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Do briefs cause low sperm / low testosterone ?
An_241906 posted:
Just recently started wearing boxerbriefs due to a varicocele (want some support) and wanted to know if not wearing boxers will decrease my testosterone or sperm count?
amyaalc responded:
Nope. The brief vs boxer is all myth when it comes for causing make infertility.

Amy Perkins, MS, TS
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy Reversal
Torcal replied to amyaalc's response:
I did some quick research on the Net and didn't find anything to support your conclusion. In fact, the Mayo Clinic, among others, say that anything that prevents the teticles from descending away from the body reduces sperm volume which can only be produced at the right temperature. Another sperm retardant a hot tub. When the Testicles are heated up well above body temperature sperm production immediately takes a dive.

In any event it all depends on temperature and the Testicles are designed to operate the best at a degree or two below body temperature. Any clothing that prevent the Testicles to move away from the body to maintain their normal temperature results in a reduction of sperm count.
amyaalc replied to Torcal's response:
Scrotal temperature is a very important topic for proper spermatogenesis and a number of factors can hugely impact the temperature. The scrotum is housed outside the body to keep the testicles below body temperature. Hot tubs and saunas will increase the temperature well above body temperature causing damage to the sperm cells. A varicocele also is a condition that causes increased scrotal temperatures and impacts fertility. Sitting long periods of time or placing a computer on your lap can overheat the testicles.

Underwear type has been debated an number of times on the topic of increasing scrotal temperatures and scientific papers such as

Reprod Toxicol. 2002 May-Jun;16(3):209-14.The relation between daily activities and scrotal temperature.Hjollund NH , Storgaard L , Ernst E , Bonde JP , Olsen J .
This paper states "No effect was found for size or reported tightness of the underwear." when looking at the effects on sperm production.

Amy Perkins, MS, TS
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy Reversal

Irfnzm replied to amyaalc's response:
Int J Androl. 1995 Jun;18(3):137-40.
Tight underpants and trousers and risk of dyspermia.
Parazzini F , Marchini M , Luchini L , Tozzi L , Mezzopane R , Fedele L .

Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy.

The association between the wearing of tight underpants and trousers and risk of dyspermia has been analysed using data from a case--control study. Cases included infertile men with a diagnosis of unexplained dyspermia. Normospermic men of infertile couples were eligible as controls. In comparison with men usually wearing loose underpants, the odds ratio (OR) of dyspermia was 1.9 (95% confidence interval, CI, 0.9-4.1) in those wearing tight underpants. Likewise, the OR of dyspermia was 1.6 (95% CI 0.9-3.0) in men reporting usually wearing tight trousers (including jeans), in comparison with those wearing loose trousers.

PMID: 7558376 [PubMed - indexed for MEDLINE>
Irfnzm replied to amyaalc's response:
Following a small study in the Netherlands (Tiemessen et al 1996), it was widely reported that men and their sperm were better off wearing loose-fitting boxer shorts than tighter fitting briefs (much to the joy of many women). However, since then a more rigorous study reported no difference in scrotal temperature between men wearing briefs and men wearing boxer shorts, although both types of underwear increased the scrotal temperature compared to wearing no underwear at all (Munkelwitz and Gilbert 1998).
Irfnzm replied to amyaalc's response:
Reprod Toxicol. 1990;4(3):229-32.
Fit of underwear and male spermatogenesis: a pilot investigation.
Sanger WG , Friman PC .

Source: University of Nebraska Medical Center, Omaha.

Abstract: We evaluated the effect fit of underwear had on sperm production in two healthy adult males in their early thirties. The subjects alternated from wearing tight fitting bikini type briefs to loose fitting boxer type briefs in an ABAB withdrawal design. Conditions lasted three months and were alternated twice resulting in a one year study. The initial condition for each subject was randomly determined with the laboratory technologist blind to the conditions. Four semen parameters were analyzed in this study: sperm density, total number of sperm, total number of motile sperm, and total number of motile sperm per hour of abstinence. The results showed the semen parameters gradually decreased in tight conditions and gradually increased during loose conditions. Although preliminary, the results support the commonly held but undocumented belief that the fit of men's underwear can influence sperm production.
Irfnzm replied to amyaalc's response:
General - Research underwear elevate the temperature of testicles and negatively impact sperm, Apr 13, 2012

Male infertility specialists have been talking about the effect of increased scrotal temperature on sperm production for a long time. It has been presumed that the testicles are designed to be outside of the body in the scrotum so that they can operate better at a slightly cooler temperature. Researching this phenomenon has never been easy, but researchers from France have now used specially designed underwear to help look into this question.

