"Men should never ride bicycles," he says matter-of-factly. "Riding should be banned and outlawed. It's the most irrational form of exercise I could ever bring to discussion."
"The majority of bicycle-related impotency cases Dr. Goldstein treats stem from this kind of accident."
"I can't prove that long-term compression causes impotency, but I kind of think it does in a very small percentage of cases."
But Dr. Padma-Nathan, who is a former student of Dr. Goldstein's, doesn't think that saddle compression alone causes impotency. Rather, he views it as just one of many factors in an aging man that can combine to sap potency.
"To be diabetic, to smoke cigarettes, to have high blood pressure or cholesterol puts you at definite risk for erectile dysfunction," he explains. "But to ride a bicycle? Perhaps it's a risk. It may just aggravate other factors."
"I take what Dr. Goldstein says very seriously," says Richard Lieberman, M.D., a clinical associate professor of surgery (urology) at Pennsylvania State University, who has treated impotent cyclists at his Allentown, Pennsylvania-based practice, "but I can think of a lot more things that are deleterious to one's health that should be outlawed before bikes. In fact, the overall vascular health of the cyclist may, in a lot of cases, outweigh some of the local deficit that's created."
Dr. Padma-Nathan, who rides a stationary bike every day to stay in shape, actually groaned when he heard that Dr. Goldstein was advocating banning bicycling. "There's no doubt there's a real issue here," he says, "but bicycling is an important form of cardiovascular exercise. Rather than terminate it, I would recommend tailoring this information to your own bicycling and body type."
Bicycle seat neuropathy is one of the more common injuries reported by cyclists.[1, 2, 3, 4, 5] The injuries and symptoms are due to the cyclist supporting his or her body weight on a narrow seat, and they are believed to be related to either vascular or neurologic injury to the pudendal nerve.[2, 5, 6, 7, 8, 9, 10]
For excellent patient education resources, visit eMedicine's Erectile Dysfunction Center and Sports Injury Center. Also, see eMedicine's patient education articles, Impotence/Erectile Dysfunction, Erectile Dysfunction FAQs, and Bicycle Safety.