On Female Anatomy and Saddle Discomfort (5 Year Anniversary Re-Issue)

I am re-publishing a reworked, expanded version of this blog post, which I originally wrote in April 2011. Despite having nothing to do with “lovely bicycles” per se, this remains my most widely read and most frequently referenced post to date. At present, it has been viewed 270,000 times and has accumulated over 200 comments - resulting in a wonderfully helpful discussion that is in of itself worth reading. I continue to receive feedback about this post via email on a regular basis, with hundreds of women having shared their experiences over the years.

To me, such popularity of what was really a very basic, unremarkable article on the topic, indicates a persistent absence of information on women-specific bicycle fit issues - both in the bicycle industry and in cycling culture at large. In the context of bicycling, as elsewhere, the topic of women’s privates remains taboo, an unmentionable. Even my own introduction to the original version of this post strikes me now as over-apologetic:

Male readers: you may want to skip this one. Of course if you feel up to it, you are welcome to keep reading. But don't say I didn't warn you. 

Female readers: I've had email exchanges with so many of you about "women's issues" with bicycle saddles, and it's amazing how much embarrassment there is among us (and I include myself) when it comes to discussing our bodies - especially given how common these problems are. While with men, we can read and hear all about perineal this and genital that, with women it's all hush-hush and seldom addressed in a manner explicit enough to be helpful.

Five years later, I am dismayed to find that things have not changed all that much. A few publications have now broached the topic - most notably, Elly Blue's Our Bodies Our Bikes, Molly Hurford's Saddle Sore, the short lived Cycling Digest blog, and - interestingly enough - the British Cycling Federation (more on that later). Nevertheless, my original post remained a go-to resource on the subject. It was for this reason I felt it important to revisit it.

And so without further ado, I offer this updated version of my notes on female anatomy and saddle discomfort. And the first thing I shall tell you, is this:

Women's saddle discomfort is the norm, not the exception

I get the sense one reason so many women are reluctant to talk about their "down there" problems on the bike is because they fear these are unusual problems to have. They imagine other women, cycling blithely, while they, freaks of nature that they are, writhe in pain and rub themselves raw, perpetually dissatisfied. Some worry that having these problems, must mean they have oddly shaped genitals. Others are embarrassed to raise the topic lest they be perceived as perverts who are keen to talk about their privates. And so it becomes a vicious cycle, where silence begets silence and we are all suffering in polite, isolated embarrassment while the bicycle industry does not think there is a problem worth addressing.

The reality is, saddle discomfort problems are not only common for women, they appear to be the norm. Most women cyclists I know have had them at some stage. More worryingly, many continue to have them, despite years of experience and thousands upon thousands of miles covered.

Consider this recent statement from the British Cycling Federation:

In the lead up to London 2012 [Olympics], with the UK Institute of Sport, we developed a special saddle for Victoria Pendleton, who had been suffering from saddle issues that were having a negative impact on her performance. After the Games, we wondered how big a problem it was and whether we had only uncovered the tip of the iceberg. We put together a team and decided to interview riders as part of a qualitative study. The findings were staggering, 100% of the riders we interviewed were having problems but, with a male doctor, physio and predominately male coaching staff, didn’t feel comfortable in mentioning it.

So, even at the level of professional athletes, we get a version of the same old: "too embarrassed to ask the bike shop guy." But the problems, however hidden, are very much there. And one of the difficulties of addressing them lies in how diverse they are.

Where does it hurt?

We experience pain in areas of intense body-to-saddle contact. These areas will depend on your position on the bike. There is a great deal of variety in the kinds of bicycles we ride - from relaxed transport bikes that position us bolt-upright, to aggressive racing bikes that place us in a deep forward lean. These differences in position are crucial, as they determine what parts of our anatomy will come into contact with the bicycle's saddle.

With the aid of the highly technical drawings I have supplied, picture what happens to your body when you ride a Dutch-style bike with high, swept-back handlebars. You are sitting on the saddle not too differently from the way you would sit in a chair: As you hold the handlebars, your back is nearly straight. In this position - and assuming the saddle is level - the bits that press into the saddle are mainly your buttocks. The rear of your vulva may rest on the saddle as well, but it is tilted slightly up and therefore pushed out of the way as it were.

