Changes in penile blood flow during cycling: what precautions should be taken to avoid a decreased perfusion?

Background and objectives: An increased incidence of erectile dysfunction h as been observed in cycling enthusiasts. Compression of the perineal region during cycling seems to cause decreased penile perfusion. The resulting hy poxaemia in the corpus cavernosum is associated with penile fibrosis, which leads in the long run to erectile dysfunction. This study set out to deter mine if cycling can cause changes in penile perfusion and, if so, what prec autions can be taken to avoid any associated health hazards, including whet her various saddle forms and designs might influence penile blood flow. Cohorts and Methods: In 100 healthy athletic men (aged 36 +/- 6.2 years) tr anscutaneous penile oxygen pressure (tpO(2)) at the glans penis was measure d during cycling in different positions and with different types of saddle, using a modified Clark oxygen electrode. Results: The penile blood supply decreased significantly during cycling in a seated position. Cycling in a standing or reclining position (on a reclin ing bicycle) did not lead to any decrease in penile blood flow. Saddle widt h was the most important factor for ensuring adequate penile perfusion whil e cycling in a seated position. Conclusion: This study demonstrates that changing from a seated to a standi ng position during cycling leads to a significant increase in penile perfus ion. Therefore we suggest frequent changes from a seated to a standing posi tion during cycling. Additionally we suggest taking sufficient breaks durin g prolonged and vigorous bike tours, in order to avoid any possible health hazards. Another, not yet widespread, alternative for avoiding a reduction in penile blood flow is cycling on a reclining bicycle.