I've struggled with the exact issue you have - perineum pressure. I have to ride a seat with a decent cut-out. Brooks was the worst seat I've ever ridden in regards to perineum pressure(though I haven't tried the cut-out). I don't even understand how others can ride them. For me, the answer was a Selle Italia Trans Am. I don't think they make the exact seat I have anymore, but maybe look at their line-up and see if anything looks good to you. Hopefully they'd have something in a width that works for you. Mine has just the right amount of padding and a cut-out that keeps me completely comfortable in that area.