As I sit in bed, a bag of frozen peas between my legs, I contemplate how I arrived at this circumstance – perhaps later than I should have. A week ago, I had a labiaplasty. Over several years, I developed vulvodynia (irritation of the vulva) caused by labia hypertrophy (enlarged labia, usually asymmetrically). After a visit to a gynecologist, this was the prescribed medicine for my ills.
I long pondered a visit to a specialist for this procedure, but admittedly, I was nervous. In addition, some of these concerns were my norm. I’ve always had asymmetry in my labia but it wasn’t always problematic. When I had my first pelvic exam at a university clinic, the nurse practitioner informed me I had asymmetry, as many women do. One of my labia was three times the size of the other; however, it wasn’t cause for concern.
Several years later, I became more involved with cycling. Opening a bike tour and rental company, I ditched my car, and began participating in endurance cycling and cycle touring. Many hours were spent in the saddle. Swelling, burning with urination and an all-over bruised feeling was frequent sensation during my first bike tours. (The irony of those sensations having come full circle at present moment does not escape me). At nighttime, in my tent, I’d let my vulva rest and the next day repeat. For some time, I pondered if I was the only female cyclist experiencing this torture. How could people choose to do this repeatedly if that was the case? My online research began, and as I hypothesized, many other women were describing similar experiences in forums. After absorbing all the information and testimonials I could, I purchased a new saddle, and experimented with tilt.
Tilting my saddle helped for a while. There was some relief from the pressure on my labia and it didn’t hurt as much. As time passed and I rode more endurance events, the familiar ache returned. Every solution of which I was aware was attempted and no stone was left unturned, but I was continuously marred by the same irritation. I recalled reading personal accounts on forums of women who underwent labiaplasty procedures, yet I wasn’t quite ready to confront that as an option.
This past summer, all of my misery came to a head after a 240-mile gravel race. I was in continuous pain throughout. Afterward, I didn’t even want to look at my bike for nearly three weeks. My apparatus for my personal passion came to symbolize a medieval torture device. As I don’t own a car and work in bikes, not riding wasn’t an option, but I avoided it other than those needs. While not cycling provided some relief, even walking caused friction and irritation. At every waking moment, I was fully aware of the sensitivity. Upon reading about the Specialized Mimic, designed alongside female professional cyclists, my hope was briefly revived. Checking out the saddle from a local shop for a test, I did a 160-mile bike packing ride up north but my hopes were dashed. No saddle, position (I visited both a bike fitter and physical therapist), or short was of assistance. It was time to see a gynecologist.
After discussing my discomfort, my gynecologist performed an exam which includes a ruler measurement of your labia. (If you are one of those people who loves data, rest assured, these doctors are armed with the adequate tools to satiate your curiosity!) My physician informed I would be a candidate for a labiaplasty. Not only did I have hypertrophy, but my other labia was a bit larger than average. With the trauma of cycling, she said I could have further elongated my labia and triggered vulvodynia, thus recognizing most sensations as irritation. Given my symptoms, she thought this would be a medically necessary procedure for me.
We discussed what the procedure would entail and she demonstrated how much tissue she anticipated removing. No experience has ever felt more Kathy Bates in Fried Green Tomatoes than examining my vulva in a mirror alongside my doctor. (Good news: contrary to Kathy’s character, I can look at my own vagina in a mirror.)
Hoping to improve my quality of life, I scheduled my surgery. Unfortunately, I would be banned from riding my bike for at least four weeks until my surgical follow-up. But the promise of a potential pain-free cycling future more than makes up for that though.
With the decision made, I chatted about my procedure with friends. I met a care provider whose partner had a labiaplasty after childbirth (also very common.) Several of my friends discussed they’ve considered the surgery too. The more I talked about my struggles, the more people opened up to me. It saddened me that, short of the forums I had read long ago, where people often choose to be anonymous, I didn’t have anyone to directly speak with that underwent the procedure. Knowing what to anticipate in terms of recovery, but also how it may impact my cycling life, would have been beneficial.
A week out of surgery, I am doing well. The labiaplasty procedure was of minimal risk, utilizing sedation with local anesthetic, and lasted about an hour. I have low pain, managed with Ibuprofen (and was given stronger meds in case.) My after-care plan is as follows: ice 20 minutes on and 40 minutes off for the first few days, use lidocaine and bacitracin gels on the area after bathing and voiding for a week and perform sitz baths two times per day for two weeks. Finally, a recommendation to “chill” this month (the hardest act of recovery for me).
Despite swelling and discomfort, I felt some immediate relief after the procedure. The simple absence of tissue was freeing. Hindsight is 20/20. I wonder if I’d discussed the surgery with someone who had personal experience, would I have done this sooner? Today, more folks are chatting about their trials and tribulations with cycling and their vulvas (for example, Hannah Dines who recently shared her experience.) Unfortunately, they also seem to link this issue mostly to professional cyclists. While yes, they spend more time on a bike, per my experience, it’s clear you need not be.
While I cannot undo the past, being a resource to others who may consider this procedure to change their cycling future is a priority for me. Similarly, my story may help someone experiencing comparable problems to use other tools in order to avoid a procedure. When people have asked, I’ve discussed my surgery. I’m not ashamed of my body – it’s a fantastic vessel that performs better than I could ever ask. Like everyone’s body, it has some glitches. In this case, one of my glitches needed repair. I don’t think surgery is the correct decision nor answer for everyone. It is not to be taken lightly, there are always risks. However, if there is physical discomfort associated with one’s given anatomy, we shouldn’t leave these options off the table.
Openly communicating about physical problems, like with labia, helps normalize them. Hopefully we will one day discuss, write, and read about procedures like a labiaplasty (or ways to avoid needing one) as candidly and frequently as we do foot numbness on clipless pedals. The cycling community has indicated a desire to and is working towards inclusion and equity. Be that the case, we need to talk more openly about the firsthand experiences, trials, and tribulations of folks with vulvas. Let’s normalize discussion around all parts of our cycling bodies.