Posedla Academy | Genital Numbness Syndrome (GNS)

Genital Numbness Syndrome (GNS) is a condition characterized by partial or complete loss or reduction of sensitivity in the genital area. This condition may affect sexual function, tactile perception, and overall sensation in the region.

1 | SYMPTOMS:

• Tingling, numbness, or decreased sensitivity in the genital and perineal area.
• Burning sensations or pain (neuralgia).
• Weakness of the pelvic floor muscles.
• Erectile dysfunction in men.
• Reduced sexual arousal or numbness in women.
  
  

2 | CAUSES:

• Compression of the neurovascular bundle, especially under the symphysis.
• Disorders of blood supply to the genital region, leading to reduced tissue oxygenation.
• Chronic pressure on the perineum and genitals.
• Trauma or long-term use of restrictive underwear.
  
  

3 | DIAGNOSIS:

• Medical history: Onset of symptoms, related factors, medications used, and presence of other health conditions.
• Physical examination: Focused on neurological and vascular status in the pelvic area.
• Imaging methods: MRI, ultrasound, or CT to detect structural or vascular changes.
• Electrophysiological tests: Assessment of nerve conduction in the genital region, particularly somatosensory evoked potentials.
• Psychological evaluation: To rule out or confirm psychosomatic causes.
  
  

4 | TREATMENT:

• Management of neuropathies or nerve compressions.
• Rehabilitation.
• Medications to improve blood circulation.
• Pelvic floor strengthening exercises.
• Physiotherapy aimed at normalizing tension and function of the pelvic region.
• Removal of the cause of compression.
• Vitamin B generally supports peripheral nerve health; e.g., Milgamma can be used as supplementation.
  
  

5 | PROGNOSIS:

The prognosis of genital numbness syndrome depends on the underlying cause and the timing of treatment. Some patients may experience quick improvement, while others may require long-term or combined approaches. In most cases, this is only a temporary dysesthesia, lasting for a few hours at most.

Most cyclists experience genital numbness; however, this does not typically lead to de novo erectile dysfunction (ED). On the contrary, recent studies highlight the protective effect of cycling against ED, as the overall vascular benefits of endurance exercise outweigh the local ischemia. Consideration of cycling suitability arises only if a pre-existing disease or pathological process in the genital or pelvic area is present.

References:

Awad, M. A., Gaither, T. W., Murphy, G. P., Chumnarnsongkhroh, T., Metzler, I., Sanford, T., Sutcliffe, S., Eisenberg, M. L., Carroll, P. R., Osterberg, E. C., & Breyer, B. N. (2018). Cycling, and Male Sexual and Urinary Function: Results from a Large, Multinational, Cross-Sectional Study. Journal of Urology, 199(3), 798–804. https://doi.org/10.1016/j.juro.2017.10.017

Peacock, J., Cobley, J., & Patel, B. (2022). Urological issues in cyclists. Journal of Clinical Urology, 15(2), 118–128. https://doi.org/10.1177/2051415820964982

Solutions: Ergonomic saddle with a perineal cut-out, frequent changes of riding position, or standing up while cycling.