Perineum issues. INSANELY frustrating
 

I've been cycling now over 2 years pretty often, around 3-4 days a week (gravel bike). I'm a guy in my 40s, in quite good shape. I had some perineum issues that flared up about a year ago and had to stop riding for a month, and visited a urologist (nothing was wrong). Then the issue came back this summer (after a lot of riding). So I finally got a bike fit, which I had never done. I even needed to go back to the fitter again to do a 2nd fit, plus I've tried several saddles. He seemed quite happy with the last fitting and saddle but the perineum issues still continues. It's not pain, it's a strange sensation in that area, quite hard to explain it exactly (almost feels some nerves are affected to a degree). It happens after around an hour of riding. Back when I was riding a lot i was riding anywhere from 2-5+ hours. Not anymore. I'm just near quitting this sport as this is massively frustrating and i can't seem to find a damn solution. So I guess I will do some exercises for that region and stretches and totally stop riding for weeks maybe months. I just feel so stuck and not sure what to do next. It's just so hard to explain the feeling I experience cuz it really isnt pain, it's just an uncomfortable sensation in that area (sometimes even going a bit down my leg/legs). Anyway, has anyone experienced something like this? I'm at total loss and ******g sick of this in all honesty. Maybe this sport just isnt for me...BTW, the sensation usually lasts about a day or 2 then goes away, unless of course I get back on my bike. It also sometimes will affect my peeing at times, like it can be a bit hard to pee, for a day or 2...

I would start messing with your saddle. Not necessarily changing saddles, although that might not be a bad idea either, but rather micro adjustments to your current saddle, up and down, fore and aft and experimenting with tilt, all the while keeping meticulous notes on everything you do along with the results.

Entirely possible.

Sounds like pressure in the area, have to fix it.

What does your setup / you on the bike look like?

I have no idea if it would help in this case, but I am much less likely to have any issue with saddle sores, chafing or any other discomfort if I wear two pairs of cycling shorts. In the winter, I usually wear soccer warmup pants over the cycling shorts and am pretty comfortable with that. Might be worth a try.

Otto

Maybe a recumbent bike if you want to stick with cycling.

It sure so7nds like you’re sitting directly on your prostate.

I'm really not. I spent 6 hours with that fitter and he showed me exactly where to sit

It's gonna be much, much harder for us to diagnose anything blindly over the internet better than a professional fitter you spent 6 hours with.

But let's start with the basics. What is the exact saddle you are using? What is your riding position? Can we see some pictures, or better yet, a video?

Actively having to transfer weight off your perineum is not a great solution for aggressive cycling. It's much better to be able to put weight on that area without causing nerve issues.

Sorry to hear this. But I think a urologist isn't the right doctor, but a neurologists who can pinpoint the perineal nerve area where the numbness is occurring. I had discomfort in the area when I first started distance cycling, going with a Brooks which is what everyone says is the best, but turns out I needed a channel/cutout long seat for my narrower hips! This may not be what you need but finding where the damaging area is and which nerve will help in finding the solution. Good luck!

I'd try different shorts that have different thickness of chamois. Sometimes less is more. Also saddles that have differing amounts of cutouts to them.

And though your fitter and doctors might be good. Sometimes they just miss something that another might realize easily. So maybe try some others.

Do you have a bike shop nearby that has a return policy on seats? A local Portland shop has a "library" with ~25 different seats. You can buy a $25 "library card" and take out seats one by one, as many as you want. Also, have you gone for rides with the wrenches to adjust seat position? (Mark your current settings first. 2-bolt seatposts can be a real asset here because they allow you to get exactly the right tilt and return to your former setting.)

One popular notion that absolutely doesn't work for me is the "level seat". I've ridden nose down for 40 years. I'd be throwing away crotch health to achieve that "ideal".

I had numbness issues, stemming from perineum pressure, when doing rides on the trainer, which is often trial by fire for saddle fit. Getting a saddle wide enough (make sure you get your sit-bone width measured), lightly padded, flattish, and with a somewhat large cutout did the trick for me (currently a Shimano/PRO Stealth).

This was an ongoing and lasting issue for me while riding (particularly) road bikes. I found some relief both in regard to saddles as well as fit of the shorts and it's chamois or lack of one. Ultimately it has turned out where an upright position such as on a hybrid, and standing regularly while riding help offset the full on pain rather than discomfort. It never fully went away for me unless riding a recumbent.

I'm sure posting about it once a month without following up on any of the helpful suggestions that people offered will really help fix your issue.

Whether is can help or not, I've found the Selle Anatomica saddles much more compatible with that area of my anatomy (my prostate was hauled to a toxic waste site a few years back). They have a curved slit so it is completely open in that area and also flexes somewhat. It is not just a depression like some saddles. It also contains a bolt at its nose to adjust the tension and flex.

A few friends, both male and female have also found it better in that area.

Done with this one
 

Good catch, thanks. :twitchy:

Everyone’s squishy parts (and bones) are different, but I’m happiest on a Brooks leather saddle, nose slightly up, atop a Nitto S-83 seat post, the one that’s infinitely adjustable (two-bolt design). I can ride 50 or 70 miles, and always five more, with no pain or soreness at all.

I think you might have to think a bit outside the box when it comes to saddles. I don’t know if you have tried a noiseless saddle. I have to admit, I would have to be in considerable pain to place one on my bike, but I would if it was the difference between riding and not riding.

79pmooney has also mention a 2 bolt seatpost more than once, even gave a good recommendation with a Suntour XC Pro. I’m not suffering with pain, but I picked up one of those seatposts and I love being able to fine tuning the tilt.

John

OP
Simple question for you….

what are the width of your sit bones?


Please go find a How To on YouTube, measure them and report back

Barry

xoxo

Yes If the sit bones are not properly supported the seat can put pressure on the perennial area. With me It was seat tilt on a new Brooks saddle. The seat post wouldn't hold it tight enough to keep it in adjustment. The OP should also send some pictures so we can see riding position on the bike and a picture of the bike without the OP on it.

Yes, could be very frustrating.

Stop carrying weight on perineum. Put your weight on the pedals.

Go for a ride with no saddle. Main problem with that is saddle is part of steering. So be careful. Just getting down the road with no saddle should be no problem.

Stand on the pedals. Stand a lot. Standing gives instant perineal relief. Sitting on the saddle should be 99.9% as good as standing.

Six hours with a fitter? Doing the same thing over and over again expecting a different result? Forget this fitter. Forget fitters in general.

Everyone has a perineum. They are vulnerable. We are all at risk of having the problem you have. Most of us succeed in riding the bike.

I agree (John undoubtedly meant to type "noseless").

I like the Spongy Wonder noseless saddle. Cured my numbness issue. No pressure at all on the perineum.