Now picture what happens as a bicycle’s fit becomes more “active” - with the handlebars set lower and further from you. As you lean forward to reach the bars, your pelvis also tilts forward on the saddle - taking pressure away from your bum and placing it instead on your genitals. The greater your lean, the more extreme this effect. So that, in an ultra-laid back position it’s your bum cheeks pressing into the saddle, in a full-on racing position it is your urethra and clitoris, with different parts of the labia taking the brunt of your weight for positions in between.

The more relaxed your bicycle’s setup, the more likely you will have problems with posterior discomfort. The more aggressive your bicycle’s setup, the more likely you will have problems with genital discomfort.


Posterior Discomfort

Beginner's Bum: Anyone unaccustomed to spending time upon a bicycle saddle, will inevitably experience a sore bum. On an upright bike this will be particularly extreme, as the buttocks take the brunt of the cyclist's weight. The good news about the sore bum issue, is that it is usually a fleeting one. With most saddles, be they hard or soft, leather or synthetic, there is an adjustment period. Your rear end is simply not used to sitting on one of these things. But build up milage gradually and give it some time to adapt. If Beginner's Bum is the only issue, the soreness should go away after a couple of weeks of regular cycling.

Excessive Padding: Somewhat counterintuitively, padded saddles tend to cause discomfort when cycling beyond very short distances. As your buttocks sink into the padding, pressure can build up between the sit-bones and begin to cause pain. And while a hard saddle you can get used to over time, a too-soft saddle that causes this type of bunching and pressure will only get worse. If it feels as if this is happening to you, look for a saddle with minimal to no padding. And no padding does not have to mean rock hard. Saddles that incorporate some means of suspension or flex (for example, leather, or leather-substitute, stretched over rails) create a lovely hammocking effect.

Saddle Too Narrow: If your bum still hurts after a reasonable break-in period, and it feels as if the culprit is the saddle's contours digging-into your sit-bones, then the saddle may be too narrow for your derriere. Consider a wider saddle.

Saddle Too Wide: A too-wide saddle, on the other hand, usually manifests itself in chafing - either on the inside of the thighs, or in the "underbum" areas - where buttock transitions into leg. If this is happening, consider a narrower saddle.

An aside here with regard to women and saddle width: It is an oft-repeated adage that women’s sit-bones tend to be set wider than mens, therefore women typically require wider saddles. And this is absolutely correct. However, it is correct in a statistico-hypothetical, “on average,” “all other factors remaining equal” sort of way. It does not mean that every woman will necessarily have wider sit-bones than every man. Do not automatically assume you need the widest saddle available because you are female. Your individual anatomy could fall anywhere on the spectrum. And remember that your position on the bike matters a great deal as well. If you have wide sit-bones but are rocking an extreme road-racing position, you may require a narrower saddle than a lady with narrow sit-bones who is positioned less aggressively. So let actual sensations of pressure and chafing guide your saddle width decisions, not some hypothetical model.


Genital Discomfort

When a bicycle places the rider in a forward lean, the genital region - in our case, the vulva - is pressed directly into the saddle. Depending on your individual anatomy and cycling position, this can result in very specific regional pain.

Labia: Probably the most common complaint I hear with regard to saddle discomfort, is that of vaginal lips bunching up and pressing painfully into the saddle - so much so, that after a long ride there can be abrasions and bleeding. In many cases, a saddle with a cut-out centre or recessed channel down the middle solve this problem, and there is a good selection available these days. But because every woman's anatomy is different, the cut-out/recessing may not be in the right place for you, so you would have to experiment with this feature. Adjusting your saddle's tilt (in either direction), even very subtly, can also relieve labial pressure. And while it's pretty much impossible to keep loose folds of skin from shifting about while you're pedaling, you can minimise abrasions with generous applications of chamois cream or vaseline before you set off on your ride. Creams that use tea tree oil as a main ingredient seem to be particularly effective. Vaseline works as well, but be aware that it can discolour clothing and saddles.

Urethra and the Clitoral Region: Pressure on the urethra or clitoris can be even more difficult to deal with, both in terms of the immediate sharp pain that sitting on these sensitive bits it causes, and the long-term adverse effects. For some women these parts of the vulva are fortunately angled, so as to sit safely out of harm's way even in the raciest position on the bike. For others they press directly into the hard nose of the saddle and it's a hugely painful problem. In the event of the latter, there are a few things you can try. The main one is saddle tilt: Tilting your saddle ever so slightly forward (but not so far forward that you slide off it - there is a sweet spot and you have to experiment) can do wonders in this regard, and this is my personal preferred technique. Another is to experiment with saddle length. Some find that a longer saddle (where the hard nose section will sit forward of the urethra and clitoris, rather than directly underneath) is helpful. Others find relief in the opposite extreme, in particular "noseless" saddles. Be aware though, that women's saddles marketed as "short" can actually make this problem worse. The short-nosed saddles are designed for cycling in a fairly upright position while wearing a skirt (the short nose is so that your hem doesn't catch when you mount and dismount), not for genital comfort in a road-racing position!

