{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T13:58:27Z","timestamp":1775224707756,"version":"3.50.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,3,7]],"date-time":"2020-03-07T00:00:00Z","timestamp":1583539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,3,7]],"date-time":"2020-03-07T00:00:00Z","timestamp":1583539200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Bicycle riding's impact on erectile function remains a topic of great interest given cycling's popularity as a mode of transportation and exercise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>We evaluated risk factors for sexual dysfunction in male cyclists with the primary intention of determining if genital\/pelvic pain and numbness are associated with erectile dysfunction (ED).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We surveyed male cyclists using an online anonymous questionnaire. Cyclists were queried on their demographics, cycling experience, and sexual function using the Sexual Health Inventory for Men (SHIM). ED was diagnosed when a completed SHIM score was &amp;lt;22. Regression analysis was used to evaluate the risk of ED in men with genital\/pelvic pain or numbness after riding. The survey was designed in the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Quantitative characterization of cycling habits, onset and timing of genital pain and numbness, and SHIM score.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1635 participants completed the survey. A majority of men were over the age of 50 (58%, 934\/1,607), Caucasian (88%, 1,437\/1,635), had been active cyclists for over 10\u00a0years (63%, 1,025\/1,635) and used road bikes (97%, 1,578\/1,635). Overall, 22%, 30%, and 57% of men reported ED, genital pain, and genital numbness, respectively. While controlling for cohort demographics, body mass index, cycling intensity and equipment, and medical comorbidities, no saddle characteristics were associated with the risk of developing genital numbness. However, men reporting penile numbness were at higher risk of reporting ED (odds ratio [OR]\u00a0=\u00a01.453, P\u00a0=\u00a0.048). In addition, quicker onset of numbness and resolution of numbness within a day was associated with impaired erectile function. For example, numbness occurring less than 1\u00a0hour after cycling had greater odds of leading to ED than numbness after 5\u00a0hours (OR\u00a0=\u00a02.002, P\u00a0=\u00a0.032). Similarly, genital pain occurring less than 1\u00a0hour (OR\u00a0=\u00a02.466, P\u00a0=\u00a0.031) after cycling was associated with higher ED risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>Strengths include a large sample size of high-intensity cyclists and validated questionnaire use. Limitations include reliance on anonymous self-reported survey data and minimal inquiry into the riding preferences and terrain traversed by cyclists.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Pelvic pain and numbness are common complaints among male riders in the United States. Men with such complaints are more likely to also report ED especially if it occurs earlier in the ride. Although direction of causality and temporality are uncertain, alleviation of factors resulting in pelvic discomfort may reduce cycling's impact on sexual function. Such interventions are critical given that cycling for both active travel and aerobic exercise confers numerous health benefits.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2020.01.022","type":"journal-article","created":{"date-parts":[[2020,3,7]],"date-time":"2020-03-07T13:01:57Z","timestamp":1583586117000},"page":"919-929","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":12,"title":["The Association Between Pelvic Discomfort and Erectile Dysfunction in Adult Male Bicyclists"],"prefix":"10.1093","volume":"17","author":[{"given":"Adithya","family":"Balasubramanian","sequence":"first","affiliation":[{"name":"Baylor College of Medicine , Houston, TX , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Yu","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine , Houston, TX , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin N.","family":"Breyer","sequence":"additional","affiliation":[{"name":"Department of Urology , San Francisco, CA , USA"},{"name":"University of California San Francisco , San Francisco, CA , USA"},{"name":"Department of Epidemiology and Biostatistics , San Francisco, CA , USA"},{"name":"University of California San Francisco , San Francisco, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Minkow","sequence":"additional","affiliation":[{"name":"Private Practice , Petaluma, CA ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael L.","family":"Eisenberg","sequence":"additional","affiliation":[{"name":"Department of Urology , Stanford, CA , USA"},{"name":"Stanford University , Stanford, CA , USA"},{"name":"Department of Obstetrics and Gynecology , Stanford, CA , USA"},{"name":"Stanford University , Stanford, CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,3,7]]},"reference":[{"key":"2023011111092584600_bib1","doi-asserted-by":"crossref","first-page":"e74685","DOI":"10.1371\/journal.pone.0074685","article-title":"The structure of spatial networks and communities in bicycle sharing systems","volume":"8","author":"Zaltz Austwick","year":"2013","journal-title":"PLoS One"},{"key":"2023011111092584600_bib2","doi-asserted-by":"crossref","first-page":"e0137922","DOI":"10.1371\/journal.pone.0137922","article-title":"Understanding Spatiotemporal Patterns of Biking Behavior by Analyzing Massive Bike Sharing Data in Chicago","volume":"10","author":"Zhou","year":"2015","journal-title":"PLoS One"},{"key":"2023011111092584600_bib3","first-page":"154","article-title":"Biking for Health: Results of a Pilot Randomized Controlled Trial Examining the Impact of a Bicycling Intervention on Lower-Income Adults","volume":"116","author":"Bernstein","year":"2017","journal-title":"WMJ"},{"key":"2023011111092584600_bib4","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s40279-018-1023-0","article-title":"Active Commuting and Multiple Health Outcomes: A Systematic Review and Meta-Analysis","volume":"49","author":"Dinu","year":"2019","journal-title":"Sports Med"},{"key":"2023011111092584600_bib5","doi-asserted-by":"crossref","first-page":"j1456","DOI":"10.1136\/bmj.j1456","article-title":"Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study","volume":"357","author":"Celis-Morales","year":"2017","journal-title":"BMJ"},{"key":"2023011111092584600_bib6","doi-asserted-by":"crossref","first-page":"e1002076","DOI":"10.1371\/journal.pmed.1002076","article-title":"Associations between Recreational and Commuter Cycling, Changes in Cycling, and Type 2 Diabetes Risk: A Cohort Study of Danish Men and Women","volume":"13","author":"Rasmussen","year":"2016","journal-title":"Plos Med"},{"key":"2023011111092584600_bib7","first-page":"1","article-title":"Can high-intensity interval training improve physical and mental health outcomes? 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Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}