Saddle sores 101: how to prevent and treat all undercarriage-related discomfort

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Saddle sores: diagnosis and prevention
Labial discomfort: diagnosis and prevention
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Saddle sores can be an annoying side-effect of long hours spent on the bike, even if you're using one of the best road bike saddles, and can vary from being slightly uncomfortable to requiring surgical removal. They come in many different guises, and affect some people more than others. If they become infected, they can put you out of action for weeks or even months at a time, so it’s important to know how to deal with them from the get-go.

Saddle sores can affect anyone, regardless of what equipment you have downstairs, yet a lot of advice you find online tends to mostly cater for the male parts. While we aim to cover all areas in this article, we’re also including a women’s specific section for anyone suffering labial discomfort and related issues.

“You have to balance what you want to do, where your body wants to be, and what the bicycle requires of you,” she says. “Some people can tolerate loading [bearing weight] on soft tissue really well, while others don’t. It puts pressure on the blood vessels and nerves, including the pudendal nerve which is responsible for sensory and motor function. This is why some men with severe saddle damage may experience erectile dysfunction.”

Saddles come in all shapes and sizes, some with cut-outs, some with channels running through the middle, and they vary in terms of the riding position they’re designed for. If you’re in a more upright position, most of your weight will be distributed through your sit bones, whereas the aggressive aero positions adopted by time trialists and the like actually put a lot of pressure on the soft tissue, which can cause a lot of the problems.

According to Bianca, you also need to make sure your saddle is set up in a way that works for your pelvis. “Do you need one that’s wider at the back for an upright riding position, or something that will allow you to bear weight at the front of the nose? Is the saddle position flat or tilted? Your pelvis will ultimately determine what angle works best for you. Try reducing the saddle height to see if that makes a difference, and if you have any problems later, be sure to seek advice.”

Getting the saddle right is important, but all that hard work can be undone in an instant if you combine it with a shoddy set of padded shorts. It’s important that your seat pad (chamois) and saddle play nicely together, and of course, this is yet another trial and error exercise. What works for someone else might not work for you, though generally speaking when you spend a bit more money on a good quality pair of shorts, you’re likely to get more return on that investment. A good chamois will be made from quality materials, and few if any seams at all: the less risk of friction, the better.

As Mrs Pisal advised above, change your shorts between rides and always keep them clean. You should also remove them as soon as your ride is finished. Sweaty bib shorts are the perfect breeding ground for bacteria that causes all the problems we’re talking about here. As soon as you get home, put your shorts in the washing machine and shower straight away. Dry yourself properly before getting dressed, and make sure your shorts are completely dry before using them again.

“Sitting on a saddle for a long time can cause sensitivity or numbness of the labia and perineal area. The pressure on the skin affects the nerve endings, and this repeated pressure on the nerve endings [can cause tingling and sensitivity]. Over a period of time that sensitivity and tingling sensation will turn to numbness, so there is almost a loss of the superficial nerve endings in that area of the skin.”

“Pressure on a woman’s vulva can cause the labia to become swollen and appear bigger. Some women already have asymmetrical or enlarged (hypertrophied) labia and this can [exacerbate the issues listed above]. I have come across women with enlarged labia who have sought labiaplasty (surgery to reduce the size of the labia) as the pressure causes intense pain during cycle rides so much so that they are unable to continue riding.”

“Thrush is a very common vaginal infection, caused by an overgrowth of yeasts which live normally in the bowel and may be present in other parts of the body, such as the mouth, skin and vagina. Thrush occurs when the good bacteria in the vagina can't keep the fungus under control, creating a suitable environment for the overgrowth of this fungus. When cycling, there is a lot of perspiration and so the sweat collects in that area of the skin and any stagnation of sweat over a surface is likely to result in growth of fungus. The advice is to not linger in your clothes after a bike ride and to wash them immediately, so not to allow the yeast to grow.”

“A UTI is an infection of your bladder, so you may feel the sudden urge to pee and experience pain or a stinging sensation when peeing. These usually are caused by bacteria entering the urinary tract. Using the right padded cycle shorts without underwear is important. Always wash the shorts immediately and use a fresh pair each time you ride a bike. Cycling shorts will get damp with sweat with little ventilation and rubbed up against your body is a breeding ground for bacteria. Also dehydration or going on long bike rides without emptying the bladder quick enough can cause this so ensure you drink plenty of water and empty the bladder without delaying too much, to help flush bacteria out and prevent urinary tract infections. This will help to avoid pressure symptoms but also prevent vaginal and urinary tract infections."

We can’t tell you what to do with your own body of course, but we do advise you to exercise caution if you choose to remove your hair ‘down there’. Pubic hair forms an extra layer of protection after all, helping to keep that area clean and free of unwanted bacteria. On top of that, the act of shaving can cause a plethora of issues, from razor burn and sore bumps, to ingrown hairs and folliculitis.

“I have a slight leg length difference,” explains Jasmijn. “On the bike that translates to a slight lateral movement with every pedal stroke. It turned out that I had major imbalances between my glutes, with one much stronger than the other. I worked with an osteopath who treats cyclists and teaches pilates, and she helped me address this imbalance. I’m not at 100 per cent just yet, but it’s getting better, and I no longer shift on the saddle. It’s also helped me to get more power and ride better as a result!”

“People who are quite long in proportion or hypermobile sometimes run into issues because their core stability isn’t sufficient to hold them over a long period of time, and so eventually they start rocking due to fatigue. In fact a lot of these things come down to fatigue. Muscular endurance is important to get right first, because when a muscle starts fatiguing, another muscle will help it out, causing all kinds of imbalances.”

RED-S [relative energy deficiency in sport] often goes hand in hand with long-distance cycling, and can have a surprising impact on your saddle health. According to Bianca if you’re under-fuelled for an activity, this can not only cause issues with healing and pain sensitivity, but also your balance: “if you’re not fuelling adequately for the task, your body’s going to give up and start moving [in ways you don’t want it to, like shifting and rocking on the saddle]. If you’re performing at a high level without sufficient energy and experiencing pelvic pain, that’s your body saying something’s wrong.”

This isn’t a cure but it’s just as important. Many of us are too embarrassed to talk about problems we experience down below, despite the fact that many of us are all experiencing the same thing. By becoming more comfortable with talking about saddle sores and genital damage caused by cycling, we can teach and learn from each other, share advice and tips, and ultimately support each other better.

It’s not a favourite solution but it’s the best thing you can do for yourself. If you’ve got a painful saddle sore, UTI or any other issue we’ve spoken about here, the first thing you should do is stop cycling for a couple of days and give that skin time to heal. Continuing to ride with those problems will only make them worse, exposing sore and damaged skin to further friction, sweat and bacteria. While you’re taking time off, here’s something else you can do to help:

Mildred joined as Reviews Writer for Cyclingnews and BikePerfect in December 2020. She loves all forms of cycling from long-distance audax to daily errand-running by bike, and does almost everything on two wheels, including moving house, and started out her cycling career working in a bike shop. For the past five years she's volunteered at The Bristol Bike Project as a mechanic and session coordinator, and now sits on its board of directors.

Since then she's gone on to write for a multitude of cycling publications, including Bikeradar, Cycling Plus, Singletrack, Red Bull, Cycling UK and Total Women's Cycling. She's dedicated to providing more coverage of women's specific cycling tech, elevating under-represented voices in the sport, and making cycling more accessible overall.

Height: 156cm (5'2")

Weight: 75kg

Rides: Stayer Groadinger UG, Triban RC520 Women's Disc, Genesis Flyer, Marin Larkspur, Cotic BFe 26, Clandestine custom bike