It isn't a matter of boxers vs. briefs. You need underwear designed by fertility experts with testicular health in mind.

The wrong underwear can damage your testicles and will worsen your varicocele. Avoid the following:

• BAD - Excessively Compressive - Over-compressing the scrotum prevents arterial blood flow to the testicles
• BAD - Moisture-Wicking Fabrics - Many moisture-wicking fabrics are not breathable enough and will trap heat
• BAD - Thick and Cotton Fabrics - Cotton and many other fabrics trap heat. They are not breathable enough
• BAD - Tight Underwear - Underwear that's tight around your hips, waist, groin, or thighs can impair blood and lymph circulation
• BAD - Underwear with Pee-Holes - Doubling up the fabric at the crotch may be convenient but traps more heat 
• BAD - Regular Boxers and Briefs - Regular underwear is designed by fashion designers, not fertility experts
• BAD - Points Penis Upwards - Your penis points down to help keep the urithera clean and dry
• BAD - Ice Underwear - Ice underwear has triple crotch fabric. Once the ice melts and excessively cools your testicles, you'll end up with testicular over-heating

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The best underwear for varicocele and testicular health has to have the following:

• GOOD - Testicular Cooling - With a breathable mesh at the crotch
• GOOD - Penis and Scrotal Separation - For maximum air flow and cooling
• GOOD - Pushing the Crotch Forward - Away from your hot thighs
• GOOD ​- Scrotal Support - To compress the testicular veins and improve blood drainage
• GOOD ​- Well-Fitted - Not too tight around the hips, groin or thighs
• GOOD ​- Thinner & More Breathable - Thinner and more breathable fabrics are best

Stud Briefs is testicular health underwear designed by male fertility experts to treat varicocele and improve fertility. Stud Briefs 3-In-1 Crotch Mesh™ will change underwear forever.

1. Ultra-breathable crotch mesh keeps you well ventilated
2. Pushes the crotch forward and away from your hot body
3. Separates the scrotum and penis to maximize cooling

Guys, the right underwear can make a massive difference for your varicocele. It is one of the most important factors you can manage: You just put it on, and get the benefits all day, every day! The right underwear cools the testicles and provides compression that enhances testicular blood drainage. It can quite literally make all of the difference for you.

Science shows that the underwear that you wear affects your fertility and also possibly testosterone production.

I say: Screw steroids and Viagra, get better underwear!

Now, the wrong underwear traps heat, prevents testicular self-heat regulation, and can increase scrotal sagging. Worse yet, you put it on, and it damages you all day! The wrong underwear can cause aching, pain, testicular sensitivity, impaired testosterone and sperm production, inflamed varicocele, and even varicocele progression to higher grades. ​

Boxers trap just as much heat as briefs. Yes, looser fitting clothes typically trap less heat, however, it is lifestyle dependent. If you’re sitting on a regular basis, the is not enough room to vent the heat. Therefore, when sitting, the extra fabric from the boxers traps more heat than the briefs.
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Moreover, men with varicocele require support to reduce scrotal sagging, and improve testicular blood draining. However, boxers allow and even worsen scrotal sagging. As we already know, the scrotum on the ipsilateral side of the varicocele stretches over time and scrotal sagging increases. So, it is critical to have proper supportive underwear.

SUMMARY: Avoid boxers because they provide no support and trap heat.

Regular briefs and boxer briefs are supportive for the scrotum but also trap heat. But, providing support while trapping heat makes for a dangerous combination! Think about it: The cremaster reflex is there to relax the scrotum when the balls are too hot. It distances the balls from the body and allows them to cool with more ease. However, supportive underwear prevents the balls from sagging to cool and also traps heat!

So, we have: #1 briefs and boxer briefs trap heat, and #2 prevent the testicles from sagging away from the body to cool. That’s a dangerous recipe for cooked balls. It is no wonder that so many men who wear boxer briefs and briefs underwear also develop infetility, testicular sensitivity and varicocele pain.
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Always ensure that your supportive underwear is also maximally cooling and breathable.

SUMMARY: Avoid briefs and boxer briefs because compression without cooling causes testicular damage.

Read: Comprehensive article on groin protectors, cups and jockstraps for varicocele.

