Photo from the Dollar Shave Club
Boxers, briefs or boxer briefs: you typically pick one or the other based on personality and preference. Some people like a loose fit. Others like a little more support. But for fertility doctors, that question means something different entirely.
If you do a quick Google search on underwear and men's health, you'll find that guys are searching for topics like:
- Which underwear is best for men?
- Which underwear is best for sperm count?
- Which underwear is good for men's health?
- Does tight underwear cause low sperm count?
- Are boxer briefs bad for fertility?
- Can boxer briefs cause testicular pain?
- Can boxer briefs cause low sperm count?
- Can boxer briefs cause erectile dysfunction?
Overall, it's pretty obvious that alot of guys are worried about fertility. In a time where male fertility rates are dropping, who can blame them?
So whether you’re a huge fan of boxers, briefs or boxer-briefs, you’ve probably come across this topic before. We’re going to take a deep dive into the history of the question: “Does tight underwear reduce sperm count?” and show you the current scientific evidence so you can make an informed decision about which underwear is best for men's health.
Does Tight Underwear Reduce Sperm Count?
Ever since the 1970s, briefs have been a pretty popular choice for guys. They fit well, give you the support you need and don’t bunch up underneath pants. In the 1990s, the famous Calvin Klein x Mark Wahlberg ad helped popularize the boxer brief (not to mention kick-start his acting career), and ever since then most guys have adopted at least one or two pairs of boxer briefs.
Compared to boxers, briefs and boxer briefs offer a more snug fit without loose material. According to Hagai Levine, a male reproduction specialist at the Braun School of Public Health and Community Medicine there’s “weak to medium evidence that tight underwear may reduce sperm count or semen quality”. While the science isn’t exactly clear, he thinks that your choice of underwear may influence your sperm health although they don’t know to what extent.
Another study from the Harvard University School of Public Health found a link between underwear preference and sperm counts. Those who wore boxers had 25% more sperm, and those sperm were a little bit healthier. But, as always, there’s some information hidden underneath the surface.
In this study, both groups of men had sperm counts within what’s considered a normal range. Interestingly enough, the men who wore briefs and boxer briefs had higher levels of a hormone called follitropin, which is important in sperm production.
Again, keep in mind that these are just associations – we still can’t say that tighter underwear reduces sperm count.
Recently, a 2016 study that looked at 501 men during a year-long attempt to conceive found no clear divide between boxer and non-boxer wearers. Clearly, there’s no consensus.
Michael Eisenberg, an associate professor of urology at Stanford University says that when he talks to patients, he usually counsels that they should just go with comfort and “any one layer of clothing isn’t going to make a huge difference”.
The real issue when it comes to tight underwear is heat. Considering most briefs and boxer briefs are made from cotton or synthetic materials, the fact that they don’t breathe very well creates what we consider to be a below-the-belt sauna. How many times have you been sitting at work or in class and things keep heating up down there?
Testicles exist outside of the body for a reason – most sperm needs to be a few degrees cooler than the body’s natural interior temperature to be healthy. Mother Nature, bless her soul, did us a solid favor and kept our scrotums outside of the body to allow our sperm to keep cool.
There’s plenty of evidence in animals and humans that sperm is usually healthiest at about four to seven degrees Fahrenheit (thirteen to fifteen degrees Celsius) below the average human body temperature. Beyond that, sperm count and quality starts to plummet.
How Heat Damages Sperm Quality and Quantity
First, let’s get the language straight. Semen is the the fluid that’s released when you orgasm. It contains, sugar, proteins and sperm. Sperm is the male reproductive cell that houses all of the things needed for fertility. Inside the sperm, you have DNA proteins that can be damaged by heat, which can decrease the likelihood of successfully fertilizing an egg (the female reproductive cell).
The thought process has been that the closer your testicles are to your body, the hotter they get. The hotter they get, the more proteins get damaged and, as a result, the less likely you are to be fertile.
