Prostatitis is a common condition affecting 50% of all men in their lifetime, particularly cyclists. But you don’t have to live with cycling-related prostatitis.
My bladder was like the core of a nuclear reactor. Its contents were being superheated, fueled by the gram-negative bacilli bacteria that had breached its core. The situation was critical. The only way to protect itself, eliminate the intruder.
Yes, like every five seconds. The burning, searing pain was like no other. Cycling-related prostatitis was the Uranium. The pain wasn’t going away on its own, either, like all the other times.
A New Year’s Eve to Remember, a Cycling-Related Prostatis Event to Forget
It was New Year’s Eve. Memorable, not for the anticipation of turning the page on the calendar. That was the day that the meltdown occurred, and it was a catastrophic disaster.
I could hear my family and friends laughing it up outside my bedroom door. I excused myself from the celebration, for the pain had encompassed my trunk, and it was a challenge to sit upright. My self-induced misery need not interfere with their good time. Cycling-related prostatitis is nothing to celebrate.
Blood in my Pee Was a Shock to Me
I felt my body rising from the bed in a pulsing rhythm with the episodic bouts of spasms that gripped me. I had a fever and chills. Then through bleary-eyed suffering from the shock of seeing blood in my urine, I knew it was the day. The day I HAD to do something about this.
I’m not ashamed to talk about it. It is a sensitive topic, but I know I’m not alone. I’m more embarrassed that I let it go on for so long. Content to rationalize the symptoms away by thinking, “This is just another of the things I have to deal with because I am a cyclist.”
Prostatitis in cyclists is nothing to be ignored or swept under the rug.
Pain is NOT the Cost of Doing Business
I’ve suffered symptoms like frequent urge to urinate (urgency) and painful urination (dysuria). Thankfully, I never suffered from THAT problem, but I did experience pruritus ani (you can look it up yourself), which isn’t nearly as bad, but definitely not a picnic.
The incessant nocturnal trips to the toilet left me sleep-deprived and unrecovered. I was the old guy that pees a lot on group rides, taking every chance to water the weeds. It was worse when I was racing IRL, and New England’s hilly stage races forced me to travel far from home.
Multiple long hard days in the saddle, yo-yo-ing hydration and dehydration, and pushing myself past the point of no return was the recipe for an urgency emergency.
I carefully timed the rest areas and strategically planned my return route based on the opportunities to eliminate. I became a pro at the panicked parkway pitstop, jumping out of the car and back in again before my kids could look up and say, “Not again!”
Stupid Rookie Mistakes
I made a lot of stupid mistakes early in my cycling career. I failed to heed the chamois cream concerns of my contemporaries, and saddle sores were my admonishment. I spent a bit too long in my sweaty bibs a few too many times and developed atopic dermatitis and cholinergic urticaria. That’s right. I’m allergic to my sweat now. Life is cruel! The irony.
Perhaps one of the most significant errors was the blind belief that the more time I spent in the saddle, the better I would get. I wanted to get VERY good, and I was willing to sacrifice the sensitivity of my nether regions for the opportunity.
Not near as significant, however, as the mistake I had been making for most of my athletic life. That the aches, pains, and unending uncomfortable symptoms I suffered were the “cost of doing business,” and I had to deal with them.
Living With Pain is NEVER Acceptable
That New Year’s day was memorable, but not because it marked the day that my body had rebelled against my irresponsible ways. No, it was the day I learned I never have to live with pain or discomfort. There is always a reason, a cause, and the pain-alleviating answer is in asking the right questions.
While my guests were sleeping off their self-induced misery, I was at my physician’s office. The urinalysis came back positive. I was diagnosed with Acute bacterial prostatitis, a urinary tract infection (UTI) that traveled to my prostate gland. In my case, the cause was longstanding Chronic bacterial prostatitis, or cycling-related prostatitis, when bacteria becomes trapped in the prostate gland, causing recurrent UTIs that are difficult to treat.
Prostatitis Affects 50% of Men, Particularly Cyclists
According to the Cleveland Clinic, 50% of all males will experience prostatitis symptoms in their lives. It’s the most common UTI issue in men younger than 50 and third in those over 50.
A recent study has sparked heated debate amongst the cycling community. There was a reported six-fold increase in prostate cancer risk in the group members of 5,000 cyclists that trained for more than eight hours per week, compared to men who trained for less than 3.75 hours. The study has been criticized for multiple reasons, leading experts to conclude that cycling has far more positive effects on urinary health than negatives.