Supporters and jockstraps are very similar to briefs but a little worse. They usually have thicker fabrics and materials than briefs, so they trap even more heat. Moreover, supporters and jockstraps provide support that is generally tighter, more compressive, and very restrictive when compared to briefs.

So, doctors and specialists who recommend scrotal supporters have it backward. I mean, they treat testicular varicocele as if it is varicose veins in the legs; they recommend that you wear compressive garments to help improve blood drainage. While it sounds like it makes sense at first, it completely ignores that testicular anatomy is very different than the legs'. Sure, compression can help, but regular scrotal support underwear overheat the testicles, and at the same time, prevents the testicles from dropping down to cool. 

Oops! It looks like they missed why your balls are outside of your body and inside the scrotum. They need to be kept cool!!!
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Try to use supporters with thinner fabric and light support. 

SUMMARY: Avoid scrotal supporters when possible, and if you must wear them, adhere to strict guidelines.

​Wearing no underwear at all is likely the best option so far. I mean, why are we wrapping the only part of our body that needs to be kept cool in additional layers? It is irrational. ​

Even though wearing no underwear is the best option for keeping your testicles cool, it allows for scrotal sagging. This sagging can be a severe concern for some men with varicocele. Some men must wear supportive underwear to get relief. However, in general, if you have to choose between typical heat-trapping supportive underwear and wearing no underwear, I think that the need for adequate cooling trumps support.

​Overall, going commando is a good option for men with varicocele. 

SUMMARY: Wearing no underwear is a good option if experiencing significant scrotal heat and minor sagging or varicocele inflammation.

​Underwear for the Gym and Exercising: ​Ideally, for being active, you would have underwear that’s both cooling and supportive. After that, no underwear is likely usually the next best option. Fabrics that provide minimal friction are also helpful. You should also avoid fabrics that retain moisture. Moisture-wicking fabrics are the way to do, because they release heat with moisture.
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Heavy Weight Lifting Underwear: ​​For those who lift extremely heavy weights, I recommend compressive undergarments. You may need more than just support, you need real compression to counteract the downward pressure that’s generated from the heavy lift. This is not to say that compressive underwear is healthy in general, but likely the best option for this situation. 

Cycling Underwear: ​​Cycling underwear needs to provide light support, be slippery to reduce heat generation due to friction, and provide light support to minimize microtrauma from the saddle to the scrotum and testicles. 

​Running Underwear: The best underwear for runners provides light support, and is maximally cooling, moisture wicking and provides minimal friction to minimize heat generation. If you have proper running underwear, you want to avoid running shorts with built-in underwear. If you do wear these type of shorts, ensure that you do not wear underwear at the same time. 

​SUMMARY: Underwear designed for your sport is critical and can significantly reduce your varicocele. Wearing the wrong underwear during specific sports can be a severe risk factor.

I have two problems with ice underwear. First, ice underwear can severely over-cool your testicles. In your avoidance of over-heating, don’t over-cool. The second problem I have with ice underwear is that once the ice wedge melt, the crotch fabrics trap far more heat than most underwear.

A potential good use for ice underwear is for hard-laborers who have high exposure to heat to for short to medium duration (approximately 1-3 hours). This way, the underwear would be used to counteract the heat, and would be taken off after exposure.

From my overall client reports, ice underwear typically increases testicular sensitivity. So, while it may have its use, in general, I don’t recommend them. 

SUMMARY: Ice underwear can be beneficial if used with caution. 

Look, if you have varicocele, then you need specially designed underwear for varicocele and fertility. The right underwear makes a world of a difference for varicocele. It’s an active treatment method that you just put on and forget, and it really gives you benefits all day long. Stud Briefs is one of our Core Varicocele Healing treatments. It will both speed up your recovery and improve your treatment outcome.
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Stud Briefs combines the right level support with maximum cooling to boost testicular blood drainage, reduce inflammation, and restores normal testicular function. Again, Stud Briefs is specifically designed for men with varicocele and infertility, and it does a great job at that.

