A 2023 YouGov poll indicated that 7% of Americans always go without underwear, with another 10% doing so often. Research on the direct health outcomes of wearing versus not wearing underwear is limited. Dr. Kyle Brenda, a board-certified family physician at Whitman-Walker Health, states that personal comfort should be the primary consideration.
Underwear's Effect on Health
Dr. Brenda notes that appropriate underwear generally does not significantly affect health, though what constitutes "appropriate" can vary.
For Men: Sperm Health and Comfort
Urologist Dr. Justin Dubin suggests boxers, boxer-briefs, and briefs are suitable for regular wear. A 2018 study observed that men who wore boxers had a 25% higher sperm concentration and 17% higher sperm count compared to those wearing tighter underwear. This is potentially due to tighter garments increasing testicular temperature, creating a less favorable environment for sperm.
Dr. Dubin clarifies that these are not significant concerns for average men with healthy sperm production, stating that fertility is unlikely to be compromised by underwear choice. He suggests boxers or boxer-briefs for those seeking to optimize sperm health.
For Women: Fabric, Fit, and Infection Risk
For women, the fabric of undergarments is a key health factor. Dr. Natasha Bhuyan, a family physician, recommends cotton due to its breathability. Fabrics like polyester can trap heat and moisture, increasing the risk of infections such as yeast infections or tinea cruris (jock itch). Fit is also important; tight underwear can cause ingrown hairs or irritation from friction.
Is Going Commando Healthier?
Experts largely consider going commando a personal preference. For healthy individuals, it is generally safe and may reduce exposure to irritants from underwear and detergents, according to Dr. Brenda.
Skipping underwear can also improve airflow to the genitals, preventing moisture buildup, especially after swimming or bathing, where ensuring dryness is crucial.
When Underwear is Recommended
Experts advise wearing underwear during exercise to minimize friction and provide support. Dr. Dubin recommends that men wear tighter underwear and a cup during contact sports like soccer, baseball, or hockey to reduce injury risk.
Underwear can also be beneficial in specific medical situations:
- After scrotal surgery, such as a vasectomy, briefs, jock straps, or tight athletic boxer-briefs are often recommended for support and comfort.
- For individuals postpartum from a vaginal delivery, stretchy mesh underwear with pads is commonly used.
Additionally, certain social situations may make wearing underwear more appropriate.