Using No-nose (Noseless) Bicycle Saddles to Prevent Genital Numbness and Sexual Dysfunction

Over 40,000 workers in public safety occupations ride bicycles as part of their job. They include police officers, emergency medical technicians (EMTs), and security staff who patrol by bicycle. Anecdotal reports from bicyclists had indicated that genital numbness, erectile dysfunction, and impotence are a concern.

The traditional bicycle saddle has a narrow nose or horn that protrudes under the groin as the cyclist straddles the bicycle. Ideally, the weight of the cyclist supported on the saddle should be under the pelvic sit bones. However, 25% or more of the body weight is supported where the groin contacts the saddle nose. This percentage greatly increases as the cyclist leans forward in more aerodynamic positions. Bearing weight on this region of the saddle compresses the nerves and arteries in the groin. These nerves and arteries run through the groin between the sit bones to the genitals. Research has shown that pressure on these nerves and arteries over time may lead to a loss of sensation and a decrease in blood supply to the genitals. This can contribute to the sexual and reproductive health effects that have been reported with bicycling.

The National Institute for Occupational Safety and Health (NIOSH) recently released a Workplace Solutions document titled No-nose Saddles for Preventing Genital Numbness and Sexual Dysfunction in Occupational Bicycling, which summarizes NIOSH research and recommendations. NIOSH researchers began investigating this issue as an occupational health concern in 2000 when complaints of groin numbness were received from officers in a Long Beach, California police bicycle patrol unit.¹ In addition, NIOSH found that those bicycle police officers who exhibited more contact pressure on the saddle nose and who spent more time on their bicycle saddle had erections for a lower percentage of their sleeping time. Erections during sleep are a measure of genital health.²

In 2004, NIOSH conducted a study to examine the effect of bicycle saddle design on groin pressure. The study found that the traditional sport/racing saddle was associated with more than two times the pressure in the perineal region than the saddles without a protruding nose. There were no significant differences in perineal pressure among the no-nose saddles. Measures of weight distribution on the pedals and handlebars indicated no differences between the traditional saddle and those without protruding noses.³

To examine the benefit of saddles without a protruding nose, NIOSH conducted another study where bicycle police officers from five U.S. metropolitan areas used a no-nose saddle for their bicycles exclusively for 6 months. After 6 months, only three of the 90 men remaining in the study had returned to a traditional saddle. The study found a 66% reduction in saddle contact pressure in the perineal region, a significant improvement in penis tactile sensation, and a significant improvement in erectile function. The percentage of officers indicating that they experienced numbness to the buttocks, scrotum, or penis decreased from 73% while using traditional saddles at the beginning of the study to 18% after using no-nose saddles for 6 months.⁴

NIOSH research has focused mostly on police officers, security officers, and emergency medical personnel who use bicycles as part of their work, rather than on recreational/sport bicyclists. However, one study reported that 21% of sport cyclists reported genital numbness after a bicycle race and 13% reported impotence⁵ while other research reported a 61% incidence of genital numbness among cyclists and a 19% incidence in erectile dysfunction among cyclists riding more than 400 km (249 miles) per week.⁶

There is much less research on female cyclists and effects associated with traditional bicycle saddles. Previous studies found 40-70 percent of female cyclists experience genital numbness with a traditional saddle.^7,8 NIOSH and researchers from the Albert Einstein College of Medicine-Montefiore Medical Center investigated the relationship between frequent and/or endurance bicycling on neurological and sexual function in women.⁹ The study concluded that there is an association between bicycling and decreased genital sensation in competitive female bicyclists. Additional research is warranted to further examine these issues among female cyclists.

Contrary to some cyclists’ belief, it is not normal for any part of your body to go numb or lose feeling. Numbness in the groin or genitals is a warning sign that should not be ignored. NIOSH recommends that workers who ride a bicycle as part of their job take the following steps to help prevent sexual and reproductive health problems:

• Use a no-nose saddle for workplace bicycling. Give yourself time to get used to riding with a no-nose saddle. At first, it may seem very different from the saddle you have used in the past. No-nose saddles may not always be available at retail bicycle shops, but they are readily available for purchase through the Internet.
• Seek guidance on proper bicycle fit from a trained bicycle fit specialist. Use of a no-nose saddle may require different saddle height and angle adjustments. Be sure that the no-nose saddle is adjusted according to the manufacturer’s instructions.
• Dismount the bicycle when at a standstill. Do not lean against a post or other object to stay seated on the bicycle saddle when you are not riding.
• Dismount the bicycle if you begin to have numbness, tingling, or loss of feeling in any part of your body.

