Assessing the Effect of Underwear Fabric and Breathability on the Vaginal Microbiome: A Cross-over Interventional Study

The vaginal microbiome is an important determinant of vaginal health and disease. Epidemiological studies have identified associations between the vaginal microbiome composition and adverse health outcomes, including increased susceptibility to STIs, UTIs and preterm delivery. With an expanding understanding of the vaginal flora's contribution to homeostasis, there arises a potential for developing straightforward, yet effective, interventions for a myriad of conditions. Simple interventions that are easy to implement – such as selecting the right underwear fabric – hold great promise.

Despite the prevailing conventional wisdom on the benefits of cotton underwear on the vaginal flora, there has been a notable lack of controlled scientific studies to substantiate this claim. To address this, we conducted a cross-over interventional study to examine the effect of clothing breathability on the vaginal microbiome of 30 reproductive-age cisgender women. Participants engaged in two week-long, controlled interventions, during which they self-collected mid-vaginal swabs for in depth analysis, including pH measurements and next generation sequencing.

The results from this study have the potential to open new avenues in designing easy-to-implement interventions that can mitigate the morbidity associated with vaginal dysbiosis and have important implications for women’s health.