This post is about the problems that women cyclists sometimes experience with our “lady parts,” due to saddle soreness. It includes an explanation of what causes the saddle soreness problems; descriptions of the various problems; advice on how to treat them and when to seek medical help; and advice on how to avoid all of these problems in the first place. The issues I have focused on are vaginitis (yeast infections); urinary tract infections; saddle soreness (includes chafing, folliculitis, saddle sores, and boils); genital numbness; and labial hypertrophy (swollen labia).
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Problems caused by cycling are not just a problem for men! More attention is given to cycling-related conditions suffered by men, rather than women. And we ladies normally suffer things in greater silence than men. Add to that the fact that the cycling media is often male-centric, and it is no wonder that this topic gets so little attention. But it is a common and often serious problem. Of course, pro cyclists are likely to suffer more as they spend so much time cycling, but even the most casual Average Jane Cyclist can experience problems.
This is a very in-depth post, and I did a lot of research to write it. For those who want to read even further, I have included a list of my research sources at the end of this post.
The Cause of Saddle Soreness Problems
When a female cyclist is on a road bike, her vulva (which is not meant to be weight-bearing) may be bearing up to 40% of her weight. Do that for a few hours, and things can get pretty unhappy down there. Add to that the fact that when you want to put on a burst of speed, you need to lean way forward, and you have a real potential for problems. Much is made of the problems men experience, but men can tuck their parts up front and largely out of harm’s way. Unfortunately, we really have no choice but to sit on ours.
Andy Pruitt, Ed.D., is the founder of the University of Colorado’s Sports Medicine and Performance Center. Dr. Pruitt has served as a medical consultant to numerous World Tour teams and cyclists. He says:
“Women actually have more problems than men, but historically haven’t talked about it as much. Now we have a generation of women cyclists who are not afraid to verbalize their issues. That helps everyone, because the more we understand the issues they’re facing, the better we can address them. No one should suffer in silence.”
Research on Saddle Soreness in Women Cyclists
The first major research on the issue was done in 2006. Dr. Marsha Guess found that competitive women cyclists had a significant increase in numbness and pain, and a significant reduction in genital sensation (compared to female runners). Not only that, but 64% of the women cyclists experienced pain and numbness in the genitals. Even more alarmingly, 10% had suffered injury, including compression of the pudendal nerve, and damage to soft tissue and lymphatic vessels. (See Sources at the end of this post.)
There was some good news – the women cyclists did not experience sexual dysfunction. Dr. Guess concluded:
“There is an association between bicycling and decreased genital sensation in competitive women bicyclists. Negative effects on sexual function and quality of life were not apparent in our young, healthy premenopausal cohort.”
Saddle Soreness Caused by Cycling (includes Chafing, Folliculitis, and Boils)
Saddle soreness refers to a whole smorgasbord of painful conditions caused by friction between your body and the bike. They are by far the most common problems experienced by women who cycle a lot.
Chafing from Cycling – the Mildest Form of Saddle Soreness
It starts with simple chafing, which most commonly affects the inner thighs. Repetitive movements against a saddle can easily cause chafing. Add to this the bacteria that may be present in the chamois area of cycling shorts, and you have a perfect storm. Chafing is not a serious problem in itself, but it can be very uncomfortable.
Infected Hair Follicles (Folliculitis)
Folliculitis is also caused by chafing. But in this case, the irritation occurs at the base of the hair follicle, and leads to infection. In this age of Brazilian body waxes, infected hair follicles are common. This is because waxing removes a protective layer of hair from the body. If you can, it is better to leave yourself “au natural” in the groin area during your cycling season.
Boils (Furuncles) as a result of Saddle Soreness
These can also be a result of chafing. However, these can grow and become extremely painful. They often require treatment. More about that below.
Raw skin caused by chafing can ulcerate and become infected, escalating to actual saddle sores. These can be excruciating, and may make it impossible to cycle for a while. They usually look like irritated, raised sections of skin. They may also look like pimples – pores filled with bacteria.
How to Treat Chafing, Saddle Sores, Folliculitis, and Boils caused by Saddle Soreness
If you have an infection, use a light layer of antibiotic ointment such as Neosporin. This applies to chafing, saddles sores, folliculitis, and boils.
A product called Boil Ease can ease the pain of boils.
For saddle sores, if you want to keep cycling without pain, try cutting moleskin to fit around the sore, so you can keep pressure off it.