While much of the scientific community has reached a consensus about the association between erectile dysfunction and traditional bicycle saddles, no-nose saddle designs have not been universally embraced by many cyclists. Informal discussions with numerous police and security patrol cyclists have revealed substantial skepticism, and often outright rejection, of bicycle saddle designs that do not incorporate a traditional narrow protruding nose. One reason for this is that some cyclists believe that the absence of the saddle nose compromises stability, maneuverability, and handling of the bicycle. A recent study¹⁰ has shown that cyclists initially have a perception of decreased stability when beginning to use a no-nose saddle. However, the most recent NIOSH study⁴ showed that 96% of bike patrol officers who tried a no-nose saddle continued to use a no-nose saddle beyond the study completion, suggesting that these individuals were able to overcome initial perceptions of decreased stability.

As we continue our research, we would like to hear about your experiences with no-nose saddles. More information on no-nose bicycle saddles can be found on the NIOSH Bicycle Saddles and Reproductive Health topic page and in the new NIOSH Workplace Solutions document, No-nose Saddles for Preventing Genital Numbness and Sexual Dysfunction in Occupational Bicycling.

The NIOSH Research Team has been studying bicycle saddle pressure and reproductive health since 2000.

Dr. Schrader leads the Reproductive Health Assessment Team within the Biomonitoring and Health Assessment Branch in the NIOSH Division of Applied Research Technology (DART).

Dr. Lowe is a Research Industrial Engineer in the Human Factors and Ergonomics Research Team within the Organizational Science & Human Factors Branch, DART.

Mr. Breitenstein is a biologist in Reproductive Health Assessment Team within the Biomonitoring and Health Assessment Branch, DART.

References

1. Schrader, S. M., M.J. Breitenstein, and B. Lowe. 2001 City of Long Beach Police Department, Long Beach, CA HETA 2000, 0305-2848
2. Schrader, S.M., M. J. Breitenstein, J.C. Clark, B. D. Lowe, and T. W. Turner. 2002. Nocturnal Penile Tumescence and Rigidity Testing of Bicycling Patrol Officers. Journal of Andrology 23:927-934.
3. Lowe, B., S. Schrader, and M. Breitenstein. 2004. Effect of Saddle Design on the Perineal Pressure of the Bicyclist. Sports Medicine. Med Sci Sports Exerc 36:1055-1062.
4. Schrader, SM, MJ Breitenstein, and BD Lowe. 2008. Cutting Off the Nose to Save the Penis. J Sex Med. 5:1932-1940.
5. Andersen, K.V. and G. Bovim. Impotence and Nerve Entrapment in Long Distance Amateur Cyclists. Acta Neurol Scand 95:233-240. 1997.
6. Sommer, F, D Konig, C Graf, U Schwarzer, C Bertram, T Klotz and U Engelmann. Impotence and Genital Numbness in Cyclists. Int J Sports Med 22:410-413. 2001
7. Buller, JC. Female Cyclists and Perineal Symptoms: An Experimental Bicycle Seat. Clinc J Sprts Med 11:289-290. 2001.
8. Slaimpour P, M Doursounian, J Catney-Kiser, M Adelstein, SS Gliolami, CC Wen, M LaSalle, CA Kim, B Goldstein, L Goldstien, K Hablow, S Viatones, S Levinson, RJ Krane, and I Goldstein. Sexual and urinary tract dysfunction in bicyclists. J Urol. 1998;159(suppl):30
9. Guess MK, KA. Connell1, SM. Schrader, S Reutman, A Wang, J Lacombe, C Toennis, B Lowe, A Melman, and MS Mikhail. 2006. Genital Sensation & Female Sexual Function In Cyclists And Runners: Are Your Feet Safer Than Your Seat? Journal of Sexual Medicine 3:1018-1027.
10. Bressel, E, Bliss, S, and Cronin, J 2009. A field-based approach for examining bicycle seat design effects on seat pressure and perceived stability, Applied Ergonomics, 40(3), 472-476.