23 Comments

Oh, wow, I’m a new subscriber and this topic is aimed straight at me! I would put seat choice at the very top of the list for more comfortable riding. There are plenty of articles out there with “top 10,” “top 5” etc women’s bike seats for mountain and road biking, so I won’t list my favorites because everybody is different, but a comfortable seat is a total game changer. Important - some bike shops have seat demo programs! You can try before you buy! I would put a good bike seat above good padded shorts in importance.

Also, I HIGHLY recommend getting a professional bike fitting. A good bike fitter can solve for all sorts of issues, including decreasing discomfort in your undercarriage. I was fortunate to find a certified bike fitter who is also a physical therapist and a woman, and it was one of the best self-care things I’ve ever done. I don’t know if that would work for a Peloton or other stationary bikes - I don’t know how many components are adjustable on those - but a good bike fit is so important.

Expand full comment
Sep 19, 2023Liked by Dr. Jen Gunter

The type of seat has a huge impact on comfort. I made the terrible mistake of getting a new saddle just before the AIDS Lifecycle ride from SF to LA one year. 500 miles on an ill fitting saddle after training for six months taught me an important lesson. If the seat isn’t right for your personal, very specific anatomy, no creams or shorts or position (all good things to pay attention to) will solve the feeling that your vulva is about to fall off. It’s worth the money to find a saddle that is comfortable for long rides- and it definitely is possible to find one.

Expand full comment

Can we also talk about a fact that most exercise equipment is simply not designed for women?

Much of the exercise bikes I've been on had to be used at the lowest and closest setting for my average sized 5'4'' body. MY LEGS ARE NOT TOO SHORT, it's a bike that is designed for gigantic men.

Expand full comment

I’m a cycle instructor / certified bike fitter. Bike settings is a must! I teach several classes/week and for yearsssss I have experienced moments of complacency where laziness wins and I don’t change out of sweaty clothes immediately and then pay the painful price 🔥 Menopause has added a “fun”, new layer of troubleshooting undercarriage discomfort. 😂 This article is a godsend and I now use aquafor and a maxi pad every time I teach. 🙏🏻❤️

Expand full comment

Oh the lanolin allergy was really "fun" to discover! Great info!!!

Expand full comment

This is great - thanks for the discussion here. Pressure on the perineum comes up often with men, too. I usually ask about biking/peloton in patients with new onset erectile dysfunction. For some there is a link, especially when other risk factors don’t add up. I would say I see this infrequently though.

I wonder if any “noseless” seats are compatible with peloton (switch seats)? I would ride much more but my body has very little cushioning down there. Bike riding patients tell me that the bike seat nose is really key for changing direction/balance when on a real bike, but for peloton I’m not sure it contributes meaningfully towards balance?

Expand full comment

Since you commented.... my husband gets some numbness in both of his feet when doing a ride of 30+ minutes. Thoughts?

Expand full comment

Hi Jill - interesting , I get that, too. It’s actually a reason I don’t do peloton very often (also want to take it easy on the nerves down there like Dr. G writing about). The feet would be a local nerve issue IMO, too much compression on the nerves in the balls of the feet, creating a kind of pins and needles sensation for me. Maybe the shoes are too narrow and stiff, too.

Expand full comment

Yes please to an article about vulvar moisturizers!

Expand full comment

What causes perianal dermatitis most often, in your experience? Dealing with this now! (And have been, on and off, for a while now.) I know food sensitivities & eczema can be causes for some people, but can perimenopause itself sometimes worsen this condition? Would love your thoughts. Thank you! (And hope your own situation down there is better now!)

Expand full comment

Great article! I get this question occasionally in my own GYN practice. My advice in the past was based only from my personal experience cycling and in my peloton. Thank you for adding info to my arsenal!

Expand full comment

Would love that closer look at moisturisers!

