title: Pelvic floor symptoms in female cyclists and possible remedies: a narrative review.
abstract: OBJECTIVE
  Cycling has become a popular athletic activity worldwide and can lead to genital and pelvic floor dysfunction. This review summarizes the current body of evidence about the epidemiology of genital and pelvic floor symptoms in female cyclists, the therapy, and preventive interventions.
  
  
  METHODS
  Two electronic meta-databases, OvidSP™ and Deutsches Institut für Medizinische Dokumentation und Information (DIMDI), comprising 40 individual databases, were searched for studies that described genital and pelvic floor symptoms in association with cycling and studies that tested possible therapies and prophylactic measures. For the literature search we explored the search terms "female", "bicycling", "pelvic floor", "lower urinary tract symptoms", and "vulvar diseases".
  
  
  RESULTS
  The search retrieved 1,219 articles, leaving 763 articles after removal of duplicates, and finally 12 articles eligible for review. We assessed 10 observational and 2 experimental studies. Genital and pelvic floor symptoms related to bicycling were pain, tenderness, neuropathy, urological dysfunction and skin lesions. Broader and conventionally shaped saddles were associated with fewer symptoms compared with cut-out saddle designs.
  
  
  CONCLUSIONS
  The quality of existing studies is generally low, but there is evidence that female cyclists suffer from similar problems to male cyclists, ranging from minor skin lesions to severe sequelae such as pain and neurological deficiencies.
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria. marie-louise.trofaier@meduniwien.ac.at.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Trofaier
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria.
authors.forename: Cora
authors.initials: C
authors.lastname: Schneidinger
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria.
authors.forename: Julian
authors.initials: J
authors.lastname: Marschalek
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria.|Multidisciplinary Continence and Pelvic Floor Center, Medical University Vienna, Wien, Austria.
authors.forename: Engelbert
authors.initials: E
authors.lastname: Hanzal
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Medical University Vienna, Waehringer Guertel 18, 1090, Vienna, Austria.|Multidisciplinary Continence and Pelvic Floor Center, Medical University Vienna, Wien, Austria.|Karl Landsteiner Institut for Specific Gynecology and Obstetrics, Silbergasse 18, 1190, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Umek
mesh_terms: D001642:Bicycling; D002081:Buttocks; D004867:Equipment Design; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D010146:Pain / Q000453:epidemiology / Q000209:etiology*; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D012871:Skin Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D014845:Vulvar Diseases / Q000453:epidemiology / Q000209:etiology*
keywords: Bicycling; Female; Lower urinary tract symptoms; Pelvic floor disorders; Pudendal nerve; Vulvar diseases