Helping Women With Saddle Pain
“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.”
The Issue of: Saddle Sores
This is an umbrella term that includes infected hair follicles (called folliculitis), chafing, and open ulcerations anywhere in your chamois region—all of which have the potential to be quite painful.
Saddle sores are usually raised, irritated sections of skin, or pimple-like bacteria-filled pores. Regardless of their shape, they’re sensitive and, yes, sore.
How to fix it
1. Lubricate: Chamois cream is designed to reduce friction between your skin and your shorts. Rub some on the chamois itself as well as your skin for maximum protection. You can find women’s-specific creams, which are specially formulated to help you maintain a healthy pH balance in your nether region.
2. Carefully remove hair: Grooming your bikini area may look good on the beach, but can open the door for sore razor bumps, ingrown hairs, and infected follicles, Pruitt says. “Your pubic hair is like MIPS for your vagina, in that it’s a protective layer between your sensitive tissues and the friction with the saddle,” he says. Shaving and waxing eliminates that protection, and can create more problems with irritating stubble. That’s not to say you have to go au naturel, but use a good (not dull) razor that provides a close shave, and take precautions against infected bumps by applying a light layer of antibiotic ointment like Neosporin after shaving.
3. Create a protective barrier: Some women have problems with inner-thigh chafing, as the sides of the saddle rub that delicate skin raw. Many triathletes (who are very prone to chafing since they jump right on the bike soaking wet from the water) swear by anti-chafing gels like Lanacane—which are specifically designed to prevent chafing from skin rubbing on skin, or skin rubbing on clothing—by forming a silky protective surface on the skin.
4. Switch your chamois: Like saddles, chamois come in all shapes and sizes and some may fit your bottom better than others. You want a seamless chamois that stays put and doesn’t irritate your skin or cause hot spots when you ride. Never wear underwear with bike shorts, which are meant to be worn commando—underwear adds one more layer that could bunch up and cause chafing.
5. Apply topical solutions: You can treat mild sores yourself with a healing, protective ointment. Moleskin with an area cut out around the sore can also help keep pressure off the sore itself, so it’s less painful to ride.
The Issue of: Vaginitis
The most common issue women cyclists face is actually one that women face regardless of whether they ride a bike: vaginal infections, like yeast infections. Cyclists are more at risk, though, because “chamois time” can be “bacteria-multiplying time,” says Mary Jane Minkin, M.D., clinical professor of obstetrics, gynecology, and reproductive services at Yale School of Medicine.
“Women who bike a lot are sweating inside close-fitting clothing. That can promote the overgrowth of yeast, which thrives in hot moist environments for many people,” Minkin says.
Unusual discharge, change in odor, itching and/or burning, especially when you pee.
How to fix it
To avoid these unpleasantries, minimize chances for bacteria and fungus to multiply. “Get out of your shorts as soon as possible,” Minkin says. “After you shower, using a hair dryer on low heat to dry your vaginal area can be helpful.” Baby wipes or witch hazel and a dry towel also help in a pinch.
You can also make yourself more resistant to infection by eating probiotic-rich foods that maintain protective bacteria in your body. “Yogurt and kefir and probiotics may help you get fewer infections,” Minkin says.
Once you have an infection, you can try to treat it with an over-the-counter cream. But if one application doesn’t work, see your doctor for an antifungal, like Diflucan, and a topical steroid cream, like Lotrisone, for prompt relief, Minkin says.
“Don’t mess around with over-the-counter creams. You want something to kill the fungus and a topical steroid to keep from itching,” she says.
Loss of Sensation
Up to 62 percent of competitive women cyclists reported feeling genital numbness, tingling, or pain within the past 30 days in one small study of 48 racers published in the Journal of Sexual Medicine. That’s 62 percent too many, Pruitt says.
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“Numbness should not be tolerated, period,” he says, as it can cause long-term damage. “Numbness is a sign you’re compressing nerves. That means something is wrong.”
How to fix it
“Along with testing various saddles, get a good professional bike fit,” Pruitt says. You want the majority of your weight to be resting on your ischial tuberosities (the hard bones you feel when you sit down) or the pubic rami (the pelvic bones further forward), depending on your riding position, and not on your soft tissues. That means dialing in your reach (being too stretched out puts pressure on soft tissue), your handlebar height (both in and out of the drops), your saddle height, fore and aft angle, as well as the shape and size of your saddle.
The Issue of: Labial Hypertrophy
As the name implies, labial hypertrophy is when the labia (either the inner or outer, or both) become swollen and enlarged.
Pressure. “Pressure can cause swelling because it keeps lymphatic drainage from occurring,” Minkin says. Once you have significant swelling, that can set up a vicious cycle of less drainage and more swelling.
Ironically, cut-out saddles—which are designed to prevent pressure problems—can contribute to swelling in some women, Pruitt says, and a sore vulva from cycling. If you have a fleshier vulva, cut-outs may not work for you, because those tissues sit in the cut-out space and gravity pulls fluid into them as you ride. “Those women find that they’re okay riding, but as soon as they get off the bike, they have trouble getting back on the bike because they’re swollen,” he says.
Swelling is the biggest giveaway, but discomfort when pressure is applied as well as irritation are known symptoms, too.
How to fix it
The solution here is similar to eliminating unwanted pressure: dialing in not only saddle choice, but also bike fit to distribute pressure—and fluids—in a healthy way
The Issue of: Urinary Tract Infection
Similar to vaginitis, urinary tract infections (UTIs) are bacterial infections that can occur in any body part involved in producing and flushing urine—mainly your kidneys, bladder, and urethra.
These infections are common in female cyclists because bacteria from our chamois can travel fairly easily into our bladder.
If you find yourself spending more time in the bathroom—and suffering while there—you might have a UTI. The most conspicuous symptoms include always feeling like you have to pee; peeing frequently in small amounts, and feeling a burning sensation when you do; and producing urine that is either cloudy, red (bloody), or particularly pungent.
How to fix it
Flushing the pipes by drinking plenty of water and peeing when nature calls generally helps avoid infection, but not always. The strategies for avoiding UTIs are similar to those for avoiding other vaginal infections. Get out of your shorts and wipe yourself clean ASAP when the ride is done.
Also, if you’re prone to UTIs, drinking cranberry juice that contains a chemical called A-type proanthocyanidins, which acts like a non-stick coating against bacteria in the bladder, may help. Research is equivocal, but some studies suggest that cranberry juice can reduce the occurrence of UTIs in women who have frequent infections.