For boils, do not pop them with a needle! Instead, make a warm compress by dipping a cloth into warm water. Then apply it to the boil. This will decrease the pain and start drawing the pus to the surface. After a few sessions of compression (2 to 3 times a day), the boil should burst. At that point, wash it with an antibacterial soap and clean with rubbing alcohol. Finish with Neosporin and a bandage.
When to See a Doctor for Chafing, Saddles Sores, Folliculitis or Boils
If an infection sets in, you may need an antibiotic prescription. Definitely see a doctor if you start running a fever (especially if you have chills); or you have swollen lymph nodes; or the skin around the infected area turns red or red streaks appear; or the pain becomes severe; or you have a boil that does not drain.
How Women Cyclists Can Prevent Saddle Soreness Caused by Cycling (including Chafing, Saddle Sores, Folliculitis, and Boils)
All of these ills start off as chafing, so they are all best targeted by prevention of chafing. Specifically, you need to look at two key things: a good bike fit, and a good saddle. The aim is to avoid repeated friction. You can read more about this below in the section called What Women Cyclists Can Do to Prevent Saddle Soreness Related Problems.
Vaginitis (Vaginal Infections, such as Yeast Infections)
According to the Mayo Clinic, “Vaginitis is an inflammation of the vagina that can result in discharge, itching, and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection.”
There can also be burning when you urinate. Most women have had yeast infections at some time. You may be more prone to cycling-induced vaginitis if you are post-menopause or have had a hysterectomy. This is because these can lead to thinner vaginal lining. Women cyclists are at heightened risk due to spending many hours in the bike saddle.
Cycling can cause infections because, as Professor of Gynecology Mary Jane Minken notes:
“Chamois time can be bacteria-multiplying time. Women who bike a lot are sweating inside close-fitting clothing. That can promote the overgrowth of yeast, which thrives in hot moist environments.”
How to Treat Vaginitis
Vaginitis can sometimes be treated by over-the-counter, anti-yeast remedies. Good products such as Monistat can even be purchased online.
And a topical steroid cream can help with the itching. In extreme cases, I have found Cortizone brings almost immediate relief. At worst, you should find that if you apply it before bed, everything is much, much happier by morning!
When to See a Doctor
If a single application of an anti-yeast remedy does not work, see a doctor to get an antifungal to treat it.
Also, see a doctor if you have vaginitis with a particularly unpleasant vaginal odor, discharge, or itching. This is especially true if you recently started to see a new partner, as it may not be the cycling. It may be an STD, such as Trichomoniasis. Also, if the vaginal discomfort is accompanied by a fever, chills or pelvic pain, see a doctor right away.
How Women Cyclists Can Prevent Vaginitis
Cleanliness is Key
To prevent vaginitis, cleanliness is your first defense to stop the fungus and bacteria from multiplying.
The chamois in cycling shorts can be a breeding ground for bacteria, so it is important to wash your chamois after every ride, and air dry completely. Some cycling shorts have a removable chamois that can be washed on its own. If you don’t have that, wash the shorts and chamois together.
Also, remove your shorts as soon as possible after every ride. Then, take a shower right away. Don’t use products that can cause or exacerbate irritation, such as scented soaps, harsh soaps, soaps with deodorant or antibacterial action, or bubble bath.
After showering, dry off completely. If necessary, use a blow dryer on low heat to completely dry your parts. This is to make sure that you are completely dry, because bacteria thrive in moisture. If a shower is not possible, then use baby wipes.
It’s best to sleep without underwear, to keep things drier, because yeast thrives in moisture.
Supplements that May Help
Some people believe that yoghurt or probiotics (specifically Lactobacillus acidophilus supplements) may help to prevent vaginitis, by helping to maintain a correct balance in the vagina. However, there is not enough research to definitively prove this. On the other hand, probiotics promote good health in a number of ways, including intestinal health, so there is no harm in trying it. (Source: Web MD)
Vaginitis may also be caused by too much friction on the bike, caused by a poorly fitting bike or saddle. For advice about this, please see the section below called What Women Cyclists Can Do to Prevent Saddle Soreness Related Problems.
Urinary Tract Infections (UTIs)
These are bacterial infections that impact any part of the urinary system – such as your urethra, bladder, or kidneys. Unfortunately, they are quite common in women who cycle, because bacteria from our chamois can make its way into our bladder.