Here is how Stud Briefs technology works:

• Cooling: Restores Normal Testicular Function
• Healthy Compression: Reduces Varicocele Swelling
• Support: Reduces Scrotal Sag (Varicocele Risk Factor)

​Get Stud Briefs, Get Support: studbriefs.com/shop

SUMMARY: Stud Briefs is varicocele and fertility underwear. Get it on to boost testicular blood circulation and cool all day

Breathability comes down to 4 major factors:

• Fabric thickness
• The amount of fabric
• And fabric construction
• Fabric type

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Fabric Thickness: We all obviously know that the thicker the fabric the less breathable it is. It therefore goes without saying that thinner fabrics are more breathable. So, when you’re choosing your pants, shorts, or underwear, choose thinner fabrics over thicker ones.
 
The Amount of Fabric: When it comes to underwear, the amount of fabric is also relevant. The more fabric there is, the more heat gets trapped. The less fabric there is, the more easily heat dissipates. Therefore choose briefs over boxer briefs, and boxer briefs over trunks, and trunks over boxers. Think: The less fabric, the cooler.
 
Fabric Construction: Fabric construction is critically important for breathability. The tighter and denser the knots and weaves, the less breathable the fabric. The more open and looser the knots and weaves, the more breathable the fabric. Therefore, look for underwear that uses fabrics with more open and looser knots and weaves. Some underwear, like Stud Briefs use special meshes panels and air vents to maximize breathability and cooling.
 
Fabric Type: Overall, the previous 3 points are fundamentally important for breathability. I would almost always prioritize them over fabric type. Fabrics that are promoted as moisture wicking, quick-drying, or cooling are usually decent. If possible, natural fabrics are typically healthier than synthetic ones, however, most breathable fabrics have some synthetic component. Some fabrics are naturally antimicrobial, making them a little better than other fabrics, especially if you have a lifestyle that exposes you to increased bad bacteria (e.g. multiple sexual partners, sexual massage parlors, etc.) Organic or non-organic fabric doesn’t matter, due to the heavy processing that they all go through.
 
Fabric type does matter during physical activity. Fabrics that are smoother, and more elastic are best, because they reduce and minimize friction. 

SUMMARY: Fabric breathability is critical when choosing underwear for varicocele. Be cautious of fabric thickness, the amount of fabric, and fabric construction. 

Too Tight Around Scrotum: ​Underwear that is tight around the scrotum physically irritates the testicles, prevents testicular self-thermoregulation by physically stopping them from dropping down to cool (the cremaster reflex), and tends to over-heat the testicles. Typically negative symptoms show within a few hours of wearing underwear that is too tight around the scrotum. Go for light support, not compression.
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Too Tight Around the Waist: ​Same as wearing tight pants or a tight belt, underwear that is too tight around your waist increases intra-abdominal pressure and makes it difficult for blood to circulate. I highly recommend to get well-fitted underwear.

SUMMARY: Underwear that's too tight might provide some temporary relief. However, after a few days or weeks of use will significantly worsen varicocele and related symptoms.

The breathability of the pants that you wear will directly determine the amount of heat trapped by your underwear. It almost goes without saying... Wear more breathable pants! Avoid thicker fabrics like some denims. Purposefully go for looser fitting, and thinner fabrics that will maximize breathability and cooling.

SUMMARY: Avoid denim and track pants. Avoid tight pants. Go for thinner and more breathable fabrics. Shorts are better than pants.

Boxers provide no benefit for varicocele because they trap heat, and do not provide no support. This means both scrotal sagging (increased varicocele size) and overheating. 

Do not wear briefs if you have a varicocele. The main problem with briefs is that they squish the testicles and penis together into a ball. This traps lots of heat. Compression and with over-heating creates testicular dysfunction (it prevents the testicles from dropping to cool, and over-heats them too.)

Scrotal support underwear has the exact same problem as briefs. They compress the testicles and penis into a lump, over heating them and preventing the testicles from dropping to cool. They cause a lot of damage to the testicles. Many ill-advised doctors recommend scrotal supporters for those suffering from varicocele. 

I advise going commando over wearing boxers, briefs, or supporters. Cooling should take precedence over compression. Without cooling compression is dysfunctional. 

The best underwear for varicocele provides maximum cooling, separates the penis and testicles, and provides healthy scrotal support & compression. These combined together are very beneficial for varicocele. They help cure varicocele pain, reduce swelling, and improve both fertility & testosterone.