The Bar Sinister: Does Handlebar Level Damage the Pelvic Floor in Female Cyclists?

Abstract

Introduction. Cycling is associated with genital neuropathies and erectile dysfunction in males. Women riders also have decreased genital sensation; however, sparse information exists addressing the effects of modifiable risks on neurological injuries in females. Aim. This study assesses the effects of bicycle setup and cyclists' attributes on GS and saddle pressures among female cyclists. Methods. Previously, we compared genital sensation in competitive female cyclists (N = 48) to that of female runners (N = 22). The current study is a subanalysis of the 48 cyclists from the original study group. Nonpregnant, premenopausal women who rode at least 10 miles per week, 4 weeks per month were eligible for participation. Main Outcome Measures. Genital sensation was measured in microns using biosthesiometry measures of vibratory thresholds (VTs). Perineal and total saddle pressures were determined using a specialized pressure map and recorded in kilopascals (kPA). Results. Handlebars positioned lower than the saddle correlated with increased perineum saddle pressures and decreased anterior vaginal and left labial genital sensation (P < 0.05, P < 0.02, P < 0.03, respectively). Low handlebars were not associated with total saddle pressures or altered genital sensation in other areas. After adjusting for age and saddle type, low handlebars were associated with a 3.47‐kPA increase in mean perineum saddle pressures (P < 0.04) and a 0.86‐micron increase in anterior vagina VT (P < 0.01). Conclusion. Handlebars positioned lower than the saddle were significantly associated with increased perineum saddle pressures and decreased genital sensation in female cyclists. Modifying bicycle setup may help alleviate neuropathies in females. Additional research is warranted to further assess the extent of the associations. Partin SN, Connell KA, Schrader S, LaCombe J, Lowe B, Sweeney A, Reutman S, Wang A, Toennis C, Melman A, Mikhail M, and Guess MK. The bar sinister: Does handlebar level damage the pelvic floor in female cyclists? J Sex Med 2012;9:1367–1373.

Les Lanternes Rouges: The Race for Information About Cycling-Related Female Sexual Dysfunction

“…Saddle pressures were unaffected by either trunk position or saddle type in the female sample (n = 11). While these findings appear to contradict previous studies recommending cyclists take a more upright position in order to relieve pressure [3,22,24,27,42], they nonetheless underscore the differences in men's and women's anatomy and how their bodies interact with the bicycle. These studies support the notion that bicycle position may play an important role in pelvic floor pathology and potentially affect sexual function in some women.…”

“…In a sub‐analysis, our group examined the effect of bicycle setup on genital sensation and saddle pressures in female cyclists. We showed that handlebars positioned lower than the saddle are associated with increased perineal pressures and decreased genital sensitivity [3]. Another study reported that the female subjects were more comfortable when sitting in a more upright position.…”

“…The ergonomics of the traditional cycling position and typical saddle designs result in the perineum being tasked with bearing the weight of the rider [2,3,[30][31][32][33][34][35][36]. Owing to their anatomy, women experience dramatic changes in the positioning of and pressure on their perineum when riding [24].…”

“…It provides an excellent moderate‐intensity, low‐impact form of physical activity. It also imparts all of the health benefits associated with this class of exertion, such as improved cardiovascular fitness, better weight control, and alleviated symptoms of chronic disease [1–4].…”

Prevention, Not Cure

“…Let us think of the preventative measures we have already explored. Finding the right bicycle seat might prevent various sexual dysfunctions in men and women, as does correct fit [2–4]. Choosing a method of contraception that does not have negative sexual side effects is another obvious preventative measure [5–8].…”