One main issue in any studies on underwear and sperm count has been the size of the studies. Generally, there are no large-scale analyses that can lead to crystal clear answers. The results from small studies may not apply to the general population. Also, the studies only consider what underwear the men are wearing at that point in time. They don’t consider the pants they wore, the fabric of the underwear, the participants’ diet, exercise routine and lifestyle. What if the guy that was wearing boxer briefs also thoroughly enjoyed using a blowdryer to dry his genitals? What if the guy wearing boxers had a phenomenal diet? These studies don’t consider that, and that means that any results have to be taken with a grain of salt.
The Downward Trend of Male Fertility
In general, health organizations like the Center for Disease Control and Prevention need to start tracking male fertility. Most people think of fertility as a women’s problem, but men can contribute 20-30% to all infertility cases. What’s the problem here? It’s the fact that there’s not a culture of men talking about fertility. Whether that’s because guys generally don’t care, are misinformed about fertility or are too embarrassed to talk about it, it’s a problem that needs to be addressed.
A large meta-analysis (review of studies) that collected data on sperm counts from 244 studies between 1973 and 2011 found more than a 50 percent decline in sperm count in that time. Couple that with the fact that people aren’t having as much sex as they used to, and we’re in trouble! This big study signals that there’s a bigger problem than boxers and briefs. Also, studies show that infertile men have also been shown to have an increased incidence of illness ranging from heart disease to liver disease and cancer. In general, poor male reproductive health can mean poorer overall health.
With regards to action, I personally think things are starting to move in the right direction. Recently, Legacy began tackling the problem of reduced sperm quality with age. The Swiss-based company won the 2018 Techcrunch Startup Battlefield prize in Berlin and raised a $1.5 million seed round to help solve the issue with at-home sperm quality test kits (think 23andme but for sperm). I for one am all for it.
What Harms Sperm Count and Quality?
Plenty of things. In fact, your underwear should probably be at the bottom of your list. Many studies have found that exposure to chemicals like phthalates (which are usually found in soft plastics) can reduce sperm health. Diet, obesity, bicycle riding, saunas, hot tubs, and putting your laptop on your lap have all been found to impact sperm count.
How Can I Improve my Sperm Count and Quality?
One of the biggest issues with trying to improve sperm count and quality is that there’s so many factors at play. It’s sort of when your car has a million lights flashing – you can’t just pour some oil in and expect everything to start working perfectly. With that being said, if you’re having any fertility issues, the first thing you should do is go talk to your doctor. Then, if you’re looking for some other ways to help improve the problem, you can start looking into some lifestyle changes.
First things are the obvious ones – don’t smoke, exercise often, cut down on your drinking habits and pay attention to your diet.
Shanna Swan, a professor of environmental medicine and public health at Mount Sinai recommends avoiding plastic containers and non-stick cook-ware because they’ve both been linked to hormone disruption. Underwear choice is low on her list of priorities.
Ok... So Which Underwear is Best for Men's Health and Sperm?
When it comes to clothing, Dr. Swan thinks that what the underwear is made of can be an important factor to consider. With that in mind, you’d probably want to go for a more breathable pair of boxer briefs to make sure that things don’t get too hot. You also want to opt for materials that don’t require plenty of chemicals to produce. Micromodal boxer briefs, for example, go through a manufacturing process that doesn’t include any harmful chemicals or dyes – the material picks up color very easily and is extremely breathable compared to cotton and synthetic alternatives.
All in all, there’s a few factors to consider when it comes to your fertility as a living, breathing guy. Whether you’re a boxers guy, briefs guy or boxer-briefs guy, there’s several places to begin looking into if you want to improve your fertility. The science on sperm count and quality and it’s relationship to underwear is weak at best and you’d be better off fixing up your diet and lifestyle. Also, you should look into breathable underwear that don’t use up a bunch of chemicals during the manufacturing process.
Now go out there and live your best life you absolute savage.