General Numbness: Some women report going numb in the genitals, but are unable to identify a specific area that is affected. This problem is a bit of a mystery, but - based solely on my observations - could be connected to a couple of issues: One, is the saddle being too high. So, try lowering your saddle a tad and see whether that relieves it. The other thing I have noticed, is that the riders experiencing numbness tend to ride dome-shaped saddles (saddles where the centre ridge sits ever so slightly higher, sloping down toward the sides). If you find this to be the case, try switching to a saddle that is completely level.

So... Which saddle is right for me?

Unfortunately, being able to identify and describe the myriad of problems we have with saddle-related pains does not lead to clearcut recommendations. I would love to put together a neat little chart for you, along the lines of "Symptom X? Try Brand Y, Model Z!" but alas I don't think this would be helpful, or even possible. Our individual anatomies - from the width of our sit-bones to the shapes, sizes and locations of our sensitive vulvian bits - are just too darn different for one size fits all recommendations.

In a general sense, factors worth paying attention to include: firmness, width, length, and the availability (and placement) of cutouts. There are a few specific brands that seem to consistently get good feedback from women that are worth looking into as well, these being: Rivet, Berthoud and Selle Anatomica (suspended leather), and Terry and the ISM Adamo (synthetic with slight padding). Personally I have also had very good luck with the new Brooks Cambiums - a cloth/rubber design with and without cutouts.

But just to give you a sense of how impossible the idea of any one saddle being right for every woman is, consider this: The aforementioned British Cycling Federation, having carried out that study which showed that 100% (!!!) of female olympic cyclists experienced genital discomfort, responded by hiring a team of medical experts and designers to create their own saddle addressing the athletes' issues. The result of much R&D was the official UKIS saddle... which only half the riders on the British team actually opted to use, the rest preferring to stick with their personal saddles. The Federation's conclusion: "Finding a saddle that works for you is largely down to trial and error." Tell me about it!

While we cannot blame the industry for failing to cater to the amazing diversity of women's genital anatomies, what surprises me is that there aren't any clever entrepreneurs offering custom saddles. It's a service for which I genuinely believe there would be demand, considering how many women actually suffer from saddle-related problems.

In the meanwhile, if you have the opportunity a good starting point would be to visit a local bicycle fitter, brace yourself for some candid talk, and ask specifically for saddle advice while describing your issues honestly. And if the fitter is a man, give him a chance and don't assume he doesn't know about (or is unwilling to discuss) women-specific issues. I have had some really good conversations about this sort of thing with male fitters and bicycle shop owners; people are people. At the very least, a saddle fit session will get you some width/length recommendations and give you a chance to try different saddles before buying. As you probably know by now, saddle trial and error can get quite expensive.

My saddle used to feel comfortable, now suddenly it doesn't! Why?

As mentioned earlier, your position on the bike is a crucial determinant in how a saddle will feel beneath you. Therefore if you make any changes at all to your position, it can make your "perfect" saddle no longer so perfect. Even something as seemingly minor as changing your saddle height, handlebar height, or stem length even the slightest bit - can makes a difference, as can simply spending more time in the drops.

Another factor to consider, is that saddles deform over time. In different, but equally annoying ways, both synthetic and leather saddles can sag, harden, twist, crack, collapse, warp, and go through various other metamorphoses with time and use - some of them repairable, others not.

In rarer cases, your body might also undergo changes. And I am not just talking about obvious changes such as dramatic weight loss/gain, or childbirth. Changes in core strength, for instance, can lead to changes in how you sit on the bike, even if your numerical fit remains the same. Bottom line is, we cannot count on the same saddle being comfortable forever and in all circumstances.


Padded shorts and chamois creams: Do they help?

In my experience, they help. But they are not a solution to a serious problem. On a roadbike, a good pair of padded cycling shorts can make an already comfortable setup more comfortable. But it will not fix an inherently uncomfortable setup. Likewise, chamois cream provides an extra barrier against chafing and irritation, but it will not make the problem go away. In general, you are better off working on finding the right position and saddle, rather than the right shorts and cream.

