Underwear Influences

Your underwear selection can impact your pelvic health

As a pelvic health specialist, I’m sometimes surprised by the questions that wander into my brain. Questions like…why do we wear underwear? 

While loin clothes were originally worn to cover up nakedness, underwear serve many purposes such as prevention of our genitals from chaffing on our clothing, protection from environmental debris, support from high impact activities. Undergarments allow us to be socially acceptable, providing modesty and good hygiene from bodily excretions or wicking away sweat from our body. 

When selecting undergarments, various priorities may guide your decision. Do you look for the comfiest fit? The sexiest looking piece? The one with the prettiest design?

Bikini cut, thong, boy short, g-string, hipster, cheeky, high rise…satin, lace, cotton, polyester…the combinations seem endless (as seen in my recent trip to the store HERE-->link coming soon!) 

Did you know your selection of panties can influence the health of your genitalia and pelvic floor muscles? If you are someone who frequently has urinary tract infections (UTIs), bacterial vaginosis (BV), yeast infections, etc. PLEASE read this article through to the end.

A couple facts to keep at the forefront of your mind:

1. The vagina is a self-cleaning organ

2. The vagina has a pH of which needs to be delicately balanced (between 3.8 - 4.9 ) towards slightly acidic to kill off any pathogenic organisms. 

Retention of moisture or lack of air flow will impact the vagina’s status. 

Let’s dive into the details from a few different perspectives so you can make a more sound and confident underwear selection.

FABRIC SELECTION

Ideally, choose a fabric that is free from dyes, so white in color. I know, it’s not super sexy but maybe granny was onto something! That’s the simple change…

…the more challenging part when shopping, is the choice of fabric type. A cotton panty is going to be the most breathable, moisture wicking fabric you can find. However, it can be tough to find a 100% cotton undie. Many companies use a polyester or synthetic blend when creating their panties, resulting in that soft and silky feeling texture that grabs our attention. Polyester, nylon, or a blend of these materials trap moisture and can create a breeding ground for bacteria, increasing the risk for infections, ingrown hairs, itching, or tissue breakdown. 

At the bare minimum, ensure that the little fabric cutout piece that makes direct contact with your genitals is fully cotton, and color free would be most ideal. Thankfully, a lot of panties, even if they are polyester blends, have options where the middle piece is cotton. 

WHAT CUT?

Preference of panty type varies greatly among women and may differ depending on the day. If planning to wear a tight fitting outfit, we might opt for a high rise thong to ‘suck everything in and tuck it away’. Or perhaps risking the occurrence of panty lines showing is your worst nightmare so thongs are a more common selection. Yet, the week of menstruation, the bikini cut or boy short might be the best choice for increased coverage or fitting of a menstrual pad. Here’s what I’d like you to take away from this section…the cut you choose should feel comfortable enough that you don’t notice your underwear throughout the course of the day. 

For example, if you prefer to wear thongs, but frequently feel like you have a wedgie, either the cut of underwear you select, or the size of your thong needs to be adjusted. In my professional experience, I’ve worked with a number of women reporting the following symptoms: tailbone pain and/or fecal smearing (the presence of fecal matter on your undergarments, despite wiping clean after a bowel movement). After seeing a trend and asking a few more detailed questions, I’ve gathered that the majority of the time, these women are chronic wearers of thongs too small for their bodies. Now I’ve got nothing against wearing a thong, but a few considerations. If the thong fits too snug, you frankly are flossing your buttcheeks and that tiny piece of fabric can dig its way into your rectal opening as you move about throughout the day. Additionally, too tight of a thong can encourage the muscles of your pelvic floor to flex the tailbone (think tucking of your ‘tail’), leading to pelvic floor overactivity of which is the culprit of numerous pelvic conditions such as tailbone pain, constipation, pain with intercourse, urinary frequency, etc.  

If the thong is too large for your body, the fabric may be moving around too much as you move around during the day.  Ensure that the region of the undergarment that mainly contacts the rectal region isn’t sliding forward, bringing fecal matter near the vaginal and urethral openings, increasing your risk for an infection (hello UTI!). If the fabric is sliding around and creeping up into crevices, it’s time to find a better fit. 

Trying to reduce the use of thongs but really want to avoid panty lines? I’ve found the best compromise to be a seamless, lace back low rise panty (see image below). No panty lines but also no fabric weaving its way between the cheeks. 

PSA: COMMANDO IS BEUNO 

Yup, I’ve said it and will continue to recommend it to everyone who seeks my professional opinion. Going commando, allows the vagina to breathe, with the caveat that most of us (myself included) reserve this for the evening time. Remember, bacteria like to grow in dark, moist spaces. A little ‘fresh air’ is a simple way to support the self-cleaning function of the vagina and prevent overgrowth of unhealthy bacteria. So, unless you’re menstruating, let her breathe at night!

OTHER CONSIDERATIONS

Changing your underwear once per day typically is frequent enough for most people. However, if you’ve been sweating from working out, hot temperatures, or wet from having sat on a wet bench, etc, you’ll want to change into a clean, dry pair. 

Also, you absorb what you put on your body. This includes the detergents you wash your undergarments with. Definitely wash your underwear regularly to reduce build up of bacteria, but if you’re noticing increased itching, redness, or tissue irritability in your pelvic region, you may want to try a detergent free from dyes and scents, or designated for sensitive skin. Avoid fabric softeners and dry sheets as the chemicals can irritate the delicate tissues. 

SO WE’RE CLEAR

Underwear should fit comfortably and be supportive of your pelvic health. Signs of chafing, skin irritation, frequent infections or tailbone pain could be your cue that you should try mixing things up and make a trip to the store to explore alternative undie options. 

Happy Shopping!