Female Pelvic Health and Bike Seats

An article appearing in The Journal of Sexual Medicine asks the following question: do bicycle seats damage the female pelvic floor? The authors studied the affects of bicycle set up on genital sensation and saddle pressures among female cyclists. Subjects included were premenopausal, non-pregnant women who rode at least 10 miles/week, and the women used their own bicycles and saddles for the study. Genital sensation was determined with use of a biosthesiometer, a research device that measures thresholds of vibration in the body. A pressure map was used to record perineal and total saddle pressures. When the bike handlebars were positioned lower than the saddle, increased perineal pressure and decreased anterior vaginal and left labial genital sensation was noted.

Prior research published in the same journal reported that female cyclists can suffer from genital pain, numbness, and swelling, and that debate exists regarding best bike seat/saddle design. 48 cyclists were included in this research, and more than half of them used traditional saddles versus "cut-out" or narrow saddles with portions of the seat removed to avoid pressures on the perineum. Although there was an association of decreased lower mean perineal pressure with use of traditional saddles, these differences were not statistically significant. Overall, cut-out and narrower bike seats were found to have increased saddle pressures measured by a specially designed pressure sensor.

When educating our patients about pelvic health and biking, the most important factor to consider is overall fit. Many therapists are trained in the evaluation of bike fit, if you are not, consider adding those skills to your tool box, or get in touch with an expert for referrals. By contacting a local bike shop, you can get names of bike experts or therapists who specialize in fitting. To learn more about bike seats and posts, click hereand you can find an entire website devoted to concepts of bike fit, including classes that you can attend to become certified in bike fitting.

Authors of each study mentioned state that more research is needed to determine if bike saddle pressures affect pudendal nerve health, sexual function, and pain. To determine if bike fit is a part of your patient's issues, ask her detailed questions about how much time is spent on the bike, what kind of bike (mountain bike versus road bike), what position she is in most of the time (in the "drops" or lowered handle position versus upright), what kind of terrain she rides (bumps that can jar the pelvis versus smooth roads), and what kind of symptoms that she has on and off the bike. Female runners were found in one study to have improved perineal vibratory sensation thresholds when compared to competitive cyclists, indicating that biking can impact genital sensation and potentially create other pelvic dysfunctions.

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