What Do You Wear Down There? Dr. B Solves the Underwear Conundrum

Like brushing your teeth or taking a shower, putting on underwear is probably one of those everyday habits you don’t put much thought into (unless you plan on getting lucky later).

But for women, what kind of briefs you’re wearing daily really does matter, especially since choosing the right underwear can have an impact on vaginal health. For instance, did you know that sometimes it’s really better to go commando?

But with all the different options out there — ranging from thongs to satin panties — it can be difficult to know which is the right pair for you. So we turned to our resident women’s health expert, Rebecca Brightman, MD, who offered some tips and insights for the next time you go underwear shopping.

Which underwear fabric is best?

Whether you’re going for briefs or thongs, Dr. Brightman recommends choosing natural materials over synthetic ones because they’re more breathable, especially during the summertime. So instead of nylon or spandex, she advises opting for a cotton material.

“People do a fair amount of sweating during the summer, and if your underwear doesn’t let you breathe, that can lead to chafing and irritation,” Dr. Brightman tells Katie Couric Media.

But if cotton isn’t your thing, then Dr. Brightman also recommends other types of natural underwear, like ones made with silk, hemp, or linen. Regardless of which you choose, these more organic options tend to be naturally anti-microbial, which means they can kill microorganisms or stop their growth. That’s key in preventing yeast infections, that notoriously uncomfortable condition characterized by burning, itching, redness, and a white discharge from the vagina and vulva.

What is cotton underwear?

The answer might seem obvious, but some brands will try to trick you. When we say cotton underwear, we are referring to undergarments that are almost 100 percent cotton — not just the crotch. Even “fully” cotton underwear usually has about five percent elastic for the waistband, which is to be expected. And it’s not as easy to find mostly cotton underwear as you’d think. At the very least, make sure your underwear has a cotton gusset (the fabric in the crotch), as that’s the part that is in most contact with your vagina and vulva.

Is nylon underwear worse than cotton?

In case we haven’t made it clear…YES. Cotton underwear is the gold standard. A lot of underwear is made of nylon, however, and it’s not the worst option out there. Nylon will feel soft and silky, and it’s fast-drying, but it’s still not cotton.

Consider changing your underwear multiple times a day

Changing your underwear once a day is kind of a no-brainer, though a 2019 survey did find that 45 percent of Americans wear the same pair of underwear for two days in a row.

But Dr. Brightman says it might not be a bad idea to change your underwear more often than daily, especially if you’ve gotten particularly sweaty after a workout or have been having a lot of vaginal discharge.

Even if you can’t get around to putting on a fresh pair of panties, Dr. Brightman recommends avoiding the regular use of pantyliners since most of them trap moisture and can lead to irritation.

Don’t be afraid of going commando

Though there’s a lot of debate about going panty-free at night, Dr. Brightman recommends it. “I’d avoid wearing underwear when you sleep, so the body can breathe,” she tells us.

This move is especially helpful for those prone to yeast infections because it keeps moisture from building up, thus creating a bacteria-friendly environment.

But if you’re not exactly comfortable going to bed sans underwear, Dr. Brightman says wearing boxers or a loose-fitting nightgown are some handy alternatives.

Are thongs bad for your vagina?

Thongs have long been anecdotally associated with a host of health issues, including yeast infections, vaginitis, bacterial vaginosis, and urinary tract infections. But scientifically, that isn’t the case: Studies have concluded these conditions had more to do with hygiene and sexual activity and less to do with your undergarment of choice.

As with certain fabrics like synthetics, thongs can exacerbate existing conditions or lead to further irritations, and that’s certainly true for women who prefer to keep their nether regions bare.

“It depends on a woman’s anatomy — every body is different,” Dr. Brightman tells us. “But a lot of times, especially with women who have removed their pubic hair, there really isn’t a buffer between the skin and underwear, so those women may be more likely to get chafed and irritated.”

What’s the safest way to wash underwear?

All undergarments should be handled with special care — and that isn’t just because they tend to be more delicate than the rest of your wardrobe. For instance, if someone has skin sensitivities, Dr. Brightman suggests washing underwear with a fragrance- and dye-free detergent and avoiding dryer sheets, which tend to contain added fragrances.

Dr. Brightman also recommends washing underwear separately, preferably in warm or hot water to kill any bacteria. But she doesn’t necessarily believe the supposed rule that you have to replace underwear every year.

“If underwear is clean and fits, keep it,” she says. “I don’t think there is a single rule of thumb. If someone wears underwear with a cotton crotch and has a tendency to get irritated, then making sure the underwear is in good shape is a must!”

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