Surgeon claims women's "saddle surgery" on the up

Industry experts have refuted claims that “saddle surgery” is the answer to on-bike discomfort and chafing for the vast majority of women, following claims by one Harley Street surgeon that more women cyclists are undergoing labia reduction surgery.

Saddle surgery, or labioplasty, involves cutting off part of the inner labia to prevent chafing and pinching against the saddle. Although industry experts agree saddle discomfort is a “huge issue” for women, in the vast majority of cases they say this can be solved through a combination of saddle fit, padded shorts and chamois cream.

Harley Street surgeon, Angelica Kavoumi, reported a rise in the number of women seeking labioplasty for anything from cycling and horse riding to golf. Where a year ago she says she carried out three consultations a week with women, that figure is now nine.

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She told the Mail: “When it comes to the inner labia, there isn't a norm. They can vary so much in terms of size and shape. Extra tissue can hang down unprotected, sometimes up to 3 or 4cm.”

Friction to this exposed skin can cause chafing and even bleeding, in some cases leading to infection, she said. However, the labioplasty procedure can be painful and leave significant bruising. A woman, who had the operation, "Kate", said she wasn't back to normal for six weeks, but she felt the procedure had improved her quality of life and confidence.

Industry expert Chris Garrison, who has worked with major bike brands researching ways to improve women’s relationships with their bikes, says there needs to be more information about the wide range of saddles available to women.

While Garrison agrees the issue of saddle discomfort is common among men and women, she adds in the vast majority of cases the issue can be solved without going under the knife.

She says: “It is a huge problem, and the problem basically exists because the bike manufacturers have put [a standard saddle] on a bike, but it’s entirely hit or miss whether it works for riders’ anatomy.”

“Like shoes, saddles come in lots of different shapes, sizes, designs, and of that cornucopia of availability there’s got to be something that works for you. There’s lots of examples of extreme saddles like there’s lots of extreme shoes. Some people think that’s what’s required, and it isn’t.”

“What I would find hard to believe is that anyone who has gone through that process [of trying out different saddle options] wouldn’t be able to find a solution other than surgery.”

Saddle discomfort is more common among women, Garrison says, because as well as being wider, the structure of the female pelvis is different from the male pelvis.

She says: “Underneath the pelvis women have a lot of vascular and nerve structure and this is what’s pressurised when we sit on a bike. That part isn’t different from men.

“What’s different in women is the shape of the pelvis - the pubic arch is significantly lower in women so when you imagine someone sitting on a bike, when the pelvis is rotated forward, women are putting a lot more pressure on the surface tissue in front of the pubic arch than men do.”

She recommends women talk to their local bike shop about saddle fit. What works for each person depends on the individual and the type of bike they are riding, as different bikes will rotate the pelvis more or less.

She says: “You can tell people in the store you are having soft tissue problems when you sit on the bike seat, because that’s something men can understand as well. If the shop acts like it’s too difficult a subject to talk about then find a different shop.”

“We need to be better at educating women that these are anatomical problems and there are other solutions than going under the knife.”

Monika Zamojska, co-founder of clothing brand House of Astbury, says: “In my days of working on the shop floor in a bike shop, every day I got at least 2-3 people inquiring about more comfortable saddles, from women with birth scars to men with prostate problems.

“Bike shops need to up their game to make sure that customers are not afraid to ask those questions. At the time of the purchase customers should be educated and fitted with the right products.”