vulvodynia

If you are experiencing hot, burning, intense pain in the saddle despite efforts to relieve your discomfort, you may want to read the following.

Vulvodynia is coming into focus again in the medical community as more women report chronic and sometimes debilitating vulvular pain. The most commonly reported symptom is feeling a hot, burning sensation that is triggered by pressure contact.

The painful onset can be triggered by several things, including walking, sitting, inserting a tampon, sex, and cycling. Changes in hormonal levels have been indicated in vulvodynia. Some women in their teens through 80's may experience a sudden onset of vulvodynia.

Women who suffer from this disorder have been reluctant to talk to their health care provider, or if they have sought treatment, were more than likely misdiagnosed. A simple test procedure in which pressure applied by a cotton swab to the trigger areas is used to diagnose vulvodynia. Upon the health care provider diagnosing vulvodynia, patients can seek treatment for the relief of pain.

Some treatment options include oral medications including antidepressants, topical pain block medications, physical therapy, nerve blocks, diet changes, and surgery to remove the nerve bundle if indicated.

20/20's Dr. Timothy Johnson did a segment on vulvodynia on 7 August.

For further reading on vulvodynia:

http://nva.org/

We have a pretty successful vulvodynia program where I work.

My advice: I'm begging, PLEADING, down-on-my-knees praying, that everyone rides a saddle wide enough to support them on the ischial tuberosities. Please, please, don't be supporting yourself on the ligaments of the pelvic floor.

If anyone reading this does have vulvodynia, before you start scarfing down gabapentin like it's m+m's and before you accede to neural ablation, please see a dermatologist who specializes in vulvodynia and a physical therapist or D.O. who specializes in it.

We seem to find 2 causes: dermatological, and derangements of the coccyx/sacrum. (you can also have pain from the pelvic floor muscles going into spasm, which PT can help, but that's not vulvodynia)

If anyone tells you you are imagining the pain, or that it's just stress, or that you are creating the pain yourself to avoid a relationship problem FIND ANOTHER DOCTOR.

Thanks Knot for the post and for being an ambassador of good saddles. :)

Knot, I would be curious to know what percentage of cyclists suffer from vulvodynia and is it more prevalent in cities with commuters?

I had that. The saddle was too small and a mans saddle. I bought a sella italia, ladys one, and also Skins womens cycling shorts( heaven) . No pain now, none! It was awful too.

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Originally Posted by sundial

Knot, I would be curious to know what percentage of cyclists suffer from vulvodynia and is it more prevalent in cities with commuters?

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That I don't know. I'll have to look it up.

Cycling tends to get blamed for starting it off, as one of several possible contributing factors. I've had a couple women who gave up cycling because of vulvodynia and they desperately missed their bikes. One was the classic "tiny butt, wide pelvic outlet" who had always been given narrow saddles just because her butt was small, and had never actually been MEASURED at the sit bones. She had her pain and incontinence under control by the time she left our program, but was still afraid to return to cycling. Vulvodynia is baaaad stuff. (incontinence isn't any fun either, and it is really a separate issue; it interferes with life but at least you can sit down...)

Being a total bike nerd that I am, I always push the many many options available to get folks back on bikes. There are always options!

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Originally Posted by KnottedYet

My advice: I'm begging, PLEADING, down-on-my-knees praying, that everyone rides a saddle wide enough to support them on the ischial tuberosities. Please, please, don't be supporting yourself on the ligaments of the pelvic floor.

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According to the Weight Weenies I've entered the Fuddy Duddy land of saddles--a Brooks B67S. :) This saddle supports everything! I have a happy hiney. :)

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Originally Posted by KnottedYet

... the classic "tiny butt, wide pelvic outlet" ...

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Wow! I've never been called a classic before!

Although one wierd, kinda rude guy on a group ride gazed disparagingly at my saddle, and when I told him it was comfortable, he said, "You must have a really unusual pelvis."

Wow, this thread is timely for me, I think! I've been riding now for a couple of years, but more intensely in the past six months. I noticed beginning about three months ago that being intimate with my BF was getting to be at first uncomfortable, and then actually painful. I've been attributing the discomfort to simply having officially entered menopause this past year, but now I'm wondering if there might be more to the story!

Thanks for posting this, especially the links to more info. My saddle is pretty comfortable---I'm not feeling undue pressure when I'm riding---at least not according to what I *think* is within bounds---but perhaps the cumulative effect of having a subtly-not-quite-right saddle is having a bigger effect than I was aware of.....I'll definitely schedule an appointment with my gyno to explore the issue more. The problem might not be vulvodynia, but whatever it is, I'd love to get to the bottom, so to speak, of the cause of the unusual (and worsening) pain I've been experiencing. At any rate, at least I'm now better educated about what could be the problem.....Thanks for the info!

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Originally Posted by sundial

According to the Weight Weenies I've entered the Fuddy Duddy land of saddles--a Brooks B67S. :) This saddle supports everything! I have a happy hiney. :)

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If I'm a Fuddy Duddy, at least I'm a happy and comfortable one. I just love my Brooks! No more saddle soreness at all.

Deb

Wide saddleists rejoice! :D

Kathi--I just spent 8 weeks or so out of the saddle so that I can heal from this health issue. It was definitely worth the time out of the saddle and I learned several things while I was off.

• long nose saddles encouraged me to ride towards the front of the saddle
• which then triggered spasms in my pelvic floor
• which then caused skin irritation and pain
• which seemed like effects from mild incontinence
• which sent me to the gyne
• who prescribed lidocaine gel
• which made me very happy again

Don't put it off--go see your doctor if you suspect you have this. The earlier the diagnosis the better. And listen to Knott when she says to get the widest possible saddle that fits you--it is absolutely worth it and consider it as a wise investment in your health. :)