following bike seat advice from prostate.net:
… many bike seats put pressure on the prostate area, causing irritation. It is important to buy the right kind of bicycle seat that will not put pressure on your groin area. Look for such seats as a soft seat with gel or a lot of padding, a split seat, a seat with holes, a noseless saddle, or a seat with a soft central area. Try out seats to find out which kind is most comfortable for you. If you find one that works, then stick with it. Angle the seat so it puts less pressure on your prostate area. The right seat will keep blood flow to the penis and groin, prevent numbness, and will not irritate the prostate area.
Change position often while riding by adding bar ends to handle bars so you can change the height of your body. Sitting in a more upright position is more prostate friendly. Be sure to wear padded cycling shorts when you ride.
Finally, many bike riders who have prostatitis find that switching to a recumbent bike, while expensive, is an excellent investment in their prostate comfort and their lifestyle enjoyment of cycling.
Clearly, the best tip for cyclists is to do whatever it takes to gain maximum prostate protection.
[i] Awad MA, Gaither TW, Murphy GP, Chumnarnsongkhroh T et al. Cycline, and male sexual and urinary function: results from a large, multinational, cross-sectional study. J Urol. 2017 Oct 13. pii: S0022-5347(17)77722-1. doi: 10.1016/j.juro.2017.10.017. [Epub ahead of print]
[iii] Leibovitch I, Mor Y. The vicious cycling: bicycling related Urogenital disorders. Eur Urol. 2005 Mar;47(3):277-86; discussion 286-7. Epub 2004 Dec 30.