Expand full comment

A bike fit is a must. As a long distance cyclist it’s not just about the shorts or saddle height, it’s about the distance from seat to pedal and from seat to handle bar. Hard to do on a stationary bike but I can make all the difference. I find that triathlon shorts with their thinner and narrower pads are actually more comfortable for me. I love “Mad Alchemy” chamois cream. I would not recommend Vaseline it can clog pores. “Chamois butter” is great. But it is a bit trial and error. What works great for one is not so great for somebody else. Needless to say wash bike shorts after each wear and change and shower after each sweaty ride.

Expand full comment
author

Vaseline is noncomedogenic, so it doesn't clog pores. Any occlusive, including oils and petrolatum, can trap oils, potentially contributing to breakouts. I always recommend Vaseline for vulvar skin care, and it's a go-to in dermatology. I recommend people wash with a gentle cleanser if they are using any occlusive regularly to prevent a build-up of oils and products.

Expand full comment

Any thoughts on cyst prevention? When I ride I sometimes develop cysts - I initially thought they were Bartholin cysts, but my GYN has advised that they are not, but similar. She suggested removing them if needed, but also said there was a high change they would still return. (I've tried the above recommendations, considering getting a different bike seat that may help.)

Expand full comment
Sep 4, 2023·edited Sep 4, 2023

I loved seeing this topic covered! As a cyclist for several years, I would recommend going to some bike shops and trying out lots of bike seats because they are not all the same and possibly buying a woman-specific bike seat, such as a Terry seat. Also,the bike seat can be moved forward or backwards in addition to being tilted. FYI, there are several different chamois materials in bike shorts; do some research. Given that a Peleton bike has you stationary, make sure you get up off your saddle a lot. I know that when I take a spin class versus riding outside, my rear tends to hurt because the movement is different when you ride outside.

I second Cyclology clothing and accessories! I love their colors and designs. Louis Garneau makes some great bike clothing too. However, if I could convince Kim to bring back Dude Girl bike kits, I would only buy her kits. :)

P.S. When we travel on bike vacations we always bring our own bike seats!

Expand full comment

OP here...thanks so much for going so in-depth on this topic! As you mentioned, lichen sclerosis is an additional factor here for me. I was diagnosed last summer. I have a prescription ointment I use for that and I had been using coconut oil for my rides. I think your tip on something thicker being better might really help and I've ordered Chamois Butt'r since it doesn't seem to have the unneeded extras as well as your Cerave recommendations. I like the idea of having a personal stash of options.

Thanks also to Dr. Jen Adjacent for the bike adjustment advice. I adjusted the seat to be flat and also lowered my handlebars. This seemed to help keep the pressure on the sit bones much better. I just finished Discover Your Power Zones today with the FTP test and PRed for a 20 min ride! I really enjoyed the program, so I definitely don't want to stop now.

Expand full comment

I LOVE the PowerZone series. I found that it really helped me on my actual road bike. It has made me a lot more aware of my breathing and how much energy I am using during a ride, especially on a climb. I found that if you can really commit to that program, 3-4 days a week, which is what is required to stay on schedule, you will definitely see improvements. I especially like Christine and Dennis as instructors. Christine is very inspirational and Dennis picks the best music, by far. He is like an encyclopedia of all kinds of music and I really do like his musical tastes. I also like Matt who is a bundle of positive energy.

It is a great program, and I hope you stick with it and go on to the next series. Note, they do get harder, so be prepared to sweat!

Expand full comment

Literally discussing this topic with my husband yesterday. He tends to get a little numb when doing a ride for more than 30 minutes. And I have noticed my right side close to where I believe the perineum gets tender when I get out of the saddle as of late.

More on this topic please.

Expand full comment

I tried every suggestion under the sun a few years ago and just decided it wasn't for me :( I bought an elliptical cross trainer that was the closest thing to a peddling situation I could find (I can't do anything high-impact due to hip and knee issues). I still use Peloton for workouts and especially love their strength programs. I use their cycle and tread classes with my elliptical.

Expand full comment