Hemorrhoids while cycling: causes, prevention and treatment
Hemorrhoids are one of those topics that hardly anyone talks about – yet they are widespread among cyclists. It is estimated that one in three adults suffers from them at least occasionally, and those who regularly ride a bike have an increased risk. But it doesn't have to be this way. With the right equipment, an adjusted riding position, and a few practical measures, you can often avoid the problem altogether or at least significantly alleviate it.
By Vincent Augustin 4 minutes read time
Published: June 20, 2026
What are hemorrhoids?
Hemorrhoids are a natural part of the human body: an arteriovenous network of vessels in the anal canal that plays a role in fine continence. They only become problematic when they enlarge, become inflamed, or prolapse – that is, when they protrude from the anal canal.
Medically, four severity levels are distinguished:
| degree | Description |
|---|---|
| I | Enlargement of the network, visible only with a mirror, no symptoms |
| II | Prolapse during straining, retracts on its own. |
| III | Prolapse, must be manually pushed back in |
| IV | Permanently prolapsed hemorrhoids, no longer reducible |
Typical symptoms: itching, burning, weeping in the anal area, blood on the toilet paper or a foreign body sensation.
Why cycling promotes hemorrhoids
Saddle pressure on the perineal area
The saddle transfers the entire body weight to a relatively small contact area. Especially with a classic road bike saddle, the pressure is concentrated on the perineum – the tissue between the sit bones and the anal area. This sustained pressure can impair venous blood flow, cause congestion in the veins of the anal canal, and thus promote the development or worsening of hemorrhoids.
Vibration and shocks
On uneven surfaces, the saddle continuously vibrates the body. These mechanical impulses put strain on the connective tissue in the pelvic area and can irritate existing hemorrhoids or lead to micro-injuries.
Bent-over sitting position
A pronounced forward-leaning posture – typical when cycling on a racing bike – increases intra-abdominal pressure. The abdominal organs press on the pelvic floor, which further increases venous pressure in the anal canal.
Dehydration and constipation
Those who don't drink enough on long hikes risk dehydration – a common cause of constipation. Straining during bowel movements is one of the main risk factors for hemorrhoids.
Prevention: How to protect yourself while cycling
1. The right saddle
The saddle is the most important lever. A saddle that is too narrow, too hard, or incorrectly aligned creates unnecessary pressure on the perineum and anal area.
- Saddle height : The saddle should be adjusted so that the knee remains slightly bent while pedaling (approx. 25–30° bend angle at bottom dead center). Too low means more weight on the saddle instead of on the pedals.
- Saddle tilt : A slightly forward-tilted saddle shifts the pressure to the sit bones and relieves pressure on the perineum. Try a tilt of 0° to -3° (nose slightly down).
- Saddle width : The saddle should fit the individual's sit bone width. Too narrow causes pressure on the perineum, too wide leads to chafing. Many specialist shops offer sit bone width measurement.
- Central channel : Saddles with a recess or channel in the middle specifically relieve pressure on the perineum and anal area and are particularly recommended for those prone to hemorrhoids.
2. Cycling shorts with padded insert (chamois)
High-quality cycling shorts with a well-fitting chamois are essential – not just for long rides. The chamois distributes pressure more evenly, reduces friction, and protects the delicate fabric.
Important: Cycling shorts are worn without underwear . Underwear creates wrinkles and additional friction. The chamois should be washed after every ride.
For longer tours, chamois creams are recommended, as they reduce friction and moisture in the seat area.
3. Seating position and technique
- Regularly get out of the saddle : Stand up briefly from the saddle every 20-30 minutes, even if it doesn't seem necessary. Standing up while pedaling relieves pressure on the perineum and reactivates blood circulation.
- Active sitting : Try making slight changes in position on the saddle – moving slightly forward or backward redistributes the pressure.
- Bike fit : A professional bike fit is worthwhile for regular training. Even small adjustments to the saddle, handlebars, or crank length can significantly improve pressure distribution.
4. Drink enough fluids
Drink plenty of fluids on every hike – not just in hot weather. A good guideline is approximately 500–750 ml per hour during moderate exertion. Staying well-hydrated will also help you maintain normal bowel movements after your hike, without straining.
5. High-fiber diet
A diet rich in vegetables, legumes, and whole grains keeps stools soft and regular. This is the most effective long-term prevention against hemorrhoids – regardless of exercise.
What to do in case of acute symptoms?
If hemorrhoids are already present and become noticeable while cycling, the following applies:
- Take a break : If you experience severe discomfort or bleeding, you should pause from cycling until the acute phase has subsided.
- Saddle break on tour : On long tours, consistently use every incline or traffic light to get up.
- Topical preparations : Zinc oxide ointments or preparations specifically formulated for hemorrhoids from the pharmacy can relieve itching and swelling. They serve to relieve symptoms, not to cure the condition.
- Sitz baths : Lukewarm sitz baths (approx. 37 °C, 10–15 minutes) promote blood circulation and can help with discomfort.
- Avoid prolonged pressure : If you have acute symptoms, avoid sitting unnecessarily long on hard surfaces – even when not on your bike.
- Bleeding , even if it is only slight – blood in the stool can have other causes.
- Pain that does not subside or worsens
- Prolapse (something protrudes from the anus that cannot be pushed back in)
- Symptoms that last longer than two weeks
When is it absolutely necessary to see a doctor?
Not every discomfort in the anal area is hemorrhoids – and you shouldn't try to diagnose it yourself. Consult a doctor if:
A proctologist or gastroenterologist can treat grade III hemorrhoids on an outpatient basis, for example by sclerotherapy (sclerosing) or rubber band ligation – both methods are minimally invasive and usually very effective.
Conclusion
Hemorrhoids while cycling are not inevitable. Choosing a suitable saddle, wearing good cycling shorts, regularly getting out of the saddle, and drinking enough fluids can significantly reduce the risk. If you experience acute symptoms, take a short break and seek medical help if necessary – the sooner, the easier the treatment. Then nothing will stand in the way of your next long ride.
Sources & References
- (1990). "Johanson JF, Sonnenberg A."The prevalence of hemorrhoids and chronic constipation". " *Gastroenterology*, 1990.
- (2012). "Weiss J, Fuchs KH."Anorektale Erkrankungen beim Sportler". " *Coloproctology*, 2012.
- Lohsiriwat V. "Hemorrhoids (2012). "From basic pathophysiology to clinical management." *World Journal of Gastroenterology*, 2012".