You are most likely familiar with the symptoms of urinary infections, but in case you are not, they include: burning urination; frequent feeling that you urgently need to urinate, even when you don’t; discolored urine; and generalized pain in the area. You may only have the first one or two of those symptoms, or you may be unlucky enough to have all of them.
How to Treat Urinary Tract Infections
Many women try non-medical treatments for urinary tract infections, including drinking plenty of cranberry juice, and drinking lots of water to flush everything out.
When to Get Medical Help for a Urinary Tract Infection
If home treatments do not help and the condition persists for longer than a day, or becomes very uncomfortable, go to a doctor. This condition can get very painful very quickly. A prescription medication, usually an antibiotic, will clear it up quickly.
Also, if you are having a lot of pain, ask your doctor about a prescription for the pain. There are prescription medications that specifically aim to relieve pain in the urethra. I have found that unless you ask for this, doctors don’t subscribe it. If you do ask for it, it seems their memory is jogged and they will prescribe it. I guess they think that the antibiotics will sort it out in a day or two, so it’s not necessary. Based on personal experience, 24 to 36 hours of a UTI is 24 to 36 hours of pain I do not want!
Some doctors insist on doing a test on your urine, but really, you know when you have a urinary tract infection. Unfortunately, it is impossible not to notice. My only aim in this situation is to start treatment as soon as possible.
How Women Cyclists Can Prevent Urinary Tract Infections
As with vaginitis, cleanliness is your first defense against urinary tract infections related to cycling. And the usual advice you have probably heard already applies: such as wiping yourself clean from front to back. Also, drinking lots of water helps to keep everything well flushed.
And as with vaginitis, getting out of your shorts immediately after cycling is important. And then immediately showering, followed by drying off completely. And laundering your shorts and chamois.
There is some research that suggests that regularly drinking cranberry juice may help you to have less frequent infections (Hisano et al., see list of sources at the end of this post). Cranberry juice has a chemical called A-type proanthocyanidins. This is thought to protect against bacteria in the bladder. Of course, it must be a 100% pure cranberry juice, with no added sugar or anything else.
However, all of this might not stop you from getting a urinary tract infection caused by friction and irritation when cycling. To reduce that possibility, please see the section below called What Women Cyclists Can Do to Prevent Saddle Soreness Related Problems.
Researcher Dr. Marsha Guess reported that 64% of a group of female cyclists (who rode at least 10 miles per week) reported genital numbness and tingling within the previous 30 days. Fortunately, she also found no association with sexual dysfunction or quality of life. Still, genital numbness is no fun for anyone. Numbness is caused by compressing nerves.
How to Prevent Cycling-Related Genital Numbness
The primary solution is a good bike fit, so that your weight is properly distributed. Also, it’s important to have the right saddle. For more on those two issues, see below in our section on What Women Cyclists Can Do to Prevent Saddle Soreness Related Problems.
Labial hypertrophy (swollen inner and/or outer labia) is a more serious condition. This condition is caused by pressure, which can result in inadequate draining of the lymphatic system. This can even cause long-term swelling of the labia. An early sign is discomfort when you apply pressure to the area. Irritation of the labia is also a sign.
Once you have swelling, the swelling can further impede drainage, so you are in a vicious circle. In some cases, a surgical intervention is required to ease the pressure.
Even in the absence of long-term damage, this condition can be intensely painful. One woman cyclist, Tess, complained after a 100 mile bike ride about her “lady parts:”
“When I got home, I inspected the damage. It was horrific. Swollen, chafed and raw. I really don’t know how female professional cyclists maintain any kind of love-life. The pain lasted for days, and the thought of getting back on the saddle filled me with dread.”
The labia may also become inflamed, and some women even get infections of the labia. Champion cyclist and doctor, Bridie O’Donnell, says:
“Labial abscesses that needed to be drained or excised were very common during my racing career, and every season, three or four of my teammates would undergo surgery for this.”
When to Seek Medical Help for Swollen Labia
This is not a problem you can treat yourself. Apart from staying off your bike, which you probably don’t want to hear.
So, when should you see a doctor for this condition? In the case of swollen, inflamed, or infected labia, the answer is, as soon as possible.
Phil Burt, head of physiotherapy at British Cycling, says: “If you have seriously swollen labia, it’s quite personal to talk about, but it really needs addressing as soon as possible.”
In the case of inflamed or infected labia, the answer is, see a doctor immediately.
