Guide for female cyclists: dealing with saddle soreness

If we ask any cyclist about the most common source of pain, their answer would probably have to do with the saddle. It can be very painful and uncomfortable for men, but for women it is even worse because they sit and rest their weight directly on their genitals. Not only can this cause the same discomfort as for men, but it can also lead to other issues. If you want to know how to stop and prevent soreness and other common saddle-related ailments, here’s a complete guide, including causes, solutions and various tips.

We will divide aches and pains into four types, from most to least common ones:

1. Numbness, chafing, folliculitis and boils
2. Vaginitis
3. Urinary tract infection
4. Genital hypertrophy

Numbness, chafing, folliculitis and boils

Numbness

64% of the competitive women cyclists in this study experienced genital numbness. There are no studies at a higher level involving all types of cyclists, but the results are likely to be similar. Numbness is not dangerous when it comes to sexual dysfunction or urinary symptoms, however, the problem needs to be addressed because it indicates that something is not right.

The most likely cause is a bad position or a wrong saddle, although it can be both.

The solution is to have a biomechanical study done to adjust the bike to your fitness, flexibility and circumstances, and try different saddles until you find the one that best suits your needs. Make sure you do both of those things, because an incorrectly positioned good saddle is just as harmful as a correctly adjusted wrong saddle.

Chafing

Chafing in the groin and inner thigh are also very common complaints. They are not really a serious problem (unless you actually get chafing burns), but they surely can be very uncomfortable. If your skin gets hurt and bleeds, make sure you take care of your personal hygiene and wash your cycling shorts properly to avoid possible infections.

The causes can be manifold: wrong saddle, incorrect body position, too big or too small bib shorts, chamois in bad condition or an improper type of chamois, wearing underwear with bib shorts, dry skin, excessive sweating, waxing… or simply the fact that you’ve been on the saddle for 10 hours and everything has its limits.

Solutions: 

• Adjust the bike and change the saddle. 
• Get bib shorts in the correct size and with the right chamois; do not wear underwear with them. 
• Maintain proper personal hygiene and wash your bib shorts regularly. 
• Keep your skin moisturized before and after cycling. 
• Apply chamois cream to prevent chafing while pedaling (there are specific ones for women that do not contain ingredients that can cause discomfort to the female genitalia). There are also anti-chafing creams for the inner thighs. 
• Be careful with hair removal. We don’t mean that you should completely avoid it, it’s your personal choice, but keep in mind that pubic hair is a protective barrier; if you remove it you expose soft tissues to friction and irritation.  

Folliculitis and boils

Inflammation and infection of one or more hair follicles can keep you off the bike for an entire season.

Folliculitis and boils can be caused by: 

• A hair that had been plucked or shaved growing back
• Excessive sweating
• Incorrect hygiene
• Excessive friction

The best way to prevent these problems is to apply the solutions listed in the previous section.

When folliculitis or a boil appears, there is no choice but to visit the doctor to get an antibiotic and leave cycling on hold until the problem is completely solved. Those things can be really annoying and painful, making it practically impossible to sit on the saddle. 

Vaginitis

It is a common condition among women, whether or not they ride a bicycle. In the case of female cyclists, the most common type is a vaginal yeast infection, since the moisture and heat in the chamois create a breeding ground for bacteria and fungi. Symptoms are: abnormal vaginal discharge, changes in odor, itching and burning as well as pain during urination or intercourse.

To prevent it, we must avoid the growth of bacteria and fungi:

• Take off your bib shorts as soon as possible after the ride, shower quickly and dry the entire genital area well. If you cannot shower, use feminine wipes, but please remember that they’re just a stopgap solution, as they too can irritate this delicate area.
• Wash and dry your bib shorts thoroughly, always following the manufacturer’s wash and care instructions. 
• Choose a good-quality pair of bib shorts with a chamois that prevents bacterial growth.

Vaginal yeast infections are treated with antifungal medications, usually in the form of a cream. Steroid creams can help with itching and burning; in some countries they are available over-the-counter. However, if you think you have vaginitis, see your doctor to find out what type it is and to get the right treatment prescribed.

As far as eating yogurt or probiotic foods to prevent vaginitis, according to research “there is insufficient evidence for the use of probiotics as adjuvants to conventional antifungal medicines or used alone for the treatment of VVC in non‐pregnant women.”

Urinary tract infection

Urinary tract infections, just like vaginitis, are common among female cyclists because bacteria can be generated in the chamois area, get into the urethra and infect the urinary tract. The most common symptoms are: 

• Pain and burning sensation when urinating
• Frequent urination
• Feeling the need to urinate, but not peeing
• Cloudy urine
• Blood in the urine

To avoid UTI, follow the same advice as for preventing vaginitis. The key is personal hygiene and washing your bib shorts regularly. 

As regards the consumption of pure, unsweetened cranberry juice to prevent urinary tract infections, this meta-analysis from Cochrane concludes that “cranberry juice cannot currently be recommended for the prevention of UTIs.” 

Genital hypertrophy

It usually occurs in the labia minora, but can also affect the labia majora or both. Continuous pressure and friction leads to inflammation due to lack of lymphatic drainage, which in turn results in size increase. The more pressure and friction, the less drainage and more inflammation. This is why this type of problem mainly affects competitive cyclists and women who spend a lot of time on the bike in the same position, such as female triathletes. 

Symptoms include inflammation, irritation and discomfort upon pressure. If you experience these symptoms, see your doctor as soon as possible.

How to prevent genital hypertrophy? The solutions are: a biomechanical study and an appropriate saddle to distribute the weight between the points of contact with the bicycle (saddle, handlebars and pedals) and allow fluids to drain the genital area properly.

In some cases, the only option is surgical intervention. It is an extreme solution and often the last resort for those women who have genital hypertrophy and who feel pain or discomfort even after adjusting the bike and choosing a suitable saddle.

Bottom line, almost all saddle-related aches and pains can be solved by adjusting the body position on the bike, getting the right saddle and good-quality bib shorts that we keep clean and dry plus taking care of our personal hygiene.