Dr. Ahmad and associated in 2012 in Toulouse, France had 5 healthy fertile male volunteers wear special underwear 15 hours a day for 120 straight days. These specially designed underwear positioned the testicle in the groin instead of down in scrotum where they normally were. As a result, these underwear would expose the testicles to slightly elevated body temperatures and the effect on sperm production could then be studied. Pretty neat! They found that all the following sperm parameters decreased over time: total sperm count by day 34, percentage of motile sperm by day 20 and percentage of viable sperm by day 34. Moreover, sperm DNA fragmentation (damage) was seen to increase by day 20. The good news is that all parameters returned to their baseline levels after the men stopped wearing the underwear.

Bottomline: This is a fun and intriguing study that supports our understanding that too much exposure to increased temperatures is probably not good for testicles and sperm production. Fortunately, few men are routinely wearing these underwear for any extended period of time. With that said, testicular heat exposure may be a contributory cause to male infertility, albeit probably a small factor, but should be considered for guys who are hanging out in steaming hot jacuzzis for many hours a week.

Reference: Ahmad et al. 2012 Fertility and Sterility 97:546
amyaalc replied to Irfnzm's response:
Thanks for the references and I always think cooler is better for the scrotum but not sure if every man needs to switch to boxers or no underwear.

More large scale, over 100 patients like the 2002 Repro Toxicol paper, studies are needed to answer the type of underwear question. Hard to hold statistical value with studies of only a few patients because of subject variation.

If a patient is presenting with male factor infertility it is always wise to recommend ways to lower scrotum temperatures.

I personally have concern with the popularity of skinny jeans in young males and how that will impact fertility.

Irfnzm replied to amyaalc's response:
By Sharmila Dhal, Senior Reporter, XPRESS / Published: May 31, 2012

Tight jeans can affect male fertility: Doctors
From nerve damage to reduced fertility, doctors in Dubai warn that they could impair both men and women's health in more ways than one

Dubai: Think before you get into favourite jeans again. No doubt a tight pair, they could just be your worst enemy.

From nerve damage to reduced fertility, doctors in Dubai warn that they could impair both men and women's health in more ways than one.

"It's better to wear relaxed and comfortable clothing than look good in a pair of tight jeans," said Dr Ashkan Haghshenas, Specialist Vascular Surgeon, EHL Dubai Mall Medical Centre.

He warned that, "Wearing tight jeans affects circulation, especially in the groin area and the knees. They have a strangulation effect on the veins and this can be very damaging. The problem usually manifests itself as a swelling in the lower leg or foot."

Dr Haghshenas said tight jeans could aggravate underlying problems like varicose veins and lymphatic disease.

But that's not all. The impact could be more serious for men. Far from the macho feel of the body-hugging pants, men who wear tight jeans could actually be risking their fertility.

Abnormal sperm production or function in the male is said to be one of the biggest factors contributing to infertility among couples in Dubai.

Mays Al Adham, Clinical Embryologist at the Dubai Gynaecology and Fertility Centre, said wearing tight jeans exerts pressure on the man's testes and increases the temperature around it. "This can have an adverse impact on the production of sperms and hence fertility."

Dr P.K. Rajiv, Head of Neonatology at NMC Speciality Hospital, said, "In Dubai, due to extreme heat, tight jeans could have an adverse physiological effect. The concern stems from the basic physiology that makes the testis drop down in the scrotal sac when the body temperature goes up. The testis has been kept out of the body by nature to reduce its temperature. Any temperature rise can adversely effect spermatogenesis and hence fertility."