A literature search of bicycling and genitourinary disorders revealed varied incidence, with nerve entrapment syndrome, presenting as genital numbness, the most commonly reported in 50-91% of cyclists. Prostatitis and other conditions were further down the list.
Prostatitis in Cyclists is Common
Repetitive compression and trauma to the perineum, the region contacting the saddle, causes recurrent prostate inflammation. When left unaddressed and the symptoms untreated, it progresses to an acute emergent situation as it did for me.
In my situation, medical treatment consisted of several months of antibiotics. The goal is sterilizing the prostate (please forgive the word choice), and eliminating the symptoms. In stubborn cases, when the bacteria have an unrelenting foothold on the prostate’s lining and refuse to go quietly, a long-term course of a low dose of antibiotics is required.
Medical Treatment and Bike Modifications Help Prostatitis in Cyclists
My acute symptoms resolved quickly, but I required more than two months of heavy-duty meds to eliminate them. I have experienced two flair-ups over the years that antibiotics treated successfully within one month. I never want to go through that again and keep a bottle of the bacteria-busters on hand just in case.
The medication reduced the symptoms, but my instituted modifications have kept it that way. I invested in a proper bike fit where I settled into a comfortable and practical pressure-reducing saddle. The bike fitter assessed my positioning to optimize efficiency without sacrificing comfort and perineal pressure.
I spent a king’s ransom for a few pairs of hi-tech pro bib shorts. Chamois cream is a constant must. My bibs hit the laundry pile the moment they are of no functional use to me. Those were the easy changes.
With the help of my coach, I revamped my training plan to maximize performance through efficiency rather than volume. It wasn’t easy, but I did it. In fact, I did a few things due to this ordeal that changed my life for the better.
Conclusion - Life and Cycling Lessons
I realized that even though I’ve had my body for a long time, a lot is left to learn about it. My experiential knowledge base is evolving. Athletes are keen observers of their body’s signals, and I must become a professor.
Never again will I dismiss my discomfort or deny its existence. I made a deal with myself and am committed to sticking to it. Cycling is not a privilege that I must pay using pain as my currency. It’s not that kind of pain—the good kind. You know what I mean.
I shared my experience with a few of my close cycling contemporaries. Wouldn’t you know it? They have suffered, too. Not to the extent that I neglected myself, but similar symptoms nonetheless. Cycling-related prostatitis is more common than you may care to know.
By opening up about the sensitive subject, it helped them avoid my fate. I am confident it will do the same for some of you. As is the intention of the other life and cycling, lessons I learned and put on paper here. I hope it helps.
Have you experienced any genitourinary symptoms as a result of cycling? Have you gotten it checked out? Why not? Comment below! Your fellow virtual cyclists want to know.
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Semi-retired as owner and director of his private Orthopedic Physical Therapy practice after over 20 years, Chris is blessed with the freedom to pursue his passion for virtual cycling and writing. On a continual quest to give back to his bike for all the rewarding experiences and relationships it has provided him, he created a non-profit. Chris is committed to helping others with his bike through its work and the pages of his site.
In the summer of 2022, he rode 3,900 miles from San Francisco to New York to support the charity he founded, TheDIRTDadFund. His “Gain Cave” resides on the North Fork of Long Island, where he lives with his beautiful wife and is proud of his two independent children.
You will read him promoting his passion on the pages of Cycling Weekly, Cycling News, road.cc, Zwift Insider, Endurance.biz, and Bicycling. Chris is co-host of The Virtual Velo Podcast, too!
Hats off for the straight talk. Cycling-induced health issues are easily downplayed, politely swept under the rug, down or outright denied, often with the best of intentions. As with all other sports, the rule of the golden middle applies here as well. Where the healthy mid-point lies will differ from athlete to athlete but we all too easily forget or wilfully neglect the pitfalls of overdoing things in our beloved sport. After all, the bigger those weekly Strava numbers the better, right? A good reminder how much it pays off in the long run to have a keen eye for the ‘little things’ – as with everything else in life. Kudos!
Your thoughtful comments are appreciated, Attila. As we age, it’s important to reassess our priorities through the perspective of time. It takes some of us a long time and a lot of mistakes. Hopefully, it is a lesson earned and learned. And yes, thank you for acknowledging the straight talk. I was a bit concerned if it would be accepted for what I intended.
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