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

Authors

  • Sarah N. Partin MSPH,

    1. Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX, USA
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    • These authors contributed equally to this work.

  • Kathleen A. Connell MD,

    1. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
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    • These authors contributed equally to this work.

  • Steven Schrader PhD,

    1. National Institute for Occupational Safety and Health—Reproductive Health Assessment, Cincinnati, OH, USA
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  • Julie LaCombe MD,

    1. University of Vermont College of Medicine, Colchester, VT, USA
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  • Brian Lowe PhD,

    1. National Institute for Occupational Safety and Health—Reproductive Health Assessment, Cincinnati, OH, USA
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  • Anne Sweeney PhD,

    1. Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX, USA
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  • Susan Reutman PhD,

    1. National Institute for Occupational Safety and Health—Reproductive Health Assessment, Cincinnati, OH, USA
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  • Andrea Wang MD,

    1. Alaska Urological Associates, Anchorage, AK, USA
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  • Christine Toennis BS,

    1. National Institute for Occupational Safety and Health—Reproductive Health Assessment, Cincinnati, OH, USA
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  • Arnold Melman MD,

    1. Department of Urology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
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  • Madgy Mikhail MD,

    1. Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
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  • Marsha K. Guess MD

    Corresponding author
    1. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
      Marsha K. Guess, MD, Section of Urogynecology & Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06511, USA. Tel: (203) 785-4880; Fax: (203) 785-2909; E-mail: marsha.guess@yale.edu
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Marsha K. Guess, MD, Section of Urogynecology & Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06511, USA. Tel: (203) 785-4880; Fax: (203) 785-2909; E-mail: marsha.guess@yale.edu

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.

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