During the pandemic, I did what many other people did: I bought an exercise bike. I joined group classes, increased my resistance, and cycled to improve my health. After a few weeks, I started to notice something unexpected: a subtle, intermittent pressure near my prostate that persisted throughout the day. As a urologist, knowing what these sensations can sometimes indicate only made me more anxious.
Was something important irritating her? Was it the beginning of chronic prostate pain or even intimacy problems? The concern grew so much that I stopped cycling and eventually sold the bike. This fear is something I hear from my patients all the time: Is cycling causing my prostate or erection problems? The scientific answer is probably not.
In my case, and in many others, the problem wasn’t the bike or the exercise. It was my posture and my mental state.
The pressure felt in the prostate
The is just below the bladder and surrounds the urethra. It is located deep in the pelvis, directly above the perineum (the soft area between the scrotum and anus). Anything that irritates this area, including pressure, tense muscles, or sitting for long periods, can create sensations that men interpret as “prostate pain.”
Cycling concentrates body weight on the perineum, where the pudendal nerve, main blood vessels and pelvic floor muscles pass. The main nerves involved in erections also run along the outer surface of the prostate, so irritation in the surrounding tissues can be felt as a problem with the prostate or sexual function, even when the gland itself is normal.
A narrow or traditional saddle can press on these sensitive areas for long periods, causing burning, pressure or a bruising sensation. This discomfort is real, but it does not mean that the prostate or surrounding nerves are damaged. Cycling affects the tissues around the gland, not the gland itself. This is in line with what the most recent guidelines from the American Urological Association point out: perineal pressure and prolonged sitting are triggers for pelvic and scrotal pain, not an actual prostate injury.
Prostatitis: a misunderstood condition
Prostatitis is one of the most misunderstood diagnoses in my specialty. The severe bacterial form — which causes fever, chills and intense urinary symptoms — is rare. Much more often, men are diagnosed with prostatitis even when there is no infection. Symptoms arise from irritation or tension in the pelvic floor muscles, nervous hypersensitivity, stress, or sitting for long periods — problems that do not show up in urine tests or cultures. Tenderness in these muscles is seen in a significant number of men with pelvic pain, which helps explain why symptoms can be so similar to prostate inflammation.
Cycling can aggravate pressure on these muscles in some cyclists, especially if they remain seated throughout the ride or are beginners. The resulting discomfort can be identical to that of true prostate inflammation, even if the prostate itself is healthy.
What about erectile dysfunction?
Fear usually arises when men feel pressure or numbness in the pelvic region after a bike ride. Older studies have raised concerns that cycling could reduce blood flow to the penis. These early studies made headlines, and many men still assume there is a direct relationship between cycling and erectile dysfunction, but that’s not necessarily true.
More recent research shows that regular cycling does not increase the risk of erectile dysfunction in the long term. In fact, many cyclists report better sexual function than those who don’t cycle, largely because cycling — or any exercise — can improve cardiovascular health. Temporary numbness or tingling may occur after a long or intense ride, but this usually goes away quickly when the pressure is relieved.
A Brief Review of Erectile Dysfunction
Erections depend on healthy blood vessels, properly functioning nerves, and balanced hormones that work in conjunction 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 causes of erectile dysfunction, as they reduce blood flow to the penis. Smoking, a sedentary lifestyle, obesity, stress and certain medications also significantly influence the quality of erections.
Testosterone affects libido and energy, but is rarely the sole cause of erectile dysfunction. This tends to be a whole-body problem, not something related to cycling. And, as mentioned previously, the cardiovascular benefits of cycling often improve erectile function rather than impair it.
Why do symptoms persist when cycling?
Although cycling does not cause permanent damage, it can still cause temporary sensations in cyclists during or after a ride. These sensations are due to the way the body interacts with the saddle: the time spent sitting, the posture and the state of the pelvic muscles to withstand the pressure in that position.
The way you pedal is also important. Exercise bikes often keep the rider in a single position for long periods, especially during hills with high resistance, which can increase pelvic pressure. This is different from outdoor cycling, which naturally redistributes weight: you pedal standing up, you adjust your posture during climbs and descents, and there is more freedom of movement, which allows the pelvic muscles to rest briefly. E-bikes offer assistance with more intense efforts and can limit forward lean, but they still depend on proper saddle adjustment and correct posture.
Factors such as the shape of the saddle, the height of the handlebars and continuous sitting time determine the amount of pressure absorbed by the pelvis. Beginner cyclists tend to notice these sensations more often simply because their bodies have not yet adapted to long periods in the saddle.
Some men may notice pelvic symptoms more than others. Cyclists with a history of lower back problems, hip stiffness, chronic stress, anxiety, or previous pelvic pain often have more sensitive pelvic floor muscles. Men with office jobs, who sit for long hours, may also feel the pressure from the saddle more intensely when they start pedaling. These symptoms do not mean that any damage is occurring, but they do indicate that the body may need more attention to bike fit, posture, and gradually increasing mileage.
How to protect pelvic health
Most cycling-related discomfort improves with adjustments rather than stopping the activity. Saddles with a center opening or split design reduce pressure on sensitive areas, and small changes in height, saddle tilt, or handlebar position can relieve pressure on the perineum.
Getting up briefly every 10 to 15 minutes, wearing padded shorts, and increasing mileage gradually can also help.
If symptoms persist, pelvic floor physical therapy is one of the most scientifically supported treatments available. The goal is not to stop cycling, but to cycle in a way that provides comfort, protects the surrounding tissues, and allows the body to adapt safely over time.
When to seek medical evaluation
Persistent numbness, discomfort that lasts hours or days after riding, painful erections, or new urinary changes should be evaluated by a doctor. These symptoms are usually treatable and do not indicate a permanent injury.
Adjustments to the equipment, a brief break or specific therapy usually resolve the problem.
Persistent symptoms should not be ignored, but they should not cause panic either. Most cyclists improve with simple changes.
In summary
Cycling didn’t damage my prostate or affect my sexual health, but the sensations I felt were real, and the fear is something I hear from other men every week. Understanding how saddle pressure interacts with your pelvic floor and nerves can help you ride more comfortably and interpret new sensations without imagining the worst.
Looking back, I probably didn’t need to sell my bike. What I needed was a better saddle, some adjustments, and remembering not to panic if I felt something different in my pelvis.
I know that many men react the same way I did: first fear, then facts. You don’t have to do it like this. With the right setup and a little awareness, cycling can remain part of your routine without putting your prostate or sexual health at risk.
And this doesn’t just apply to cycling. Any new exercise involves an adaptation period, and it’s normal to feel unfamiliar discomfort as your body adjusts. A little preparation, good technique, and seeking help when needed will allow you to stay active safely.
*Dr. Jamin Brahmbhatt is a urologist and robotic surgeon at Orlando Health and an adjunct professor at the University of Central Florida College of Medicine.
