Get the Bottom Line on Saddles

Ischial tuberosities is neither the narrator of "Moby Dick" nor a snowboarder's expression of joy. The ischial tuberosities — "sit bones" — are the pelvic bones we sit on.

Cyclists riding longer than an hour may become painfully aware of these bones and the soft tissues between the bones.

Wrong Choice Is Painful
Bicycle seats are actually saddles, designed to be straddled and not to hold all of a cyclist's weight all of the time. Some body weight is carried by the legs, arms, and hands. When riders get tired, they tend to sit more weight in the saddle.

Squishy, soft saddles may seem like a logical option, but soft saddles tend to put more pressure on soft tissues. Seats with holes in the middle or toward the front relieve that pressure and are becoming increasingly popular for distance road cycling. Keep in mind that no one saddle is right for everyone. Take the Goldilocks approach and keep searching until you find a saddle that's "just right" for you.

Additionally, most distance cyclists wear padded bicycle shorts — without underwear — to prevent chafing from seams. Lubricants such as the lanolin-based Chamois BUTT'r, Noxzema, and Vaseline provide another barrier to chafing.

Male Issues
"There are many companies that now sell special seats that don't exert as much midline perineal pressure as a standard bicycle seat does," says Marc Lowe, a Group Health urologist who practices at the Capitol Hill campus in Seattle. "I advocate testing various seats to see what feels comfortable for each man. It's a matter of trial and error."

Q: Do uncomfortable bicycle seats cause prostate cancer?

A: There is no evidence linking prostate cancer or benign prostatic hyperplasia (enlargement of the prostate gland) with bicycle seats.

"Sometimes a man can end up with urinary symptoms similar to prostate-type problems because of the pressure and irritation a bicycle seat can cause," says Dr. Lowe. "The symptoms are similar, such as urinary frequency, perineal discomfort, and pressure. However, these are two separate conditions."

Q: Do hard bicycle seats cause permanent impotence?

A: Long-distance cycling can be associated with erectile dysfunction, especially in older men. But three more common causes of impotence are smoking, obesity, and inactivity.

"The pressure that the seat exerts can damage blood vessels and nerves that normally help a man achieve an erection," says Dr. Lowe. "Usually, in young men the erectile dysfunction is temporary, but in an older man the ability of the vessels to recover is more limited, and the damage can be permanent. It's a good idea to take breaks from sitting by standing up on the pedals when cycling for prolonged period of times."

Female Issues
"Proper adjustment of seats is important, as well as the rider shifting position occasionally to avoid discomfort," says obstetrician/gynecologist Sumi Lavin, who practices at the Group Health Eastside Women's Center in Redmond. "Training, that is, enough time on the bike, is the best prevention of discomfort."

Q: Do female cyclists risk permanent damage if they don't ride using seats made for women?

A: No, but women should experiment with different types of seats to find one that is most comfortable.

"Bicycle seats designed for women may be more comfortable, but permanent damage to the labia or nerves would be extremely unlikely on any bicycle seat," says Dr. Lavin.

Q: Do cycling shorts' chamois lubricants increase the risk of yeast infections and urinary tract infections (UTIs) for women?

A: Cycling can cause irritative urinary symptoms in women. But there has been no link made between chamois lubricants and increased risk of yeast infections or UTIs.

"The lubricants designed for cyclists should not be harmful to women," says Dr. Lavin. "The placement of the lubricant is not near the vagina as a cyclist's position on the bike is resting on the ischial tuberosities."

By Pamela Richardson
Group Health staff writer

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