How to Prevent Cycling-Related Labial Hypertrophy
As with most of the problems in this post, the primary solution is a good bike fit, followed by the right saddle. See just below in the next section.
No. 1: Get Your Bike Fitted Properly
To reduce pressure points, Joe and I always recommend having your bike fitted to your body. None of us is the ideal model for any bicycle manufacturer, so it is unlikely that a bike will be a perfect fit straight out of the store.
For example, almost everyone has a leg that is slightly shorter than the other. This means that you will be shifting on the saddle at the bottom of each rotation, which can create a chafe point in your groin area. Sometimes all that is needed is a simple shim in your shoe to equalize the length.
If your bike does not fit your body, all kinds of problems can ensue. These include back, knee, hip, and elbow pain. And more to the point here, an ill-fitting bike can cause saddle soreness.
Professional Bike Fitting
The best solution is a professional bike fitting. The aim is to customize your bike to you so that it fits perfectly. As a result, most of your weight will be on your ischial tuberosities (your sit bones), or on the pubic rami (the pelvic bones, which are further forward). Where your weight rests will depend on your cycling position. The key is not to have too much weight on your soft tissues.
Professional bike fittings are usually expensive. But if you can afford it, they are worth their weight in gold. If you have been experiencing saddle soreness, be sure to tell your bike fitter about it. Yes, it’s a bit embarrassing to talk to a stranger about this, but it’s worth your while. If you have a choice of bike fitters, phone around and try to get one who understands the specifically female issues that you are dealing with.
Electronic Pressure Mappers
The most expensive bike fittings will include measurements done with an electronic pressure mapper. This will expose potential pain areas where your body is in contact with the saddle in minutes. If you can afford this, you could save yourself hours of painful trial and error, trying to find the right saddle and fit it correctly.
Of course, you need to be lucky enough to have this service available in your area, and be able to afford it. Expect to pay hundreds of dollars.
Do It Yourself Bike Fitting
If you cannot afford a professional bike fitting, the book below will help you do your own bike fitting. Bike Fit: Optimise Your Bike Position for High Performance and Injury Avoidance is written by Phil Burt. Burt is the head physiotherapist at British Cycling and Team Sky. Working with the UK Sport’s Research and Innovation team, Burt played a leading role in researching women’s saddle soreness problems, and coming up with solutions. (That’s why he is quoted elsewhere in this post.) So, unlike with many cycling books, women’s needs are specifically addressed in this book, rather than ignored.
When you do your own bike fit, focus on a fit that does not require you to be stretched forward too much. The more you stretch forward, the more your weight shifts from your glutes and your sit bones, onto your vulva. Not desirable! Changes to the stem of the bike can make a huge difference.
No. 2: Get the Right Bike Saddle
Once your bike is perfectly fitted to your body, you need to turn your attention to your saddle. Note that a professional bike fitting will include help with your saddle. But if you don’t have access to that, there is plenty you can do to make sure your saddle is helping the situation, not making it worse.
First, it is important to get the right saddle to suit your body. We have two related posts that can help with that.
Related Posts to Help You Pick Out the Right Saddle and Fit it Properly
It can be tough to find the right saddle. One way is to find a bike shop that will let you try saddles out.
Tips on Getting Your Bike Saddle Right
It’s not only about finding the right saddle; it’s also important to mount it correctly. This may be a case of trial and error, because what works for one woman doesn’t necessarily work for all. A couple of things to remember:
- Women do not necessarily need wider saddles. It is the space between the sit bones, not the width of the hips that governs saddle comfort. Some women swear by women-specific saddles; others do not need them. In fact, some women find that over-wide saddles cause chafing on the inner thighs.
- More padding does not always translate into more comfort. A lot of people praise Brooks saddles, which are made of hard leather, which conforms to the shape of your body over time. My most comfortable bike saddle ever was the stock saddle on my Giant Avail road bike. It was very narrow and only lightly padded, but I never once had any problems from ride one!
- Newer saddles that include center cut-outs do not work for everyone. However, many women find them essential. For some women, they relieve the pressure on our most sensitive parts. But for others, they re-distribute too much weight outwards, causing inner thigh chafing and other problems.
- Try tipping the nose of your saddle down by a degree or two. This may reduce pressure.
- Standing on the pedals every ten minutes or so could help to keep your blood flowing and reduce pressure.
