What can we learn from the Olympics to improve sexual wellbeing?

Written by Dr Amy Cleese (Reviewed by Dr Josh Kadirgamar)

The Olympics are here… and in Paris, the city of love!

Of course, this led me to think how the Olympics - and sport in general - relate to sexual wellbeing. And the relevance of this to primary care.

As the saying goes ‘couples that sweat together, stay together’. Studies have shown couples feel more ‘in love’ and satisfied with their relationship after doing physical activity together. This is likely due to feeling the closeness of having a shared goal and because your partner may appear more attractive. Sport/activity can cause the same feelings as arousal; racing pulse, shortness of breath and sweating. 

(This would put a whole new spin on a public health campaigns and discussions around healthy lifestyle!)

However, when it comes to sport and sexual wellbeing it isn’t all good news. For sport-related sexual dysfunction, there is one sport that is continuously mentioned…

…Cycling!

If you google cycling and sex, pages and pages of information will be presented to you about cycling and erectile dysfunction (ED).  It was originally thought that constant pressure on the perineum (the area between the anus and the posterior part of the external genitalia) could damage the nerves, and slow blood flow - and that this could lead to ED. However, research over the last decade has in fact shown evidence that there is no correlation between cycling and ED. It does cause an increase in the PSA (prostate specific antigen) which is worth noting for men who are being checked for prostate cancer. 

We know that, unfortunately, women's health is generally far less researched compared to men’s health - and, unsurprisingly, when it comes to sport this is no different. 

Even with the limited research so far, we know that women are actually at higher risk of genital conditions due to cycling, including: vulval infections, cysts and chronic inflammation due to long-term vulval trauma. My impressive friend, Dr Emily Powell (anaesthetics doctor & health-tech fellow), explained that she has seen patients who have developed painful abscesses, and had to present to A&E for urgent treatment.

In fact, back at the 2016 Rio Olympics, the women's cycling team were “banned” from (or strongly advised against) waxing or shaving, in order to prevent these conditions. Many have said there needs to be urgent research into better saddles and preventative measures to help female cyclists. 

For many women (and those AFAB), their vulva is associated with pain on a daily basis! 

Periods, thrush, dermatitis, lichen sclerosis, penetrative sex, labour, postnatal complications, menopause - and of course cycling-related trauma! 

Paralympic cyclist Hannah Dines has written candidly about her experience with chronic vulval swelling, which required surgery. She writes, ‘Your regular general practitioner will be flummoxed by any chronic saddle complaint’ - I laughed out loud; she is probably right!

In her article, she highlights the shame that she felt due to her condition, and she describes ‘worrying needlessly about what a new [sexual] partner would think’. She was also worried by the notion of having to explain about her condition to multiple healthcare professionals - who were not familiar with the appearance of saddle-related vulval changes.

Diving - at Olympic speed - further into the world of sexual wellbeing and sport, there are various other examples, such as: gymnastics & weakened pelvic floor; horse riding and vulval pain; swimming and chlorine-related vulvar dermatitis; and athletes with breast pain from ill-fitting sports bras. All of these areas require more research into their impact and management, including preventative measures.

This is of course not to say we shouldn’t be enjoying sport - of course we should. Sport has amazing physical, mental, and social benefits; it gives us purpose, and challenges us to improve and work towards our goals. 

But more research is needed to ensure that women's health, and their sexual wellbeing, are not negatively impacted by the sports they love. After all, sport is going to improve everyone’s sexual wellbeing. 

 References

Aron, A., Norman, C. C., Aron, E. N., McKenna, C., & Heyman, R. E. (2000). Couples' shared participation in novel and arousing activities and experienced relationship quality. Journal of Personality and Social Psychology, 78, 273-284.

Hollingworth, M., Harper, A. and Hamer, M. (2014) 'An observational study of erectile dysfunction, infertility, and prostate cancer in regular cyclists: Cycling for Health UK study,' Journal of Men S Health, 11(2), pp. 75–79. https://doi.org/10.1089/jomh.2014.0012.

Gan ZS, Ehlers ME, Lin FC, Wright ST, Figler BD, Coward RM. Systematic Review and Meta-Analysis of Cycling and Erectile Dysfunction. Sex Med Rev. 2021 Apr;9(2):304-311. doi: 10.1016/j.sxmr.2020.01.002. Epub 2020 Mar 6. PMID: 32147498.

Harrison, Lizzie & Edey, Katharine. (2023). Vulval symptoms in female recreational cyclists. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 12. 3446-3451. 10.18203/2320-1770.ijrcog20233616. 

Dines, H. (2020) '‘I had a huge swelling’: why my life as a female cyclist led to vulva surgery,' The Guardian, 2 November. theguardian.com/lifeandstyle/2019/mar/26/hannah-dines-saddle-research-pain-swelling-female-cyclists (accessed 30th July 2024) 

British Society for the Study of Vulval Disease (2024) External Resources - BSSVD. bssvd.org/practitioner-portal/external-resources/.(accessed 30th July 2024)

Disclaimer:

This article is intended for informational purposes only and does not constitute medical advice. For any health-related concerns or conditions, please consult a qualified healthcare professional. Always seek the guidance of your doctor or other qualified health providers with any questions you may have regarding a medical condition or medications.