Ask the Doctors: Clitoris Damaged from Bike Riding

Dear Dr. Queen,

I got your email from my gynecologist at Planned Parenthood Golden Gate because she had no idea how to help me.

You see, about a year ago I had a bike with a very, very hard seat. I suppose I was a careless rider because I ended up whacking my crotch quite a few times, going over bumps, getting on and off, et cetera.  Now, and it has been like this for a while, my clitoris is basically destroyed.  Well, not entirely, but it is really sensitive and it hurts to orgasm.  It is kind of hard to describe the feeling, but there is a sharp pain in the top and more pain, not as sharp, throughout the rest.  The nerve formation also feel different in the shaft (? sorry, my clitoris terminology is probably not accurate). The only thing I can think of is that my nerves got rearranged or damaged.  I have asked a couple of doctors and they have never heard about this before, but I honestly feel as if that is what happened.  Do you know anything about this and can something be done????

Please let me know! I am sure you feel the same way: orgasms are important to me!

Thank you so much and I eagerly await your response, sincerely and desperately!

P.S. I have also been experiencing a burning sensation throughout my crotch area when I masturbate and it sometimes hurts the mouth of my vagina to have sex.  I don’t really think this is related, but what do you think?

Oh, your poor clit!

I’m a little surprised the doctors you asked had never heard of something like this — genital effects from riding bikes, and especially things like bike accidents where people come down very hard on the seat or the bar, are by no means unheard of, especially if you are here in the land of the Critical Mass bike rides. In fact, in my years writing an advice column for the East Bay Express I got three relevant queries — the URLs for the questions from two women who wrote to me are below, in case they are of any further use to you. (A man wrote in, too–this problem of smacking your bits on your bike seat knows no gender.) Here they are: http://www.carolqueen.com/post/52838655010/advice-column-february-22-2002 and http://www.carolqueen.com/post/52837123223/advice-column-april-20-2001.

However, medical doctors, as I have said so many times, get very little education about sexuality and genital functioning beyond the basics of reproductive health. And you might think something as potentially problematic as genital bruising and nerve damage from bike-riding would have been part of your sex ed in high school, wouldn’t you? Heaven knows they try to worry you about everything else! Unfortunately, contemporary sex education, especially the abstinence-focused kind, has been far more about preventing youth from riding each other, never mind bicycles. But a lot of folks DO ride bikes, and here’s an important message: Invest in one of those cushioned seats! You CAN in fact do permanent nerve damage from rough biking on a hard seat. And even if you don’t, you can bruise the daylights out of your lower pubic area.

Please note that I’m not a medical doctor and can’t diagnose you, but I can certainly give you some information and encourage you to share that with the next physician you see. And if you can, find a doc who at the very least deals with sexual issues on a regular basis. Two ways to locate one: look at Kink-Aware Professionals to see whether there’s anyone in your area listed there; and check the member directory at AASECT (American Association of Sex Educators, Counselors, and Therapists) to look for professionals there. Most members of each of these organizations will be therapists rather than MDs, but these are a good place to start. Please note that you need not be kinky yourself to find a higher degree of understanding and ability to communicate about your possible injury with a Kink-Aware Professional. Also, it’s possible that the network of bike riders in your area can come up with a doctor who’s got some info about this type of injury. Ask around at bike shops if your local bicyclists aren’t online (in San Francisco we have a Bicycle Coalition and plenty of groups).

OK, about your actual clit. Two things are likely going on here. Soft-tissue injuries — bruising, basically, whether or not you were ever able to see an actual bruise externally — are common side effects of riding bikes roughly (and falling on fences, being kicked in the crotch, and other traumas that might ensue when you leave the house in the morning). And it’s certainly also possible that your nerves are the culprit. In fact, both could be true. If you sustained soft-tissue damage to your public area, the swelling would have involved cellular fluid and blood flooding the area which might have not resolved completely, even months after the initial injuries were sustained. (And in your case, you kept on biking, thus kept aggravating those injuries and getting new ones.) Not only would this affect your ability to become engorged normally, as you would usually do with sexual arousal — more blood flowing in won’t necessarily feel good if your ability to DIS-engorge has been compromised — these injuries might indeed have involved nerve damage also, or at the minimum, nerves may be affected by the swelling.

