Background: Cycling is a popular sport among men. Despite its health benefits, fears have been raised regarding its effects on erectile dysfunction (ED), fertility, and on serum prostate-specific antigen levels. This study aimed to examine associations between regular cycling and urogenital abnormalities in men. Methods: A cross-sectional population study of 5,282 male cyclists was conducted in 2012-2013 as part of the Cycling for Health UK study. The data were analyzed for risk of self-reported ED, physician-diagnosed infertility, and prostate cancer in relation to weekly cycling time, categorized as < 3.75, 3.75-5.75, 5.76-8.5, and > 8.5 hours/week. Results: There was no association between cycling time and ED or infertility, disputing the existence of a simple causal relationship. However, a graded increase ( p-trend = 0.025) in the risk of prostate cancer in men aged over 50 years (odds ratios: 2.94, 2.89, and 6.14) was found in relation to cycling 3.75-5.75, 5.76-8.5, and > 8.5 hours/week, respectively, compared to cycling < 3.75 hours/week. Conclusions: These null associations refute the existence of a simple causal relationship between cycling volume, ED, and infertility. The positive association between prostate cancer and increasing cycling time provides a novel perspective on the etiology of prostate cancer and warrants further investigation.
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