Why Underwear May Be Terrible for You!

To go commando or not to go commando… that is the question! Is it purely a matter of choice, or are there health consequences? Stick around to the end to find out!

Don’t have time to read this post? Watch the video here instead!


Our recent viral short posed the question: “Is it better for your vulvar health to sleep in your underwear or sleep in your birthday suit?” Many viewers had VERY strong opinions on the topic! 

Some were diehard commando fans — and some were terrified of the idea! Some viewers were even afraid of spiders, bedbugs, and other critters. I would need to see what kind of magical suit of armor underwear you’re wearing to protect against that (or perhaps I might just suggest Terminix instead of underwear… but I digress!).

But what is the actual medical evidence? Don’t worry, I’m here for you! In the comment section below, drop the green underwear emoji (for those of you who want to keep it tight) or the military green helmet (for those of you who are on Team Commando)!

To frame this video, I’m going to go beyond the underwear debate to discuss the broader topic of vulvar health.

So what is the vulva, and what do we know about health and maintenance? 

So the vulva is the external female genitalia, and medical science knows *shockingly* little about what constitutes ideal hygiene/maintenance of the vulva. 

A 41 BILLION-dollar global industry has been developed around feminine intimate wash — with virtually no scientific evidence supporting this… and in most cases, actually promoting products that contradict all published medical recommendations! These are products that actually neutralize your body’s vulvar natural microbiome and increase the risk of infection!

In contrast to vulva health, there have been many studies on the vaginal microbiome, and we know definitively that the vagina is a self-cleaning organ. She needs no outside assistance. So any intimate washes, douches, and steaming products are all definitely a scam. 

Run, don’t walk away! 

But what do we know about the vulva? I mean, surely debris, moisture, sweat from working out, and menstrual fluids can build up. So doesn’t the vulva need cleaning?

Science to the rescue!

A recent scientific publication reviewed all available literature on vulvar health and gave the following recommendations. The study goes on to describe that vulvar skin is unique and has its own microbiome and hydration. The vulvar skin also has a higher permeability, which can result in more sensitivity. Excessive washing or the use of harsh chemicals can disturb this balance and result in itching, pain, bleeding, and even predisposition to infection. 

Now if only there were a set of rules or guidelines we can follow…

There is! The Royal College of OBGYN and the Middle Eastern and Central Asia College have recently published guidelines for optimal vulvar care. Most women with vulvar disorders (contact dermatitis or vulvar vaginitis) need advice on ideal skincare routines and how to avoid these irritants.

And here are the recommendations:

Washing with water can cause dry skin and make itching worse — so a small amount of soap substitute and water to clean the vulva. Actually, showering is better than bathing. I know people love their bubble baths, but that actually can worsen the dermatitis.

Emollients can be helpful — there’s one specific vaginal formulation called Replens, which is very useful. 

The guidelines mention avoiding sponges — just pat dry with a soft towel.

And finally… the underwear recommendations!

  • So choose loose-fitting (silk or cotton) underwear.
  • Avoid tight-fitting clothes (wear loose-fitting skirts or trousers).
  • And the answer you’ve all been waiting for… sleep without underwear! That is a recommendation straight from the Royal College of OBGYN! 
  • Avoid fabric conditioners or biological washing powders. Those are powders with enzymes that are designed to get stains out — but they can be irritating. 
  • Again, bubble bath, harsh soaps… those are out!
  • There are some creams (even herbal creams) that can be irritative as well, so you want to skip that.

This next one’s kind of funny because most of my patients are coming to see me because they have menstrual problems…

  • So it says to avoid wearing panty liners (good luck with that one!).
  • Avoid antiseptics in the vulva area. 
  • Again (as far as underwear is concerned), choose light-colored or white because the dyes can cause allergies. And regardless of the color, make sure you wash them before the first use. 
  • For those of you using colored toilet paper, that’s out!
  • And for those of you with long fingernails or varnishes, just be careful. Scratching can be very irritating to the skin.

So in conclusion, you want to use a hypoallergenic, soap-free, pH-friendly, mild cleanser with no irritants and that protects against dryness and maintains the balanced microflora. So what in the world is that? Click on the links below for the list of our recommended products.

Recommended Products:

Replens: https://amzn.to/3x8jax8

White Cotton Underwear: https://amzn.to/3VllrhV

Dove Bath Bars: https://amzn.to/3wV9oP4

Summer’s Eve: https://amzn.to/4c0glgx

Royal Body Wipes: https://amzn.to/3XadkpA

Vagisil Daily Intimate Wash pH Balance: https://amzn.to/3wMpxq5

Maude Wash No. 0: https://amzn.to/3wWKj6c

The Honey Pot Bath Bomb: https://amzn.to/3X41nSl

Fur Oil: https://amzn.to/4aHZkXe

Fur Ingrown Concentrate: https://amzn.to/4cirY2L

Momotaro Apotheca Salve: https://amzn.to/3R3e8Jm