And your clit, I probably don’t need to remind you, would have gotten the brunt of any injuries you’ve sustained, because it’s right in between the hard bike seat (or center bar, if you ever came down hard on that — oww!) and your pubic bone. Your clitoral terminology is actually right on when you say you’re feeling something on/in the shaft: the clit’s shaft is just like the penis’s, only generally smaller, and it becomes engorged when you’re aroused — that means it swells, which in itself might help explain why the pain you feel there is sharper than that felt by the surrounding tissues. The other thing to note: the clitoris, also like the penis, has two legs that make its shape like a wishbone. These legs (or crura, their Dr. Science name) point into the body, on either side of the vagina,  and they, too, would be subject to a certain amount of bruising from hard and heavy biking.

Moreover, you may be re-irritating this injured area when you engage in sexual stimulation, whether it’s via masturbation or partner sex. It’s likely that touch and massage is actually good for the situation, but you may need to keep it lighter than you’re used to for a while. Your body will send you messages when it’s ready for more vigorous stimulation. Anti-inflammatory meds might make a difference for you, too — but don’t take my word for it, get a doctor who knows about soft tissue injuries to tell you what your optimal healing strategy ought to be, ideally with a neurologist to evaluate you for good measure.

The vaginal burning: Hmm, maybe. If the soft tissue damage is diffused throughout the area, it may cause irritation there. Of course, other things can cause vaginal discomfort and a burning sensation too, so this is another puzzle for the sex-savvy docs to help you unravel. Good luck!

I’m not suggesting, by the way, that you get rid of your bike (though you probably ought to stay off it while you heal up). But get a cushy seat! Bikers of the world, take good care of those soft bits between your legs; the only thing more fun than racing downhill with the wind in your hair is racing uphill toward a big satisfying orgasm.

– CQ

PS — According to pelvic pain specialist and sexologist Heather Howard, Ph.D., “The best medical specialists for this person’s initial evaluation would be pelvic pain docs (typically urologists or
uro-gynecologists) or sexual medicine doctors. Neurologists who are comfortable with the pelvis would also be good, but the best way to find them would be through a pelvic pain doctor. I would send her to IPPS (International Pelvic Pain Society) for a pelvic pain specialist, and to the Sexual Medicine Society of North America (SMSNA) to begin her search.”


We’re dedicated to getting you the information you need about sex, pleasure and your health. If you have any questions, please email our staff experts, Dr. Carol Queen and Dr. Charlie Glickman, at education@goodvibes.com! For product-related questions, please email or call our customer service staff at customerservice@goodvibes.com.

Dr. Carol Queen

Carol Queen has a PhD in sexology; she calls herself a "cultural sexologist" because her earlier academic degree is in sociology: while she addresses individual issues and couple's sexual concerns, her overarching interest is in cultural issues (gender, shame, access to education, etc.). Queen has worked at Good Vibrations, the woman-founded sexuality company based in San Francisco that turned 35 years old in 2012, since 1990. Her current position is Staff Sexologist and Good Vibrations Historian; her roles include representing the company to the press and the public; overseeing educational programming for staff and others; and scripting/hosting a line of sex education videos, the Pleasure-Ed series, for GV’s sister company Good Releasing. She also curates the company's Antique Vibrator Museum. She is also the founding director of the Center for Sex & Culture, a non-profit sex ed and arts center San Francisco, and is a frequent lecturer at colleges, universities, and community-based organizations. Her dozen books include a Lambda Literary Award winner, PoMoSexuals, and Real Live Nude Girl: Chronicles of Sex-Positive Culture, which are used as texts in some college classes. She blogs at the Good Vibes Magazine and at SFGate's City Brights bloggers page and contributes to the Boston Dig. For more about her at carolqueen.com.

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