Might cycling affect the prostate?

Whilst prostate problems and benign prostatic enlargement (BPH) can affect nearly one in two men over the age of fifty (and as many as 9 out of 10 men in their seventies and eighties may have some symptoms of BPH) and one in eleven men may get prostate cancer making it the most common cancer in men, there does not appear, from the literature that we are aware of, to be a causal link between cycling and prostate enlargement or prostate cancer. However there is some evidence (see Mayo Clinic) that trauma from bicycle riding can irritate a man’s prostate and could exacerbate, and some suggest lead, to prostatitis (inflammation of the prostate) or chronic pelvic pain syndrome. A recent study by published in the Journal of Men’s Health (Volume 11:2:2014) lead by researchers at University College London on erectile dysfunction and infertility and prostate cancer in regular cyclists found no link between cycling and infertility and or between erectile dysfunction and cycling. It did however find that there was an increased risk of being diagnosed with prostate cancer in those men over 50 who cycled over 3.76 hours per week and particularly in those men who cycled more than 8.5 hours per week.

The authors of this study indicated that this may be because men who cycle frequently may be more health conscious, leading to more regular check-ups and a greater chance of being diagnosed, or that as cycling increases levels of PSA which in turn lead to increased rates of investigation for prostate cancer, or that cyclists are more likely to suffer urogenital abnormalities such as blood in the urine or pain around the prostate making them more likely to be tested for prostate cancer or that cycling time and prostate cancer are both associated with an unknown factor that was not accounted for by the study or that there could be a genuine biological link between trauma in the area of the prostate associated with bike riding. They stated that they ‘were quite surprised by the size of the finding for prostate cancer, so it that it does warrant further research but that we can’t draw any conclusions from this study ’ They have also stated: ‘We cannot say on the basis of our results that prostate cancer is caused by cycling. We would not recommend that people reduce their cycling volume. Cycling has many physical and mental health benefits that at present outweigh any risks it may cause’

Also it is known that cycling may transiently increase a man’s prostate specific antigen (PSA) level – PSA levels are often used as a key test of possible prostate problems – so men who are due to have a prostate test should avoid significant levels of cycling before a PSA test to avoid a possible false reading.

Although cycling is not directly linked to the development of prostate problems if you have prostate problems and you cycle frequently you may find it helpful to discuss the potential impact with your doctor, particularly if you are going to have a PSA bloodtest. Also some literature suggests than men should consider avoiding cycling during episodes of prostatitis or chronic pelvic pain syndrome. The key issue in regard to cycling and prostate problems is to find ways of reducing pressure on the perineum, or groin area (as the prostate is located just below the bladder and in front of the rectum). This can be done in a number of ways – from wearing padded shorts, regularly standing on the pedals, considering the adjustment and position of the saddle, to actual saddle choice. A study in the British Journal of Urology International in 2007 (99:135-140) showed that a grooved seat produced less pressure and numbness in the penile area and impact on erectile dysfunction, but also that rider position was very important.

A particular approach that has been taken has been to utilise saddles which aim to reduce pressure on the perineum. These tend to fall into three groups: those with grooves and holes cut in them to reduce pressure on the perineum or groin area, saddles with holes cut out of them and a cutaway at the back, and more recently ‘split saddles’ which have two sections and no central area or noseless saddles. (In regard to saddles with holes cut in them you should check to ensure that the edges are not shaped in such a way as to inadvertently increase pressure or pinch).

Many saddle manufactures today make saddles with grooves, cut out holes and cutaways – and these are now much more available and numerous bicycle riders websites suggest different models and styles and are probably too numerous to list. Readers should remember however that the most expensive is not always the best answer – the answer is to look for a saddle which is most likely to reduce pressure for you and enables you to adjust it best for your shape and riding style and if possible try it out. There are also a growing number of companies which produce saddles with either split seats/dual pad or differently shaped saddles some of which have no noses (including several with contact addresses in the UK).

A couple of articles and discussion fora that it may be interesting to look at include:

http://www.livestrong.com/article/386549-prostate-pressure-bicycle-seats/.