Urogynecological and Neurological Consequences of Cycling in Women and Training Performance: From Compression to Biomechanical Protection. A Narrative Review.

Abstract

Introduction: Clinical consequences of perineal compression in female cyclists, such as neuropathy and edema, are described in the literature, but their direct impact on training quality and performance is rarely analyzed in research. Equipment not adapted to the female pelvis leads to injuries and secondarily limits athletic potential.

Aim of the study: To synthesize evidence from urogynecology and biomechanics to demonstrate how compressive perineal injuries, mental fatigue, and pain reduce training effectiveness. Additionally, the paper defines the role of professional bike fitting in maintaining training continuity.

Materials and methods: Twenty-five English-language publications from PubMed and PMC were included in the synthesis, integrating data on female pelvic anatomy, kinematics, mental fatigue, and vulvar pathology.

Results: A wider ischial tuberosity in women causes standard saddles to generate pathological perineal pressure. This results in saddle sores, urinary tract infections (UTI), chronic vulvar edema, and pudendal nerve compression. Chronically, pain and genital numbness increase mental fatigue, raise the rate of perceived exertion (RPE), and reduce cadence. These injuries force postural modifications, increasing the risk of training interruptions and sexual dysfunctions (FSD).

Conclusions: Urogynecological compression injuries pose a significant biomechanical and psychological limitation, directly disrupting training quality and continuity. Chronic pain leads to mental fatigue, negatively affecting performance, cadence, and riding economy. Equipment personalization through professional bike fitting is key to protecting intimate health and maximizing athletic potential. This requires close cooperation between coaching teams and uro-physiotherapists.