Presentation Authors: Zoe Gan*, Mark Ehlers, Feng-Chang Lin, Sarah Wright, Bradley Figler, Robert Coward, Chapel Hill, NC
Introduction: Conflicting evidence exists on the relationship between bicycle riding and erectile dysfunction (ED). A major limitation to several prior studies is the lack of a validated measure of ED. Our objective was to determine if there is a significant association between cycling and clinically validated ED.
Methods: We searched Pubmed, EMBASE, CINAHL, Web of Science, and Cochrane Database from database inception through 2018 using a variety of search terms relating to â€œcyclingâ€ and â€œerectile dysfunction.â€ Studies were included if they were written in English, reported original data, compared ED between cyclists and non-cycling controls, and used a validated measure of ED, such as the International Index of Erectile Function (IIEF) or the subset Sexual Health Inventory for Men (SHIM). Age, SHIM score, and comorbidities were extracted for all groups. Primary outcomes were mean SHIM score and presence of ED (SHIM â‰¤ 21). A generalized linear mixed effects model was used to fit the collected data for meta-analysis. Odds ratios (OR) of ED and mean SHIM score difference between groups were calculated and adjusted for age.
Results: After a systematic evaluation of 843 studies, six cross-sectional studies met the inclusion criteria for meta-analysis. 3,330 cyclists with a mean age of 43.8 years and 1,524 non-cycling controls with a mean age of 39.1 years were analyzed. When comparing cyclists to non-cyclists in an unadjusted analysis, there were no significant differences in ED prevalence (56.8% vs. 56.2%; OR 0.99, 95% confidence interval (CI) 0.88, 1.14) or mean SHIM score (20.3 vs. 19.7; p = 0.08). However, after controlling for age, cyclists had a significantly higher odds of having ED (OR 1.98; 95% CI 1.54, 2.55), and they had a lower mean SHIM score (-0.5 points, 95% CI -1.1, 0.1) which approached statistical significance. Comorbidities were inconsistently reported among studies and were unable to be included in the analysis.
Conclusions: Based on all existing literature using validated measures of ED, cyclists have a two-fold higher odds of ED compared with non-cycling controls. Future investigation into the mechanism, contributions of cycling intensity, and a history of perineal trauma may be beneficial.