A “gooch” is a slang term for the perineum, the small patch of skin and tissue located between the genitals and the anus. Everyone has one, regardless of sex. In men, it sits between the base of the scrotum and the anus. In women, it lies between the vaginal opening and the anus. Despite being the butt of jokes, this area is a surprisingly important piece of anatomy that anchors your pelvic floor muscles and plays a role in bladder control, bowel function, and sexual health.
What the Perineum Actually Is
Medically, the perineum is a diamond-shaped region bounded by the pubic bone at the front and the tailbone at the back. An imaginary line drawn between the two “sit bones” (the bony points you feel when sitting on a hard surface) divides it into two triangles: a front triangle containing the genitals and urethra, and a back triangle containing the anus.
The visible part is just skin, but underneath sits a dense knot of fibrous tissue and muscle called the perineal body, sometimes referred to as the “central tendon of the perineum.” Think of it as a structural anchor point. At least nine different muscles converge here, including the sphincter muscles that control your anus and urethra, and the deep muscles of the pelvic floor. Without this central hub holding everything together, those muscles would have nothing firm to pull against.
Why It Matters for Your Body
The perineal body is critical for pelvic floor integrity. The pelvic floor is a hammock of muscle that supports your bladder, rectum, and (in women) the uterus. Because so many muscles anchor into this one small point between your legs, damage to it can compromise the entire system. Weakness here can contribute to urinary incontinence, difficulty controlling bowel movements, and organ prolapse, where the bladder, uterus, or rectum drops out of its normal position.
This area is also rich in nerve endings. The pudendal nerve, the primary nerve responsible for sensation in the genitals, perineum, and anus, runs through this region. It carries sensory, motor, and autonomic signals, which means it handles everything from sexual sensation to the muscle control you need for urination and bowel movements.
The Perineum During Childbirth
For women, this area takes on special significance during vaginal delivery. Pregnancy hormones alter the tissue density in the perineum, making it more elastic so it can stretch as the baby’s head passes through. Even so, tearing is common. Perineal tears are classified into four grades:
- First degree: A superficial tear affecting only the skin
- Second degree: Extends deeper into the perineal body tissue
- Third degree: Involves the anal sphincter muscles
- Fourth degree: Tears through the sphincter and into the rectal lining
Minor tears often heal on their own, while more severe ones require stitches. If the perineal body ruptures significantly, the gap between the pelvic floor muscles on either side can widen permanently, raising the long-term risk of rectal, uterine, or bladder prolapse.
Common Problems in This Area
Perineal pain isn’t limited to childbirth. One of the more common causes is pudendal neuralgia, a condition where the pudendal nerve becomes compressed or irritated. People with this condition describe burning, tingling, stabbing, or electric shock-like pain in the perineum and genital area. A hallmark symptom is that pain gets worse when sitting and improves when standing, lying down, or sitting on a toilet seat (which relieves pressure on the nerve). Some people describe the sensation as sitting on a golf ball. The condition can also cause urinary urgency, painful sex, and bowel dysfunction.
Cycling is another well-known source of perineal trouble. Prolonged saddle pressure compresses the blood vessels and nerves running through this area. Research from UCSF found that as vibration and road oscillation increase during cycling, perineal pressure rises by 10 to 19 percent above baseline, with a strong linear relationship between rougher riding conditions and greater pressure. This repeated compression is what causes the genital numbness many cyclists experience, and in some cases can contribute to erectile dysfunction. Proper bike fit, a saddle with a cutout, and shock absorption features can reduce this risk.
Keeping Your Pelvic Floor Healthy
Because the perineum is the foundation of your pelvic floor, keeping the surrounding muscles strong benefits this area directly. Pelvic floor exercises (often called Kegels) strengthen the muscles that attach to the perineal body, improving bladder and bowel control and supporting sexual function. These exercises involve repeatedly contracting and relaxing the muscles you’d use to stop the flow of urine.
If you spend long hours sitting, especially on hard surfaces or a bike saddle, periodic standing breaks help relieve sustained pressure on the perineum. For cyclists specifically, adjusting saddle tilt, using a noseless or cutout saddle, and wearing padded shorts can meaningfully reduce compression. Anyone experiencing persistent burning, numbness, or pain in this area, particularly pain that worsens with sitting, should have it evaluated since nerve compression responds better to early intervention.