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Doctors say women cyclists can be affected by genital injuries 

 

Bianca said: ‘You may experience pressure on the Ischial Tuberosities – better known as sitbones – or pain that radiates down the back of the thighs.

‘This could typically be because your saddle is either too high, or not wide enough to sufficiently support your sitbones, leading to pressure around the soft tissues called the bursa. 

‘In the end the main thing is your saddle and the position you have it in. The more upright you are on the bike, the more support you need to provide for your sitbones so a wider saddle may work better. 

‘However if you are cycling in a ‘more aggressive’ manner and leaning your upper body towards the handlebars you may need to consider a different shaped saddle, one that supports your pelvic bone and reduces pressure through the soft tissues.

‘It is here where a technique known as saddle mapping can very helpful. Pressure mapping helps to show what contact you have with the saddle, and how much pressure is occurring at a given point.

In this example, more of the pressure is concentrated towards the nose of the saddle which is where the sensitive soft tissues are located.

‘A physio specialising in cycling could point you in the right direction if it was thought saddle mapping could be the answer to your problem.’

The most common issue women cyclists face is vaginal infections like yeast infections, according to experts at industry publication Bicycling. 

While all women experience such infections, cyclists are more at risk because bacteria can be multiplied in the saddle thanks to sweating and close-fitting clothing. This hot, moist environment can trigger an overgrowth of yeast. 

Vaginal infections typically present as unusual discharge or a change in odor, as well as an itching or burning sensation, particularly when urinating. 

Cyclists can take steps to minimise chances for bacteria to multiply by changing out of their exercise shorts as soon as possible once the session has finished, explained Pradnya Pisal, consultant gynaecologist at London Gynaecology. 

If an infection has already developed, try over-the-counter treatment creams or seek medical advice.

Ingrown hairs can look like raised, red, itchy spots on the skin and are more likely to occur if you have coarse or curly hair. As public hair tends to be thicker and coarser than hair in other parts of the body, it is an area more prone to ingrown hairs. 

Shaving increases the risk of ingrown hairs, as does other hair removal techniques such as waxing or threading. 

Bianca said: ‘The latest fashion amongst women for pubic grooming is not something I would advise if you were taking up cycling. The hair in that region is there to protect the skin and hair removal could help add to irritation in that area.’

Endurance cyclist Jasmijn agreed, saying: ‘An infected follicle, in addition to the pressure caused by cycling and the hot and sweaty environment, can lead to significant pain. Generally the advice is to trim the public hair, cut it short but not to remove the hair because it is protective.’

Experts are divided over whether cycling causes a loss of sensation. 

One 2016 study by the Yale School of Medicine suggested that cycling for more than 100 hours a week can cause genital numbness, tingling or pain. 

A small study published in the Journal of Sexual Medicine in 2006 supported this finding, concluding that competitive female cyclists experienced decreased genital sensation.

However other experts believe the claims have not been substantiated enough and say there is no long-term effect.

Bianca explained this is an issue that can be tackled by making tweaks to the set up of your bike. 

She said: ‘Numbness almost always indicates too much pressure in the wrong place. 

‘Speak with your local bike fitter or physio that specialises in cycling biomechanics so they can help identify the best saddle or bike position.’ 

While the saddle can be important, it is also crucial to check the ‘contact points’ on the bike, such as the handle bars and height of the seat to ease pressure. 

If the cockpit – the section that brings together the groupset, frame and wheels together to form a bike – is too low or too far away, you may move yourself to the narrower front part of the saddle which is more likely to cause tissue pain.

However pain in the vagina is less common. Bianca said: ‘Pain in the vagina is not typical and could be related to something other than cycling. Again your saddle position could be causing the problem but it might be an idea to have a word with your physio or even your GP if the pain persists.’ 

While the urinary tract cannot be damaged from riding, the environment created by cycling can lead to the development of bacteria that causes such infections. 

As with vaginal infections, the bacteria responsible for UTIs thrive in hot, moist environment like the one created in sweaty cycling shorts after a long ride. 

Wash your clothes as soon as the session has finished to reduce the amount of time the bacteria has to multiply, according to Pradnya. Drinking more water can also help.

Women might also experience symptoms similar to UTIs, such as irritation when passing urine, that are actually the result of bruising to the vulva caused by pressure of time on the saddle. 

Women who are particularly slim or have thin labia are more likely to experience this type of pain.

Swelling can occur in the inner labia, outer labia or both. This can be the result of a lack of lymphatic drainage that occurs as a result of sustained pressure being applied. Once you have significant swelling, that can set up a vicious cycle of less drainage and more swelling.

The best way to tackle this is to eliminate unwanted pressure by reassessing your choice of saddle and overall bike fit. 

Ironically cut-out saddles, which are designed specifically to reduce pressure problems in women can lead to greater swelling in some women, particularly those with a fleshier vulva, because the tissue sits in the cut-out space and gravity ‘pulls’ fluid in as you ride. 

Saddle sores is an umbrella term that includes infected hair follicles (called folliculitis), chafing, and open ulcerations anywhere in the groin region. 

These can range from small, spot like sores to larger, painful ones that look like boils. 

Consistent pressure and chafing in the same place will irritate and inflame your skin over time, leaving it open to infection. 

The best way to avoid these sores is to take preventative measures, like wearing a thick chamois cream to lubricate the area and maintaining public hair grooming as outlined above. 

Bianca added: ‘Chamois cream, an anti-bacterial, viscous substance can help reduce friction between skin and clothing but I prefer emollients such as Doublebase or Cavilon. 

‘Ongoing issues mean you need to seek professional advice from a dermatologist or gynaecologist. 

‘However if symptoms coincide with the menopause then you may find topical oestrogen, that can be obtained on prescription, helps.’ 

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