An aside here about cycling shorts: I have noticed that an often-overlooked but very common cause of chafing issues, is wearing cycling shorts that are too big. Now, because the skin-tight nature of roadcycling shorts makes them profoundly unflattering for 99% of us non-professional-athlete women, it is tempting to size up and minimise that horrible sausaging effect. But the thing is, cycling shorts are designed to be skin-tight for a reason. If you wear them even a tiny bit loose, the fabric can bunch up in those crevices between inner thigh and labia, causing surprising amounts of damage in even a short amount of time. Over the years I have learned the hard way that it is better to wear cycling shorts slightly too tight and look ridiculous, than to wear them slightly too loose and have the insides of my thighs bleeding by mile 20.


What about hair, down there?..

Although there is some degree of personal preference to this, overwhelmingly the word on the street is: Avoid shaving. Keeping the hair natural and wild provides a soft cushioning buffer, and some extra warmth in winter month. Waxing it all off (actually sugaring is nicer) has the benefit of the area being frictionless. But shaving, or even close-trimming, creates a prickly coarseness that can contribute to skin abrasions when you pedal. If you are sensitive to abrasions especially, be aware of this.

Recurring Infections

Female cyclists can be prone to yeast infections and urinary tract infections (UTIs). The causal factors underlying both are numerous, and contrary to what some believe, they are not necessarily due to poor hygiene. Of course, showering both immediately before and after a strenuous cycle ride will lower the risk of infections, but most women who get them are already doing this.

In some cases, synthetic shorts or underwear could be to blame: bacteria thrives underneath synthetic fabrics, even when the garments are advertised as anti-bacterial. And because each of our body chemistry is unique, some are more susceptible to this than others. So if you get recurring yeast infections or UTIs when you cycle, consider wearing exclusively silk or wool underwear and wool cycling shorts (yes, they exist!). Consider also a suspended leather saddle - which, unlike other saddles, is breathable. Basically: natural fabrics, good ventilation and moisture-wicking are key.

It also helps to use simple soaps (made of actual soap, not perfumed body washes or moisturising soaps) and to avoid artificially perfumed sprays or lotions in or around your vaginal area. Be especially cautious on hot and humid days, as well as on days during which there are drastic weather changes - infections are more likely to occur at these times.

Menstruation

As any form of physical exercise, cycling has the potential to relieve menstrual cramps and counter PMS symptoms. So if you're up to cycling during your period there is no reason not to. But straddling a bicycle saddle for hours while menstruating can present its own set of challenges. Blood flow increases during exercise, so if you are planning on a long trip, it's a good idea to change your tampon or sanitary napkin more frequently than usual. As well as to drink more fluids.

For road cyclists who do not use tampons, there are other options available - most notably menstrual cups. While I have no experience with these myself, they are discussed in great and helpful detail in the comments after this post; if you are interested have a look.

But if you like to keep it old school and prefer to use sanitary napkins, there is the question of how to attach those to cycling shorts: the sticky underside will often not stay in place (and whatever you do, don't wear underpants under your shorts, just so that you can wear a sanitary napkin - they will chafe horrifically!). In this regard, an experienced randonneuring friend gave me some excellent advice, which I at first found disgusting, then exhilarating: Don't wear a sanitary napkin. No tampons, no "maxi pads," nothing. Wear an old pair of (ideally black!) padded cycling shorts, and go ride your bike. Let the blood soak directly into the chamois padding (which is amazingly absorbent - it's a pad after all) and no one will be the wiser. Then wash the shorts when you get home. Freedom! Just watch that, with blood being an irritant, the potential for abrasions and infection increases. For long trips, have a shower right before you set off on the bike, then take wet naps with you and stop every hour or so to clean up. I did this on a 300K brevet a couple of years back, and it was grand. Grand, I tell you!

***

And on that colourful note, I hope this updated post remains helpful. It is not meant to be exhaustive, or prescriptive. These are just my own notes on the issue - gathered from personal experience and from talking to other women. If you have anything to add, please do.

I want to thank all of you who have contributed to the wonderful discussion in the comments section over the past 5 years the original post had been live. And remember, if you would like to talk about these issues in the comments - especially to share your own experiences and remedies - I allow anonymous comments and you don't need to log in under your regular screen name.