What Underwear Do Gynaecologists Recommend?

By Aileen Gana, founder of Cuurve

Gynaecologists and NHS clinics generally recommend loose, breathable cotton underwear. They also suggest avoiding tight clothing, scented products and fabric conditioner, and, for some vulval conditions, sleeping without underwear. If you're sore or itchy, that advice matters most.

I'm not a doctor. I'm the founder of an underwear brand, so I've read a lot of this guidance. Below is what NHS and gynaecology sources actually say, quoted directly, with links so you can check.

What underwear do gynaecologists recommend?

The advice is consistent across sources:

• The NHS page on vulval pain says: "wear loose, cotton underwear". (NHS: Vulvodynia)
• Cambridge University Hospitals' vulval skin care leaflet says: "Wear only cotton underwear, loose if possible." (CUH: Care of the vulval skin)
• The American College of Obstetricians and Gynecologists says: "Wear 100% cotton underwear." (ACOG: Vulvodynia)

The two words that come up again and again are loose and cotton.

What should you avoid?

The same sources list things that can irritate the vulva:

• Tight clothing. CUH advises: "Avoid tights. Avoid tight trousers or leggings."
• Scented products. The NHS advises: "do not use scented products, such as soaps and deodorants, in or around your vagina".
• Harsh laundry products. CUH advises: "Do not use biological detergents or fabric conditioner."
• Other irritants. ACOG advises: "Avoid irritants, such as perfumes, dyes, shampoos, detergents, and deodorants."

Should you sleep without underwear?

Some gynaecology sources say yes, at least if you have vulval soreness. ACOG advises: "Do not wear underwear while sleeping." CUH suggests: "Whenever convenient, wear no pants under a skirt or dress."

If you'd rather wear something at night, the general principle still applies: choose something loose and soft that doesn't press.

What about modal and other fabrics?

I want to be straight with you here. Cuurve makes underwear in modal and recycled nylon, not cotton.

Modal is a soft, breathable fibre made from beech wood pulp. I chose it because it feels gentle and smooth. But the medical guidance above names cotton, not modal. If your doctor has advised cotton, follow their advice.

I explain the differences in more detail in Is Modal Good for Underwear?

Does the shape of your underwear matter?

The guidance keeps returning to "loose", and shape is part of that. Underwear that digs in at the legs, rides up or has a narrow gusset presses on the area you're trying to keep comfortable.

When I measured four well-known high-street brands, their gussets were 5.5 to 6cm wide. I made Cuurve's 8cm wide for more coverage and less shifting. You can read why in The Gusset: Why It's Different and Why You Should Care.

When should you see a doctor?

Underwear can make you more comfortable, but it doesn't treat anything. If you have itching, soreness, pain or unusual discharge that doesn't go away, see your GP, a pharmacist or a sexual health clinic.

If you're dealing with irritation now, my guide to what underwear is best for vulvar irritation covers what to wear and what to avoid.

Frequently asked questions

What underwear do gynecologists recommend? Loose, breathable cotton underwear. The NHS, NHS hospital clinics and the American College of Obstetricians and Gynecologists all say the same.

Is cotton underwear really better? It's the fabric gynaecology sources name. It's breathable and absorbent. If you're sensitive or sore, start there.

Should I wear a thong? None of the sources above recommend tight underwear. If you're prone to irritation, choose a looser style with more coverage.

Should I wash new underwear before wearing it? Many people do. If your skin is sensitive, use a non-biological detergent and skip fabric conditioner, as CUH advises.

Is it OK not to wear underwear? Yes. ACOG suggests not wearing underwear while you sleep if you have vulval soreness.

Aileen Gana is the founder of Cuurve, a UK comfortwear brand. She trained as a chemical engineer and has designed and sewn underwear since 2021. This article is general information, not medical advice. Always follow the advice of your own doctor.