Abstract
Background. Cycling is a globally popular form of active transport, recreation and competitive sport, valued for its cardiovascular and metabolic benefits. The prolonged, forward-flexed seated posture characteristic of riding loads the perineum and has prompted longstanding concern about urogenital health in both sexes.
Objective. To synthesize current evidence on urogenital health in male and female cyclists and to translate it into practical implications for sports medicine.
Methods. Narrative review of peer-reviewed studies spanning cycling epidemiology, perineal biomechanics, lower urinary tract symptoms, sexual dysfunction, prostate markers, genitourinary trauma, perineal pain and preventive strategies.
Overview. Genital numbness, saddle sores and perineal pain are the most consistently reported complaints in both sexes and increase with riding volume. Evidence linking cycling to erectile dysfunction is conflicting and not supportive of a simple causal relationship; women report more urinary tract infections and numbness than comparable athletes; cycling does not appear to elevate prostate-specific antigen; mountain biking is associated with scrotal abnormalities; and acute genitourinary trauma is uncommon, with the kidney most often injured. Saddle design, handlebar height, padded shorts and intermittent standing measurably modify perineal pressure and symptoms.
Conclusions. For most riders the benefits of cycling outweigh its urogenital risks. Symptoms are common but largely modifiable through equipment and positioning; women remain under-studied. Sports medicine practitioners should incorporate symptom enquiry, bike fit and saddle selection into routine care.