Huge Study Links Tight Underwear With Sperm And Erectile Issues In Men

A huge new study involving almost 27,000 men has unearthed a link between wearing tight underwear and poor semen quality, as well as a higher likelihood of experiencing erectile dysfunction and premature ejaculation.

The study, from researchers at the University of Science and Technology of China, followed 26,836 men who reported wearing either loose- or tight-fitting underwear, and then underwent a semen analysis and filled in a questionnaire. 

The study found wearing tight pants such as Y-fronts, boxer briefs and thongs, was associated with reduced semen volume, motility and sperm count.

Erectile dysfunction and premature ejaculation were also more prevalent among those who reported wearing tight-fitting undies, leading the researchers to conclude that opting for loose-fitting underwear (basically, boxers) “may represent a simple, modifiable approach to help protect semen quality and sexual function”.

It’s not clear why there’s a link, however Dr Deborah Lee, from online doctor and pharmacy service Dr Fox Pharmacy, suggested body temperature may play a role. 

“For many years we have known that the testes hang outside the body for a reason – sperm need to be kept cool, at least 2-3C lower than body temperature,” she told HuffPost UK.

“Tight underwear (TU) holds the testes closer to the genital area and raises scrotal temperature. Higher temperatures probably do not allow essential enzymatic processes to take place required to produce large amounts of functioning sperm.”

The study doesn’t prove that tight underwear causes a reduction in sperm quality or quantity – and experts suggest it’s not a reason to throw out all your tight-fitting underwear just yet.

Dr Akash Kapadia, a urologist at Georgia Urology, said he often gets asked about underwear by his patients – and it’s a question that “should certainly be considered”.

“However, a study like this should not cause alarm,” he told HuffPost UK. “Since this was an observational study, we can’t establish with absolute certainty that tight underwear causes problems in semen volume, sperm movement, shape, and sperm DNA fragmentation.

“It’s also important to remember that this study relied on self-reported data. In other words, it’s an interesting study and worth considering, but I wouldn’t run to the store to buy new underwear because of it alone.”

If you’re trying for a baby, the urologist did say an underwear switch is a “reasonable and relatively inexpensive change” that men can make.

“We can say this study supports considering a change in underwear type, but not recommending it as a treatment,” he added. 

What about erectile issues?

Dr Crystal Wyllie, a GP at Asda Online Doctor, noted that a change of underwear alone is unlikely to fix erectile dysfunction or premature ejaculation – both of which were found to be more likely in men who wore tight-fitting underwear.

“Men often feel reluctant to talk about these issues, but they’re very common, and often treatable,” said Dr Wyllie.

“Erectile dysfunction is seen in around 55% of men between the ages of 40 and 70 years old, and becomes more common as you get older. If you’re experiencing erection problems, you can speak to a doctor who can assess the right course of treatment for you.”

Per the NHS, men with erectile dysfunction may be offered certain medicines to increase blood flow to the penis, while some selective serotonin reuptake inhibitors (SSRIs) can help with delaying premature ejaculation. 

Lifestyle changes you can make for improved sperm quality

Fertility issues are increasingly common, with one in seven UK men thought to be impacted.

Smoking, heavy drinking, recreational drug use and anabolic steroid use are high on Dr Kapadia’s list of concerns as far as their impact on sperm is concerned. 

The expert noted that TRT, or testosterone replacement therapy, also “deserves particular attention as it can substantially affect sperm production and, as a result, alter the ability of a man to conceive”.

He continued: “Today’s environment is also full of potential fertility-altering medications, foods, and drinks. Men should prioritise good health through proper diet and exercise, cut back on high-sugar and high-fat foods, and avoid highly processed foods.

“Even microplastics in the environment may potentially affect male fertility.”

Dr Lee agreed that overall lifestyle is important when considering how to boost sperm health. 

“It’s important to note that healthy sperm need a healthy body,” she said. “Note that it takes three months to make a batch of sperm. So, improvements made today will take three months to show up on a semen analysis.

“To improve your sperm, you need to think across the board and improve your lifestyle – but simply changing to new looser underpants such as boxer shorts is a great way to get started.”

If you’re having trouble conceiving, experts advise speaking to a fertility specialist or reproductive urologist to get the appropriate testing to understand what might be going on.