Do tight underwear harm? The largest study

Over the past decades, scientists have observed a decrease in sperm count in men worldwide. The reasons for this trend are not fully understood. Among possible factors, researchers name the impact of pollutants, but they also study how daily habits affect reproductive health.

One of them is the choice of underwear. The possible harm of tight underwear has been discussed for a long time, but there have been few large studies on this topic. In 2018, Harvard University scientists studied data from 656 men and found that those who more often wore loose boxer briefs had higher sperm concentration and total count.

However, whether these differences mean that men in loose underwear find it easier to conceive remains unclear. In a 2022 study involving 3041 couples from the USA and Canada, scientists found no convincing link between the likelihood of conception and factors capable of raising scrotal temperature. These included wearing tight underwear, visiting saunas, using a laptop on the lap, and heated car seats.

What the study of 27,000 men showed

Chinese scientists conducted a much larger study, the results of which were published in the Asian Journal of Andrology.

They analyzed data from 26,836 men who sought fertility assessment — the ability to conceive — at a clinic. The median age of participants was 30 years. Each was asked to report what type of underwear he most often wore over the past three months, and then sperm analysis results were compared, taking into account other health factors.

It was found that 21,221 men preferred loose underwear, while 5,615 preferred tight models, including briefs and fitted boxers.

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In the second group, unfavorable sperm parameters were more common. The chances of having a reduced semen volume in its participants were 18% higher, and an insufficient number of motile spermatozoa — 12%. The chances of detecting too small a proportion of normally shaped spermatozoa were 48% higher, and an increased level of DNA damage — 108%.

The latter figure looks particularly impressive, however, in absolute terms, the difference was not that large. An increased level of DNA damage was found in 10.7% of men who wore tight underwear, compared to 5.8% in the loose underwear group. This means that in the vast majority of participants in both groups, this indicator was not excessively high.

The researchers also conducted an additional analysis of sexual health. Among men who wore tight underwear, erectile dysfunction and premature ejaculation were more common. However, scientists emphasize that these results are preliminary and require further verification.

How can tight underwear be harmful?

One possible explanation is related to temperature. For normal sperm formation and maturation, the testicles require conditions approximately 2-3 °C cooler than inside the body. This is why they are located in the scrotum, outside the abdominal cavity.

Tight underwear allows less air circulation and can raise scrotal temperature by up to 1°C compared to loose underwear. Scientists suggest that even such an increase can affect the final stages of sperm maturation, including their shape and motility. Researchers also hypothesize that prolonged overheating may reduce testosterone production and affect sexual function, but this still requires confirmation.

However, the discovered correlation does not prove that tight underwear was the direct cause of poorer sperm parameters. Scientists compared men with different habits, rather than testing how changing underwear affects their health. Additionally, all participants sought fertility assessment, so the results cannot be automatically generalized to all men.

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