Women On The Saddle Watch Out For Bicyclists Vulva
Problems With The Lymph Drainage
Many conditions such as cyclist’s nipple, neuropathic syndrome and many skin conditions caused by the saddle have been described for female cyclist athletes. However, bicyclist’s vulva is a condition of the female genital parts described by Belgian gynaecologists when they observed this condition in six of the high volume (cycling more than 500km per week) cyclists. This new condition has been recognized because of problems with the lymph drainage when it comes in contact with the saddle.
This problem was first noticed in six athletes in Belgium – they all had unilateral vulval swelling and no other history of lymphedema was present in any case. And their diagnosis of lymph drainage abnormality was diagnosed on lymphoscintigraphy. Vulval lymphedema may be caused by continuous compression of inguinal lymph nodes due to the posture of cyclists on the saddle and also due to chronic inflammation of the vulvo-perineal area.
Usually the cyclists present a unilateral swelling of the genital area with mild pain and discomfort which reduces when they are oft the saddle.
Due to continuous pressure on the vulva which inhibits proper lymph drainage from the inguinal region and inflammation of vulvo-perineal area, increased saddle time aggravates it. It increases from higher pressure in bent position of cyclists when their back is 40 degrees from horizontal as compared to 60 degrees from horizontal. The type of saddle also may be responsible, such as cut out saddle or flat saddle; it has been shown that cut out saddle has more pressure impact on soft tissues as compared to flat saddles.
This condition is usually diagnosed clinically by taking proper note of the history, thorough examination and ruling out other pre-existing causes such as previous history of lymphedema. However, this condition should be differentiated from other vulval conditions such as bartholin’s cyst, cellulitis, vulval hematoma, furuncle and soft tissue abscess. Lymphoscintigraphic studies are not advised routinely, it clinically there is no doubt, but it is being used in research.
- Decreasing saddle time
- Raising the handle bar which would help increasing the angle of the back to horizontal
- More standing during cycling
- Changing the saddle type from cut to flat or flat to cut
- Wearing padded shorts
- Maintaining perineal hygiene
- Elevation of limbs while taking rest which enhances lymph drainage
- Cold compress
- Surgery is rarely required when discomfort increases