8 Underwear Rules to Live by for a Healthy Vagina

Opting for breathable, natural fabrics like cotton for your underwear can promote vaginal well-being. Other habits — such as proper cleaning and knowing when to replace your panties — also matter.

Your practical handbook for laundering, wearing, and living with underwear.

Did you realize some textiles are healthier, that sometimes sleeping without underwear is beneficial, or that panties have a kind of shelf life?

These unwritten underwear guidelines can influence vaginal health.

We reviewed research, examined several underwear-hygiene studies, and consulted an OB-GYN to compile eight underwear rules worth following.

1. Prefer natural materials, especially cotton

This is a repeat-worthy reminder: among the many cute fabrics available, cotton remains the top choice for underwear.

“The vulva is a delicate and sensitive area, much like the lips on your face. It should be treated gently,” says Dr. Alyse Kelly-Jones, a board-certified OB-GYN.

Cotton is the simplest, softest fabric to rest against your skin. It’s breathable and absorbs excess moisture, which can help lower the chance of yeast infections.

“Having some vaginal discharge is normal—like the natural moisture in your mouth—so you want underwear that will gently soak up extra dampness,” Kelly-Jones explains.

Cotton vs. synthetics (nylon, spandex)

Synthetic fabrics such as nylon and spandex restrict airflow. They can hold in heat and moisture, creating a favorable environment for yeast overgrowth.

For supporting vaginal health, natural, breathable fabrics—cotton in particular—are the best option. They can help minimize odor and reduce the risk of yeast-related issues.

2. Change your underwear daily (or more often if needed)

Most people wear one pair per day and then launder them. If it feels better, you can change more than once a day.

You might wear the same underwear for two consecutive days when there’s little discharge or sweating, but studies indicate most underwear carries trace amounts of fecal matter, so daily changes are generally advised.

If you become uncomfortable because of accumulated discharge, feel free to switch pairs during the day, as Kelly-Jones tells her patients.

“Many patients are bothered by moisture and rely on panty liners constantly,” she says. “That’s not ideal—liners can cause chafing and irritation. Cotton-lined underwear helps, and it’s fine to change more than once a day.”

After wearing, place them directly in the hamper. Unlike jeans, underwear shouldn’t be re-worn just to avoid a laundry load.

3. Sleep without underwear to let moisture dissipate

There’s ongoing debate about whether sleeping commando is healthier.

For individuals with a healthy vagina, either option is acceptable. If you frequently get yeast infections, sleeping without underwear may help.

Removing the fabric barrier allows the area to breathe overnight and prevents moisture buildup that could encourage bacterial growth.

“I believe the vulva should be exposed to air, just like any other part of your body,” says Kelly-Jones.

If sleeping naked is uncomfortable, wear loose pajama bottoms. But remember: if you wear bottoms instead of underwear, wash them regularly too.

In short, going without underwear at night is unlikely to harm you and might even be beneficial.

4. Wear well-fitting, moisture-wicking underwear for exercise

Whether to forgo underwear while working out is a personal choice. If your workout shorts already have built-in moisture-wicking liners, you can skip an extra layer.

Having a layer between your skin and the shorts may improve comfort and better manage sweat. Such liners are often made from lightweight, technical polyester.

Kelly-Jones emphasizes, “The most important thing is a good fit that doesn’t cause chafing.”

Once you determine the right size and cut, you can choose from performance-specific underwear options.

5. Thongs aren’t necessarily harmful to vaginal health

Thongs have long been assumed to be unhealthy for the genital area.

But research hasn’t shown that thongs cause yeast vaginitis, bacterial vaginosis, or urinary tract infections. A 2019 study explored links between thongs and UTIs, BV, and YV and found no supporting evidence that thongs cause these problems.

An older 2005 study specifically examined string-style underwear and found the vulvar microenvironment didn’t change due to underwear style. There were no differences in pH, skin microclimate, or aerobic microflora. The researchers suggested hygiene habits matter more.

Douching increases infection risk. A 2022 review indicates douching and washing the vulva with soap or shampoo can disrupt natural bacteria and raise BV risk.

So feel free to wear a thong when appropriate. If it’s uncomfortable or you have symptoms, switch to breathable cotton underwear.

6. Wash underwear with hypoallergenic detergent

All underwear should be treated carefully—not only lacy or delicate pieces. That’s because they sit against sensitive skin for extended periods.

Kelly-Jones recommends mild, hypoallergenic detergent since “soaps or chemical residues near the vulva can cause irritation, itching, and allergic responses.”

Best practices for washing underwear

• After washing, tumble-dry on low heat for 30 minutes.
• If someone in your household is ill, avoid washing your underwear in the same load.
• If you have BV, don’t mix affected underwear with clean underwear or pants.
• Wash underwear separately from garments contaminated with bodily fluids.

Pro tip: Worried about the washing machine? Run a hot, bleach cycle (about 1/2 cup of bleach) on a full wash-spin-drain setting to sanitize it before laundering your underwear.

7. Think about replacing underwear yearly

It may seem extreme, but underwear can harbor bacteria and viruses that routine laundry might not completely remove, especially if washed in cold water and air-dried.

Underwear can also contain traces of fecal matter; studies report the average adult pair carries a small fraction of a gram.

Throwing out underwear annually isn’t the greenest approach. If you don’t have frequent bacterial issues, yearly replacement may not be necessary.

However, if you regularly experience BV or other recurring symptoms, consider refreshing your underwear collection each year.

Recommended laundering tips

Practical washing guidance includes:

• Tumble-dry on low heat for 30 minutes after washing: Tumble-drying or ironing after washing can help reduce bacterial contamination picked up during the wash.
• If someone is sick, don’t mix underwear in a shared load: This reduces the chance of spreading bacteria or viruses. Experts also suggest using warm water and washing these items promptly rather than leaving them in the hamper.
• If you have BV, avoid mixing affected underwear with other garments: For those who launder less often, a separate wash helps keep bacterial levels down and prevents cross-contamination.
• Wash items contaminated with bodily fluids separately: In clinical settings, clothes with vomit, blood, or urine are washed separately. Apply the same caution at home—clean affected garments independently and keep them away from underwear.

8. Underwear style can influence your mood

Although usually hidden, underwear can significantly affect how you feel.

Research from 2020 suggests underwear can impact mood, boost confidence, and enhance sexual desire.

Tight or unattractive underwear may negatively affect your mood.

Don’t underestimate the psychological effect of your most private garment just because it’s mostly unseen.

If you’re feeling down, wear your sexiest pair—like a power pose, it may give you a confidence lift.

Frequently asked questions

What underwear do gynecologists recommend?

Gynecologists usually advise wearing underwear made from natural fibers such as cotton. Cotton underwear may help lower the risk of certain infections.

What underwear helps prevent yeast infections?

Cotton underwear can absorb moisture and help reduce the likelihood of yeast infections.

Which material is best to prevent odor?

Cotton underwear supports vaginal health and helps manage moisture that could lead to odors.

Takeaway

Wearing underwear made from natural fabrics like cotton can reduce moisture and help prevent infections.

Other habits — changing underwear daily, drying on low heat, and laundering thoughtfully — can lower bacteria, viruses, and yeast that may contribute to infections.