He said, "It has been hypothesised that testis kept close to the body prevents effective circulation, so it makes sense to avoid tight dresses in the pre-pubertal and pubertal age and later as standard clothing."

In contrast, he said loose-fitting clothes are believed to enhance circulation and testicular temperature and subsequently spermatogenesis.

Mays said the ideal testicular temperature is two notches less than that of the rest of the abdomen. "So we advise men to wear loose clothes, avoid hot baths and not sit in the same position for long hours."

A US doctor has also been quoted by the western media as saying that there are patients who suffer from meralgia paresthetica, a serious nerve disorder, as a result of wearing skinnies. It could show up as numbness, tingling or pain in the legs.

They talk about how skinnies coupled with high heels could aggravate the problem as they tilt the pelvis and exert undue pressure.
amyaalc replied to Irfnzm's response:
Great info and I hadn't taken the time to research the topic but sure glad it has gotten lots of attention.

Some of these young males don't even look comfortable in those jeans and it is just puzzling that we go for hanging around the knees to painted on tight.

I guess this is similar to the damage caused by bicycle seats and still very few pay any attention to all the documented studies and information about nerve damage in as little as 15 minutes on a traditional bicycle seat. Seems like a simple switch to a no-nose seat is an easy solution but few change and just take the chance of long term damage to the genitals.

Irfnzm replied to amyaalc's response:
I think it is true that any tight cloth like, pants, jeans, underwear etc around genitals is really not good for the health, especially for male, it is better to avoid tight underwear as much as possible.

I think "going commando" once in a while is not a bad idea for men; women may have some different story
Our ancestors mostly wore loose cloths around the waist, and it was very sensible
Only the evaluation in fashion changed the picture dramatically

I would to admit that I do forgo underwear most of the time, and feel it really comfortable

Majority of doctors are of the opinion that better to avoid tight underwear, pants or jeans as much as possible
Irfnzm replied to amyaalc's response:
By Jeanie Lerche Davis
WebMD Feature
For about one-half of couples with fertility problems, experts say low sperm count is the cause. But maybe something as simple as changing the kind of underwear a man wears can make a difference.

In the Breeze
The temperature of the testes is at issue: In order for testes to produce sufficient quality and quantity of sperm, the temperature of testes must be lower than the core body temperature .

"That is why [testes> are located outside of the body," explains Celia E. Dominguez, reproductive endocrinologist, Center for Reproductive Medicine at the Emory University School of Medicine. "Testes were made to be out in the breeze."

Testes can overheat when a man wears brief underwear. If the testes are too hot -- several degrees above where they should be -- they are not able to produce sufficient sperm, resulting in low sperm count.

Just be aware, it takes 10 to 11 weeks for sperm to be produced -- so plan accordingly, says Amos Grunebaum, MD, director of clinical maternal-fetal medicine at the New York Hospital-Cornell Weill Medical College.

"You can't just wear boxer shorts the night before romantic date, and expect it to work," he tells WebMD. "Anything you do that damages sperm will affect them for the next 10 to 11 weeks."
Irfnzm replied to amyaalc's response:
Schuyler - ANP
Board Certified Nurse Practitioner, MS, RN. Private practice and hospitalist experience.

Question: From WebMD regarding sperm, "wearing tight-fitting clothing can negatively affect spermcount , so too can spending time in hot tub or Jacuzzi". My question is...does taking a hot bath every evening (which I do) fall into this category? My wife and I are thinking of trying to have a child, and I dont want to do anything to put this in jeapordy.

Answer: The things all these warnings have in common is temperature of the testes to assure good spermatogenesis (the making of sperm). The testes need to be cooler than core body temperature for this to occur. That's why they drop away from the body in the scrotal sac when it is hot and stay closer to the body when it is cold. It takes about 100 days from the start to finish of making a sperm. During that time you should limit your "heated" experiences (bathing, spas, hot tubs, tight clothing). Warm baths and showers are better for sperm production .
amyaalc replied to Irfnzm's response:

Thanks for all the insight on the topic!


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