Try a Forked Saddle
The author of Bike Fit, Phil Burt, recommends that women cyclists try forked saddles made by Adamo. He notes that many Olympic women cyclists swear by their ISM Adamo saddles. He believes that this saddle helps “not solely because of the cutaway but because the two arms of the saddle front flex and rotate with the rider as they pedal.”
This saddle was originally aimed at men, but has been more warmly embraced by women. It was designed for time trialists and triathletes, has a curved nose for a comfortable forward leaning position, and combines foam and gel padding.
Finally, one cure for saddle soreness is to ride more often. Sometimes the first few rides of the season can be painful, but then our bodies adjust. As with most things, it is important to start slowly and build up gradually. This is most definitely not a situation of “No pain, no gain!”
No. 3: Get Good Cycling Shorts
Good cycling shorts are essential, even if you only cycle once a week. They will help to minimize the chances of saddle soreness, by providing an anatomically-appropriate layer of protection between your body and the saddle. This protective layer is provided by a chamois that is intended to provide cushioning at points of contact between your body and your bike. It should not have seams to irritate your skin.
Cycling shorts are designed to minimize chafing on long bike rides. They help by wicking moisture away from your skin. And the seams are carefully placed to reduce irritation and chafing. More expensive shorts are usually more skillfully designed to avoid chafing.
If you do multi-day rides, you will need at least two pairs of shorts. This is so that you have a clean and dry pair at all times. These Terry bike shorts are very highly rated, affordable, and come with foam padding. Terry specializes in women’s cycling wear, and makes a range of foam chamois pads. They offer an unconditional warranty on their shorts, which is unusual.
No. 4: Consider Getting Bib Shorts
Bib shorts are shorts with an attached top. They are usually more expensive than regular shorts, and can make toilet breaks a bit tricky. However, they are worth their weight in gold because they substantially reduce the chance of saddle soreness.
Marijn de Vries, retired pro bike racer from Holland, says:
“A really good, well-fitting pair of bib-shorts will definitely help … the bibs keep the [chamois] pad firmly in place and make them much more comfortable. And you should use plenty of chammy cream.”
I found this pair of bib shorts from Giro that cleverly solve the toilet break problem. They have a women-specific bib short that has a halter top. So, you can quickly take it off! The price is very reasonable for bib shorts too.
No. 5: Use Chamois Cream
Chamois cream will help to keep your chamois from irritating your body. This cream can be applied to the chamois directly, or to your body. It is usually less messy to apply it to the specific parts of your body that are prone to chafing. A good cream will reduce friction between skin-to-skin points or skin-to-fabric points.
Note that there are women-specific chamois creams. These are formulated specifically to maintain a healthy pH balance down under. For example, Chamois Butt’r Her’ is pH balanced for women and contains aloe vera, green tea leaf extract, tea tree oil, shea butter, and lavender oil for their naturally occurring beneficial properties.
No. 6: Try an Anti-Chafing Gel
If you are one of the many women who suffers chafing on the inner thighs, consider an anti-chafing gel. Many triathletes use these. They are especially prone to chafing since they jump on a saddle while still wet from a swim! The gel is designed to provide a silky protective layer.
No. 7: Do Not Wear Underwear!
It is important to not wear underwear with your cycling shorts. If you add a layer of underwear, this will impede your short’s ability to wick moisture away from your body. And it may move around and bunch up, increasing the chance of chafing and saddle sores.
We may all soon be cycling more, as warmer weather arrives and (hopefully) the Covid-19 virus recedes. If so, make sure to have your bike and saddle, and your shorts and chamois, ready for many hours of cycling without problems. Follow all of our tips, especially the ones about scrupulous cleanliness, bike fit, and saddles, and you should be just fine. And if not, get help right away, so you can be back on your bike as soon as possible!
Sources Used in this Post
Burt, Phil. The Guardian: How Female Cyclists Can Combat Saddle Soreness
Henry, Thomas. Cycling UK: How to Stop Female Saddle Soreness
Hisano, Marcelo et al. Cranberries and Lower Urinary Tract Infection Prevention. Clinics (Sao Paulo, Brazil) vol. 67,6 (2012): 661-8. doi:10.6061/clinics/2012(06)18
Liv Cycling: How to Deal with Discomfort “Down There”
Mayo Clinic: Vaginitis
Web MD: Boils.
Web MD: Vaginal Yeast Infections.
Yeager, Selene. Bicycling: How to Prevent Saddle Sores and Common Issues for Women
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