Vulval symptoms in female recreational cyclists

Abstract

Background: Cycling is linked to altered genital sensation, numbness, pain and sexual dysfunction in males and the professional female cyclist. After noticing an increase in women presenting to gynaecology clinics with cycling related vulval symptoms, we aimed to identify the incidence, significance and management of vulval pathology among female recreational cyclists. Methods: An anonymous online questionnaire was distributed to 5 Devon cycling clubs and promoted on the “South West Women’s Cycling” Facebook group. Participants were asked about vulval symptoms, management and if these symptoms had affected their cycling. Results: 508 women responded to the questionnaire between the ages of 20 and 60+. Overall 221, 43.5% of women said they had been deterred from cycling due to vulval/perineal discomfort. The commonest symptom experienced was pain, 37.4%, followed by chafing, 33.3% and redness, 26.6%. Just over a fifth of women had experienced infections they attribute to cycling: 9.8% urinary tract infections, 7.5% vulvovaginal candida and 3.1% bacterial vaginosis. The most important recommendation for the management of vulval discomfort was to use a women-specific saddle with a central cut out. Other recommendations included the benefits of professional bike fit, use of chamois cream and avoidance of hair removal. The menopausal group (the modal group) also commented on the benefits of topical oestrogen to counter the effects of atrophy. Conclusions: Vulval/perineal symptoms are a significant problem for female recreational cyclists. Further research and randomised control trials into the prevention and management is required so that evidence-based guidelines can be developed.