J Sex Med 2006;3:1018–1027 © 2006 International Society for Sexual Medicine 1018 Blackwell Publishing IncMalden, USAJSMJournal of Sexual Medicine1743-6095© 2006 International Society for Sexual Medicine20063610181027Original Article Genital Sensation Is Altered in Women BicyclistsGuess et al. ORIGINAL RESEARCH—WOMEN’S SEXUAL HEALTH Genital Sensation and Sexual Function in Women Bicyclists and Runners: Are Your Feet Safer than Your Seat? Marsha K. Guess, MD,* Kathleen Connell, MD, † Steven Schrader, PhD, ‡ Susan Reutman, PhD, ‡ Andrea Wang, MD, † Julie LaCombe, MD, † Christine Toennis, PhD, ‡ Brian Lowe, PhD, ‡ Arnold Melman, MD, † and Magdy Mikhail, MD † *Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, † Departments of Obstetrics & Gynecology and Women’s Health and Urology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, and ‡ National Institute for Occupational Safety and Health—Reproductive Health Assessment, Cincinnati, OH, USA DOI: 10.1111/j.1743-6109.2006.00317.x ABSTRACT Introduction. Bicycling is associated with neurological impairment and impotence in men. Similar deficits have not been confirmed in women. Aim. To evaluate the effects of bicycling on genital sensation and sexual function in women. Methods. Healthy, premenopausal, competitive women bicyclists and runners (controls) were compared. Main Outcome Measures. (1) Genital vibratory thresholds (VTs) were determined using the Medoc Vibratory Sensation Analyzer 3000. (2) Sexual function and sexually related distress were assessed by the Dennerstein Personal Experience Questionnaire (SPEQ) and the Female Sexual Distress Scale (FSDS). Results. Forty-eight bicyclists and 22 controls were enrolled. The median age was 33 years. The bicyclists were older, had higher body mass indices (BMIs), were more diverse in their sexual orientation, and were more likely to have a current partner. Bicyclists rode an average of 28.3 ± 19.7 miles/day (range 4–100), 3.8 ± 1.5 days/week, for an average of 2.1 ± 1.8 hours/ride. The mean number of years riding was 7.9 ± 7.1 years (range 0.5–30). Controls ran an average of 4.65 ± 2.1 miles/day (range 1.5–8) and 5.0 ± 1.2 days/week. On bivariate analysis, bicyclists had significantly higher VTs than runners, indicating worse neurological function at all sites ( P < 0.05). Multivariate analysis found significant correlations between higher VTs and bicycling at the left and right perineum, posterior vagina, left and right labia. Increasing VTs at the clitoris, anterior vagina, and urethra were associated with age. In bicyclists, there were no correlations between VTs and miles biked per week, duration of riding, or BMI. Composite SPEQ scores indicated normal sexual function in all sexually active subjects. Neither group suffered from sexually related distress. Conclusion. There is an association between bicycling and decreased genital sensation in competitive women bicyclists. Negative effects on sexual function and quality of life were not apparent in our young, healthy premeno- pausal cohort. Guess MK, Connell K, Schrader S, Reutman S, Wang A, LaCombe J, Toennis C, Lowe B, Melman A, and Mikhail MK. Genital sensation and sexual function in women bicyclists and runners: Are your feet safer than your seat? J Sex Med 2006;3:1018–1027. Key Words. Sexual Function; Quantitative Sensory Testing; Pudendal Nerve Introduction stimates from surveys conducted by the United States Department of Transportation in 2002 suggest that approximately 13 million American E women bicycle regularly [1]. Whereas the benefits of this sport are many, bicycle riding has also been associated with several detrimental consequences. In both men and women riders, the most serious injuries and fatalities are usually the result of motor