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Are You Wearing the Wrong Underwear?

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It’s easy for both men and women to make these common mistakes…

Unless you’re the type of person who shares lots of personal information, you probably don’t discuss your underwear with your doctor. Perhaps you should.

Whether you’re a man or a woman, there are certain types of underwear that may be better for you than others. What you need to know about underwear—but may have been too shy to ask… 

PANTIES VS. THONGS

Once favored mainly by the young and daring, the G-string has become the go-to underwear for women of all ages who want to avoid panty lines.

Unlike panties, thongs press tightly against the genitals/anal area. Some experts speculate that this could cause irritation and skin damage—and that the back-and-forth movement of the “string” could spread the bacteria that cause vaginal or urinary tract infections and/or irritate hemorrhoids.

Over the years, I’ve heard anecdotes about a few thong-wearing patients who got infections. It makes intuitive sense that anything that transfers bacteria from one area to another could cause infection. But I’m not aware of any studies that have proved it.

My take: Wear a thong if it feels comfortable and you like the look. Women have been wearing thongs for a long time. If they were causing an increase in infections, we would have seen it by now.

BREATHABLE OR NOT?

“Pretty” panties and thongs are often made from rayon, nylon or other nonbreathable fabrics. These fabrics trap heat and moisture and can lead to maceration (skin damage) as well as infection.

Scientific evidence: Research published in the European Journal of Obstetrics & Gynecology and Reproductive Biology found that synthetic underwear was one of the factors associated with yeast infections. Synthetic “shapewear” such as Spanx, which limits air circulation, could cause similar problems.

My take: For all-day wear, cotton or other breathable fabrics are healthier than synthetics. It’s fine to wear lacy/sexy underwear under a cocktail dress or when you’re planning a romantic evening, but consider these fabrics “for recreational purposes only.” After a few hours, change into cotton.

Another choice: Synthetic thongs/panties with cotton liners. You’ll get the look you want without sacrificing breathability.

BOXERS OR BRIEFS?

Many fertility experts still recommend boxers for men who are trying to become fathers. Their thinking is that tight briefs increase testicle temperature and could decrease both the quantity and quality of sperm.

The testicles need to be about two degrees cooler than the rest of the body for optimal sperm production. Tight underwear holds the testicles close to the body. This could potentially heat things up just enough to cause a decrease in fertility—but the effect is probably minimal.

What recent research shows: Some older studies did find that briefs impaired sperm quality/production, but more recent evidence indicates that it makes little difference. Even when the testicles “overheat,” the effects on sperm production are temporary.

My take: Your choice of underwear is less important than other fertility risk factors, such as smoking, getting too much saturated fat in your diet, substance abuse, etc.

Exception: For men who have been tested and diagnosed with sperm-related issues, boxers are probably a safer choice than briefs. If you prefer briefs, however, you can still give the testicles a break by wearing boxers or no underwear when you go to bed at night.

ANTIBACTERIAL UNDERWEAR

Undies impregnated with bacteria-killing triclosan or nanosilver (small silver particles with antimicrobial properties) are relatively new to the men’s and women’s underwear market. Manufacturers claim that killing bacteria reduces odors.

Does antibacterial underwear work? Maybe. The same products are often made with moisture–wicking fabrics, which might have more to do with reducing odors than the chemicals.

My take: You’ll do just as well by wearing breathable underwear and changing it regularly (see below). I worry that the chemicals could migrate and increase yeast infections by changing the vagina’s bacterial balance.

GOING COMMANDO

Do you need to wear underwear? Not for health reasons. In fact, going bare gives the genital and anal areas a chance to air out. If you live in a hot, humid climate, it can be good for the skin. It can also help those who are overweight or obese—that’s because yeast can proliferate in thigh creases, under the belly or in other sweaty areas.

Forgoing underwear could cause chafing when delicate skin rubs against pant seams, but this isn’t a problem for everyone. For women, going underwear-free could allow traces of natural discharge to end up on clothing, but this is an issue only if it bothers you.

My take: If you enjoy the airy feeling, go for it!

CHANGE THEM DAILY OR NOT?

It makes sense to change out of damp or dirty underwear. But, in general, how often should underwear be changed?

My take: There’s no health reason to change clean underwear more often than once a day.

However, if your underwear gets damp from urine—even a few drops—swap them as soon as possible for a fresh pair. Odor is an obvious problem, but dampness increases the risk for yeast infections on the skin—which can affect men as well as women.

Extra Protection…

If you “leak” now and then, you may benefit from disposable or washable incontinence briefs (available in several styles and all sizes) that look like regular underwear and aren’t visible under clothing.

Alternative: Both men and women can wear thin disposable pads (such as Butterfly Men’s Body Liners or Depend Shields for Men…or, for women, Poise Liners or Equate Thin Liners) that slip inside regular underwear and wick moisture away from the skin.

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Source: Richard Bennett, MD, an associate professor of urology at Michigan State University in East Lansing and Oakland University William Beaumont School of Medicine in Rochester. He is also the director of urologic robotic surgery at McLaren Oakland Hospital and a staff urologist at William Beaumont Hospital and Huron Valley-Sinai Hospital. Date: August 1, 2016 Publication: Bottom Line Health
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