If there’s a hard-core jock in your life—or even just a weekend warrior—find out how to be sure his fitness routine doesn’t compromise his fertility.
Exercise is a healthy habit for men and women—improving health, energy level, weight, sleep, and sex life. Plus it reduces stress. These factors make regular physical activity a must for you and your guy when you’re trying to conceive or adopt. In the past, this column has discussed how women can make sure their exercise routine doesn’t harm fertility, and can even promote it. But we don’t want to ignore the other half of the baby-making equation. Men also need to exercise with caution when trying to father a child. Without precautions, exercise itself can introduce male fertility and potency problems. The three biggest concerns? Heat, pressure, and trauma.
The Problem: Sperm production requires a temperature between 94 and 96 degrees Fahrenheit. Even a one-degree increase is enough to stop production and kill off any sperm already produced. The scrotum’s location outside the body usually keeps the testes cool. But a jock strap or the stretchy, tight shorts favored by cyclists and runners pull the testes in close to the body and increase scrotal temperature. (Padded bike shorts can raise the temperature even more.) Though temporary, these temperature spikes can be enough to interfere with conception. Although some studies have shown that excessive exercise can raise scrotal temperature as well, Marc Goldstein, M.D., director of the Center for Male Reproductive Medicine and Microsurgery at the New York Weill Cornell University Medical Center, says this is uncommon.
The Solution: Ditch the tight shorts for a looser fit. And any man having fertility problems should let his testicles hang free after exercising to allow them time to cool down. “Saunas, hot tubs, steam baths should all be avoided,” says Dr. Goldstein.
The Problem: Not the pressure-cooker at the office; we mean what happens when men’s private parts get squished, such as on a bicycle seat. When seated, the human body is designed to rest its weight on the ischial tuberosities, or “sit bones.” Older-style bicycle seats are hard and narrow—far too narrow for a guy to rest on his sit bones. Instead, his weight rests on the perineum—the area between the rectum and scrotum—which is the area where the nerves and arteries run. As a result, cyclists who spend more than a few hours a week in the saddle frequently complain of numbness in the genital area.
“Any numbness in the penile area should be a big warning sign for riders,” says Dr. Goldstein. Numbness indicates compression of the nerves running into the penis, which could mean the arteries are getting squashed as well. And a reduction in penile blood flow can cause impotence.
While this pressure won’t diminish sperm count, failure to achieve or maintain an erection will certainly complicate conception . . . plus it can ruin your sex life. What’s worse, among serious riders the problem may not be as easily rectified as simply getting off the bike. In one study, called the Massachusetts Male Aging Study, male sport cyclists who rode hundreds of miles a day showed evidence of penile artery atherosclerosis—the same hardening of the arteries that occurs in much older adults throughout their body. The treatment, according to Dr. Goldstein, is Viagra and similarly acting drugs, which must be taken every day—not just on the days when a man wants to have sex—to be effective. In cases of complete impotence, microsurgery is sometimes used as a last resort.
Compression can be a risk in other sports, too. For example, in a boat or on a rowing machine, rowers can experience the same type of numbness because the seat is usually raised in the center, creating perineal compression when the rower stretches forward at the start of the stroke. However, Irwin Goldstein, M.D., a sexual medicine specialist in Boston and editor-in-chief of The Journal of Sexual Medicine, says the incidence of numbness and erectile dysfunction (ED) is thought to be far less among rowers. “While I have seen many bicyclists for ED, I have only seen a few rowers,” he says. Rowers may be protected because their weight shifts throughout the stroke, alleviating the constant perineal compression. Also, rowers are less likely to be in the seat for as many hours as a long-distance cyclist.
The Solution: What’s a cyclist’s (or serious rower’s) sweetheart to do? Get him a properly designed saddle. But shop carefully. Steven M. Schrader, Ph.D., team lead of the Reproductive Health Assessment at the National Institute for Occupational Safety and Health, cautions that not all ergonomic saddles are equal. “Saddles [that have] a cut-out or hole and yet have a protruding nose do not appear to resolve the problem,” he says. Instead, cyclists should look for saddles without the “nose” in the front. “Noseless” seats take some getting used to, but Schrader says they’re worth it. Schrader doesn’t recommend traditional seats, but if your man can’t adjust to the noseless style, be sure his seat is properly angled to minimize pressure on the perineum, and persuade him to limit his riding to three hours per week.
The Problem: It’s a classic movie gag: A guy takes a hard blow to the groin and doubles over, his eyes rolling back in his head. And for some reason, everyone laughs. In real life, testicular trauma isn’t funny. Their placement outside the body makes the testes vulnerable, but freedom of movement and sponge-like composition usually allows them to escape serious injury. “However, testicular trauma has been known to affect a man’s fertility,” Dr. Marc Goldstein says.
And men are most likely to get hit playing sports. Not only can trauma compromise the testicles’ sperm-producing ability, explains Dr. Goldstein, but a severe blow can result in testicular rupture, an injury that requires prompt medical attention. A rupture causes bleeding from the testicle into the scrotum, breaking the barrier that normally protects the sperm from the body’s immune system. When the immune system comes into contact with sperm, it can begin producing antibodies against it, hampering fertility.
Warning signs that an injury to the testicles requires medical attention include pain that doesn’t go away, bruising, and swelling. “In men who are embarrassed, who don’t get to the doctor right away, the testicle can atrophy and cause fertility problems if the injury affects both testicles,” explains Dr. Irwin Goldstein.
The Solution: “Men should definitely be wearing a hard athletic cup in any activity where there’s a risk of contact,” Dr. Marc Goldstein says. The list includes football, soccer, hockey, lacrosse, boxing, and martial arts. “A cup will raise scrotal temperature temporarily, but the risk of not wearing a cup outweighs the risk of the temperature increase.” If your guy participates in an impact sport in which a cup isn’t feasible—like equestrian events, in which the cup could be uncomfortable—consider a hiatus from the sport before and during conception attempts.
A version of this article originally appeared in the Winter 2006 issue of Conceive Magazine.