Men’s Health: A “Brief” History

Set of male underwear. Isolated on a white background.

The history of medicine has seen some major breakthroughs and small triumphs, alike. Worldwide average life expectancy has almost doubled since the early 1900’s. What is the one medical innovation in the last 100 years that has had the most effect on the human lifespan? It was the discovery and subsequent widespread use of antibiotics. Of course, longevity is affected by improvements in healthcare, sanitation, nutrition, and living conditions, among other factors.

Throughout this same period, underwear has evolved—reflecting societal norms, fashion trends, and innovations in textiles. In ancient civilization, people wore draped garments without underwear. By the Renaissance Period, men started wearing undergarments as a fashion statement. By the 20th century, underwear was designed mostly with hygiene and support in mind. More recently, the consumer is inundated with the promotion of underwear fashion. As they say, history repeats itself.

The goals for staying healthy below the waistband are three-fold—maintenance of hygiene, sexual function, and fertility. When choosing the best underwear, comfort is often the first consideration. Preferences can vary based on body type, outerwear (e.g., shorts versus pants), activity, and expected perspiration.

When it comes to male fertility, “boxers or briefs?” is an age-old question that has no clear answer.

The testicles are located in the scrotum so that their temperature can be regulated slightly lower than body temperature. Although briefs may keep the male parts slightly warmer than boxers, there is no definitive evidence of an effect on fertility. For couples with fertility concerns, an analysis of a semen sample is the only way to assess the quantity and quality of the sperm.

The choice depends on activity, comfort, and personal preference. Briefs have the advantage of better support and protection, whereas boxers have the advantage of freedom of movement (although the extra material may cause bunching). Boxer- briefs combine the features of both styles but tend to be form-fitting like briefs.

When it comes to the controversy of going brief, boxer, or commando (not pictured here), sorting the laundry is not always easy. Be sure to look for my article in the next issue, “Spring Cleaning: The Men’s Health Checklist.”

Scott D. Miller, MD, MBA, is Wellstar’s Medical Director of Urology and of Robotic Surgery. He has practiced in Atlanta for over 20 years and sees patients at Wellstar Urology in Roswell, Wellstar North Fulton Hospital and Wellstar Avalon Health Park. Wellstar North Fulton Hospital offers the Know Your Heart Screening that can determine your risk of heart disease, stroke, and other serious conditions. Call 770-956-STAR (7827) to learn more or schedule an appointment.