Can biking kill your sex life? A urologist weighs in

By Dr. Jamin Brahmbhatt, CNN

(CNN) — During the pandemic, I did what many other people did: I bought a stationary bike. I joined the group rides, pushed through the resistance and pedaled my way to better health. A few weeks in, I started noticing something I didn’t expect — a subtle, intermittent pressure near my prostate that lingered throughout the day.

As a urologist, knowing what those sensations can sometimes signal only made me more anxious.

Was the bike irritating something important? Was this the start of chronic prostate pain or even trouble in the bedroom? The worry built up enough that I stopped riding and eventually sold the bike. That fear is something I hear from patients all the time: Is biking causing my prostate issues or erection problems? The science-based answer is that it probably does not.

In my case — and in many others — the problem wasn’t the bike or the exercise. It was my form and my mind.

The pressure your prostate feels

The prostate sits just below the bladder and wraps around the urethra. It is located deep in the pelvis, directly above the perineum (the soft area between the scrotum and anus). Anything that irritates that region, including pressure, tight muscles or prolonged sitting, can create sensations that men interpret as “prostate pain.”

Cycling concentrates your body weight on the perineum, where the pudendal nerve, key blood vessels and the pelvic floor muscles all travel. The major nerves that support erections also run along the outer surface of the prostate, which is why irritation in the surrounding tissues can feel like a prostate or sexual function problem, even when the gland itself is normal.

A narrow or traditional bike saddle can press on these sensitive areas for long periods, creating burning, pressure or a bruised feeling. That discomfort is real, but it isn’t the prostate or surrounding nerves themselves being damaged. Cycling affects the tissues around the gland — not the gland itself. This mirrors what the latest American Urological Association guidelines note: Perineal pressure and prolonged sitting are known triggers for pelvic and scrotal pain, not true prostate injury.

Prostatitis: The misunderstood condition

Prostatitis is one of the most commonly misunderstood diagnoses in my field. The severe bacterial form — the one that causes fever, chills and intense urinary symptoms — is rare. Much more often, men are told they have prostatitis, even though there is no infection. Their symptoms come from irritated or tight pelvic floor muscles, nerve hypersensitivity, stress or prolonged sitting — problems that don’t show up on urine tests or cultures. Tenderness in these muscles is found in a significant number of men with pelvic pain, which helps explain why the symptoms can feel so similar to prostate inflammation.

Cycling can aggravate these muscles for some riders, especially if they stay seated the entire ride or are new to the activity. The discomfort that follows can feel identical to true prostate inflammation, even though the prostate itself is normal.

What about erectile dysfunction?

The fear of erectile dysfunction often appears the moment men feel pressure or numbness in the pelvic region after a ride. Older research studies raised concerns that cycling might reduce blood flow to the penis. Those early studies made headlines, and many men still assume there is a direct link between biking and erectile dysfunction — but that’s not necessarily true.

More recent research shows that regular cycling does not increase the long-term risk of erectile dysfunction. In fact, many cyclists report better sexual function than those who don’t ride, mainly because cycling or any exercise can improve heart and vascular health. Temporary numbness or tingling after a long or intense ride can happen, but it typically resolves quickly once pressure is relieved.

A quick ED reality check

Erections depend on healthy blood vessels, well-functioning nerves and balanced hormones working together with psychological factors such as stress and arousal. Chronic conditions such as diabetes, high blood pressure, high cholesterol and heart disease are among the most common contributors to erectile dysfunction because they reduce blood flow to the penis. Smoking, inactivity, obesity, stress and certain medications also play major roles in the quality of erections.

Testosterone affects libido and energy but is rarely the sole cause of erectile dysfunction. The latter is usually a whole-body issue, not a cycling problem. And as mentioned earlier, the cardiovascular benefits of cycling often help erectile function rather than harm it.

Why biking symptoms still happen

Even if cycling doesn’t cause permanent harm, it can still leave riders with temporary sensations during or after a ride. These feelings come from how your body meets the saddle — the amount of time you stay seated, your posture and how conditioned your pelvic muscles are for supporting pressure in that position.

How you ride also matters. Stationary bikes often keep you in one position for extended periods, especially during high-resistance climbs, which can increase pelvic pressure. That’s different than outdoor cycling, which naturally shifts your weight — you stand to pedal, adjust during climbs and descents, and move more freely — giving the pelvic muscles brief breaks. Electric bikes assist during harder efforts and may limit how far forward you lean, but they still depend on proper saddle fit and posture.

Factors such as saddle shape, handlebar height and uninterrupted time in the seat determine how much pressure the pelvis absorbs. New riders tend to notice these sensations more simply because their bodies haven’t yet adapted to longer periods in the saddle.

Some men may notice pelvic symptoms more than others. Riders with a history of lower back problems, hip tightness, chronic stress, anxiety or previous pelvic pain often have more sensitive pelvic floor muscles to begin with. Men with desk jobs who sit for long hours may also feel saddle pressure more intensely when they first start cycling. These symptoms don’t mean harm is being done — but they do mean your body may need more attention to bike fit, posture and gradual mileage.

How to protect your pelvic health

Most cycling-related discomfort improves with adjustments rather than stopping the activity. Saddles with center cutouts or split designs reduce pressure on sensitive areas, and small changes in seat height, tilt or handlebar position can shift weight away from the perineum.

Briefly standing every 10 to 15 minutes, wearing padded shorts and building mileage gradually can also help.

If symptoms persist, pelvic floor physical therapy is one of the strongest evidence-backed treatments available. The goal isn’t to stop cycling — it’s to ride in a way that supports comfort, protects the surrounding tissues and allows your body to adapt safely over time.

When symptoms deserve evaluation

Persistent numbness, discomfort lasting hours or days after cycling, painful erections or new urinary changes should be evaluated. These symptoms are usually treatable and do not imply permanent injury.

Equipment adjustments, a short break from riding or targeted therapy often resolve the issue.

Persistent symptoms shouldn’t be ignored, but they also shouldn’t trigger panic. Most riders improve with straightforward changes.

The biking bottom line

Cycling did not damage my prostate or affect my sexual health — but the sensations I felt were real, and the fear is something I hear from men every week. Understanding how saddle pressure interacts with the pelvic floor and nerves can help you ride more comfortably and interpret new sensations without assuming the worst.

Looking back, I probably didn’t need to sell my bike. What I needed was a better seat, a few adjustments and a reminder not to panic the moment something in my pelvis felt different.

I know many men react the same way I did — with fear first, facts later. You don’t have to. With the right setup and a little awareness, cycling can stay part of your routine without putting your prostate or sexual health at risk.

And this isn’t just about cycling. Any new exercise will come with an adjustment period, and it’s normal to feel unfamiliar aches as your body adapts. A little preparation, good form and asking for help when you need it can keep you moving safely.

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