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Ultrasonographic and Doppler findings of subclinical clitoral microtraumatisms in mountain bikers and horseback riders.
Abstract: Repeated microtraumas in horseback riders and mountain bikers are, in males, associated with perineal and scrotal lesions. No data are reported in the females. Objective: To report five cases of clitoral microcalcifications, diagnosed by ultrasonography, in six healthy, eumenorrheic athletes, and to verify the clinical and sexual impact of the ultrasonographic findings. Methods: Translabial ultrasonographic evaluation of the clitoris, Doppler analysis of dorsal clitoral arteries, and the two-factor Italian McCoy Female Sexuality Questionnaire (MFSQ) METHODS: The patients were assessed with a detailed history, and were submitted, in the periovulatory phase of the cycle (day 14), to clitoral ultrasonographic analysis and color Doppler evaluation of the dorsal clitoral arteries. The women were not sexually aroused. On the same day, in a separate room--and prior the ultrasound and Doppler examinations took place--the subjects completed the two-factor Italian MFSQ. Results: All the patients were completely asymptomatic but reported a past history of intermittent perineal tenderness or discomfort. In five out of the six subjects, the ultrasonographic assessment of the clitoris evidenced a disseminated clitoral microlithiasis. Only the youngest (18 years old) biker showed a normal pattern of the clitoral structures. A normal clitoral body volume (0.68 +/- 0.21 mL) and a normal mean dorsal artery pulsatility index (PI) was found (PI = 1.75 +/- 0.32) in all the patients. The two-factor Italian MFSQ showed a mean value of 42 +/- 4 (range 37-45). Conclusions: The chronic traumatisms may be responsible, especially in well-trained riders, for microhematomas, inflammation, and/or degenerative processes at level of the clitoral structure. Further studies should be undertaken to determine the clinical significance of the described disseminated clitoral microlithiasis.
Publication Date: 2008-12-09 PubMed ID: 19138367DOI: 10.1111/j.1743-6109.2008.01124.xGoogle Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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This research study investigated the occurrence of tiny calcifications (microcalcifications) in the clitoral structure in female athletes, especially horseback riders and mountain bikers. The study found that these sports, often associated with microtraumas in the genital area, lead to clitoral microcalcifications, but without evidence of pain, discomfort, or sexual dysfunction.
Objective and Methods
- The study aimed to document instances of clitoral microcalcifications, spotted via ultrasound, in six healthy female athletes. The secondary objective was to ascertain if these microcalcifications had any clinical or sexual impact on the studied individuals.
- Each participant underwent a comprehensive clinical history along with an ultrasonographic examination of the clitoris on the 14th day of their menstrual cycle, a non-aroused period for the subjects. This was accompanied by a Doppler study of the dorsal clitoral arteries. They also completed the two-factor Italian McCoy Female Sexuality Questionnaire (MFSQ), used to evaluate any potential sexual dysfunction.
Results
- All participants reported no symptoms but admitted to a history of intermittent perineal tenderness or discomfort. Five of the six subjects displayed microcalcifications in their clitoral structures during the ultrasonographic evaluation.
- The youngest subject, an 18-year-old biker, was the exception with a normal pattern of clitoral structures.
- Even with the microlithiasis, all patients fell within a normal range for clitoral body volume and mean dorsal artery pulsatility index (a measure of blood flow), indicative of a normally functioning clitoris.
- The MFSQ results showed no signs of sexual dysfunction among participants.
Conclusions and Future Scope
- The study concluded that continuous microtraumas, especially in seasoned riders, could lead to small hemorrhages, inflammation, and decay in the clitoral structure, eventually causing the observed microcalcifications.
- Despite the evident physical changes, these do not appear to disrupt sexual function or cause significant discomfort in the affected individuals.
- The researchers suggest further investigations to properly gauge the clinical implications of widespread clitoral microcalcifications.
Cite This Article
APA
Battaglia C, Nappi RE, Mancini F, Cianciosi A, Persico N, Busacchi P.
(2008).
Ultrasonographic and Doppler findings of subclinical clitoral microtraumatisms in mountain bikers and horseback riders.
J Sex Med, 6(2), 464-468.
https://doi.org/10.1111/j.1743-6109.2008.01124.x Publication
Researcher Affiliations
- Department of Obstetrics and Gynaecology, University of Bologna, Bologna, Italy. cesare.battaglia@unibo.it
MeSH Terms
- Adolescent
- Adult
- Animals
- Athletic Injuries
- Bicycling
- Clitoris / injuries
- Female
- Horses
- Humans
- Mountaineering
- Ultrasonography, Doppler / methods
- Young Adult
Citations
This article has been cited 6 times.- Murer S, Polidori G, Beaumont F, Bogard F, Hakim H, Legrand F. Could Horse Gait and Induced Pelvic Dynamic Loads in Female Equestrians Be a Risk Factor in Pudendal Neuralgia?. Sports (Basel) 2023 Jan 10;11(1).
- Di Stasi V, Maseroli E, Rastrelli G, Scavello I, Cipriani S, Todisco T, Marchiani S, Sorbi F, Fambrini M, Petraglia F, Maggi M, Vignozzi L. SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction. Front Endocrinol (Lausanne) 2021;12:641446.
- Trofaier ML, Schneidinger C, Marschalek J, Hanzal E, Umek W. Pelvic floor symptoms in female cyclists and possible remedies: a narrative review. Int Urogynecol J 2016 Apr;27(4):513-9.
- Partin SN, Connell KA, Schrader SM, Guess MK. Les lanternes rouges: the race for information about cycling-related female sexual dysfunction. J Sex Med 2014 Aug;11(8):2039-47.
- Zalewski M, Kołodyńska G, Piątek A, Mucha A, Misztela W, Andrzejewski W. Prevalence and risk factors of stress urinary incontinence among female horseback riders in Poland. Sci Rep 2026 Jan 17;16(1):5606.
- Cygańska AK, Giżewska B, Zdunek K. Evaluating Pelvic Floor Dysfunction in Female Horse Show Jumpers Using the Australian Pelvic Floor Questionnaire. Med Sci Monit 2025 Mar 16;31:e946830.
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