What’s the lowdown?

• UTIs affect people with vaginas eight times more frequently.
• Thrush is the second most common infection of the genital tract, and approximately 75% of people with vaginas will experience it at least once in their lifetime
• The NHS advises wearing cotton underwear to help ease symptoms of thrush
• Cotton underwear can help to absorb excess moisture, which helps to prevent yeast infections

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First, let’s talk about thrush and UTIs… 

Before we get into the benefits of cotton, it’s helpful to know a bit more about two of the most common infections it can help prevent. Let’s start with the good old urinary tract infection. If you’re reading this and haven’t got a clue what we’re on about, let us start by saying – we’re jealous! 

A urinary tract infection (UTI) is an infection in any part of your urinary system – so your kidneys, bladder, ureters or urethra. Symptoms can include pain or a burning sensation when you pee (joy), needing to pee ALL the time, lower tummy pain/back pain, and a high temperature (quadruple joy). 

These infections are far from uncommon. In fact, according to one study in 2016, it was estimated that UTIs are the cause of 8.3 million outpatient clinic visits and 1 million emergency department visits globally each year. Although urinary tract infections affect all genders, “women are the most vulnerable due to their anatomy and reproductive physiology”.   

Another study conducted in 2013 revealed UTIs are one of the most frequent clinical bacterial infections in women, accounting for nearly 25% of all infections. The study goes on to say that “around 50-60% of women will develop UTIs in their lifetimes”, affecting women eight times more frequently than men. 

And what about thrush? Thrush is a symptomatic inflammation of the vagina and/or vulva, caused by a fungal infection. In plain English – thrush feels like a burning or itching sensation in your vulva and vagina, which can be extremely irritating and sore. Thrush is the second most common infection of the genital tract and affects millions of women worldwide; approximately 70-75% of women will experience at least one episode in their lifetime (don’t mind us, we’re just on infection number 310). Similarly to UTIs, certain types of underwear have been statistically associated with the development of thrush. Which leads us nicely on to… 

What has cotton got to do with thrush and UTIs?

Well, quite a lot, truth be told. As co-founders of an organic cotton underwear brand, MERRI Intimates, don’t just take our word for it, the NHS also endorses the benefits of wearing cotton pants. According to a 2003 epidemiological survey, one of the factors most commonly associated with vaginal yeast infections “is wearing underwear made from synthetic fabrics, which don’t breathe, and thus keep the genital area warm and moist, the perfect conditions for growth of yeast”. In the study of eight Italian hospitals and gynaecology facilities on the causes of recurrent thrush found that “the most frequent associated factors were related to lifestyle: synthetic fabric underwear, vaginal douching and bike training”.

Aside from all its benefits for intimate health, cotton is a pretty great all round fabric. It’s soft, natural, breathable, comfortable AND looks good. Part of the reason cotton is so comfy is that it absorbs excess moisture, keeping you cosy and dry. It’s also a natural polymer and hypoallergenic, which may decrease your chances of other infections and health risks. 

So what should we be doing to prevent the irritating, infuriating infections that so often knock on our doors? It’s perhaps most succinctly summarised by the RCOG guidance on care for vulvar skin: “wear loose-fitting silk or cotton underwear. Avoid close-fitting clothes.”

One 2018 study summarised that “organic cotton can properly be known as the most skin-accommodating, most calming, and most safe regular fibre”. It’s no coincidence then that a Cotton Incorporated Lifestyle Survey, found that 83% of women prefer their underwear to be made of cotton. 

What is organic cotton’s impact on the environment? 

Wondering if organic cotton is too good to be true? Don’t worry. Organic cotton (as opposed to just cotton) is a sustainable choice for lots of reasons. Firstly, organic farmers use natural methods to grow cotton, instead of fossil-fuel based fertilisers. By working with nature, they build healthy soils that store carbon and help to combat climate change.

Organic cotton also helps maintain a balanced system on farms. Farmers always grow it alongside their other crops, which helps to keep soils healthy, encourage wildlife and protect topsoil. These farmers use natural methods like crop rotation to control pests and diseases, whereas non-organic farming can damage ecosystems with hazardous synthetic pesticides. 

Why doesn’t everyone know about the benefits of organic cotton pants? 

As with all pelvic health related issues, there’s nowhere near enough available information about the things that can help or harm us. Working in the cotton underwear industry, with a direct focus on intimate health, we have been blown away by how often people assume a UTI or thrush is a sexually transmitted infection (STI). 

There’s so much misinformation about these infections, let alone knowledge on how to go about treating them. A 2021 study in Nigeria, looking into the different factors causing a predisposition for UTIs, showed that diseases like UTIs are often “mistreated and diagnosed because of confusing and overlapping symptoms. Particularly in the developing world, more education is needed.” And another study in 2017 looking into the role of female intimate hygiene in vulvovaginal health, concluded that “there is a paucity of published medical literature related to the vulva and how personal hygiene practices can affect it”. 

If you’re struggling with UTIs, thrush, or both, and are feeling frustrated, check out The Lowdown’s blog on itchy vaginas, as it could be caused by your contraception. In summary –  dry properly after washing, avoid sex if it’s uncomfortable, don’t use soap on your vulva, drink lots of fluids and of course… wear cotton underwear.