Sauna and Fertility: Should Men Wear Ice Packs During Sauna?

To ice, or not to ice: that is the question.

There's a viral trend in the sauna world: sitting in extreme heat with an ice pack pressed to your groin. The logic? That heat is so damaging to sperm production that you need an ice pack to counteract it.

It's a trend, but the evidence doesn't support it as a universal requirement.

The relationship between heat exposure, spermatogenesis, and scrotal thermoregulation is more nuanced than social media suggests. Yes, heat affects sperm production. But no, you don't need to ice your testicles every time you step into a sauna.

Heat Regulation: By Design

Here's the mechanism: optimal spermatogenesis occurs at 2–4°C below core body temperature. The testes hang external in the scrotum – a deliberate thermoregulatory architecture of the human body that dissipates heat through surface convection and vascular countercurrent exchange. Two smooth muscle layers, the cremaster and dartos, actively modulate scrotal position and surface tension to maintain testicular temperature within a tight homeostatic band below 37°C.[1]

When this system is chronically disrupted – via constrictive clothing, prolonged sitting, occupational heat exposure, hot tubs, or febrile illness – genital heat stress degrades semen parameters. Men with idiopathic oligoasthenoteratozoospermia (low count, poor motility, abnormal morphology) consistently present with elevated scrotal temperatures exceeding ~35.5°C throughout waking hours, even under ambient conditions identical to fertile controls.[1]

Controlled heating studies validate this dose-response relationship. Sustained scrotal warming over weeks suppresses sperm concentration and motility, with measurable deterioration in morphology. Remove the thermal stressor, allow scrotal temperature to normalize, and semen parameters recover across one or more complete spermatogenic cycles – approximately 74 days.[2] These are reversible perturbations to a dynamic biological system, not permanent damage.

Sauna: Whole Body x Localized Heat

Finnish saunas are a serious metabolic stressor. Air temps hit 80–90 °C, sessions run 10–20 minutes per round, often repeated. Core temperature spikes 1–3 °C, heart rate climbs, peripheral blood flow surges, and you sweat hard.[3][4] This is whole-body thermoregulation under load.

Systemically, the data supports this as hormetic stress. Large Finnish cohort studies link 2–4 weekly sauna sessions to reduced cardiovascular events, all-cause mortality, and improved cardiometabolic markers.[4][5] The body reads the heat as a challenge and upregulates vascular, autonomic, and inflammatory pathways in response.

For the testes, the evidence is narrower but clear. Garolla et al. ran a small trial on healthy men using a Finnish-style sauna at 80–90 °C for 15 minutes, twice weekly, for three months.[6] Sperm count and motility dropped. Mitochondrial function and DNA integrity markers shifted. Sex hormone production stayed stable. When sauna exposure stopped, semen parameters recovered over several months. Translation: heat temporarily suppressed sperm production in this protocol, but the effect was reversible.

Background: From Infertility Clinics to Online Culture

The ice-pack-in-sauna trend takes ideas from real medical research on scrotal cooling, but that research was done on a very specific group: men already struggling with fertility who had measurably warmer testicles than normal.

In a landmark study, Jung and colleagues enrolled men with reproducible oligoasthenoteratozoospermia and measurable genital heat stress.[1] Using 24-hour scrotal thermometry, they confirmed elevated baseline temperatures compared to fertile controls – then prescribed nocturnal scrotal cooling via an air-based device for 12 weeks. Cooling dropped night-time scrotal temp by ~1°C. Result: sperm concentration and total output increased significantly, with moderate improvements in motility and morphology.[1]

Other studies have tested targeted cooling protocols in clinical settings:

• Cyclic cooling underwear – drops scrotal skin temp by ~0.7°C during wear.[7]
• Customized cooling devices – tricky to wear, with low tolerability over weeks to months.[8]

Scrotal cooling shows promise for men with elevated scrotal temps and compromised semen parameters. But here's the distinction: clinical cooling protocols involve prolonged, mild exposure – hours per night, over months. Not acute ice blasts during acute heat exposure.

Clinical scrotal cooling is an intervention for a specific scenario: men with documented genital heat stress and fertility markers outside normal range. It's not a universal sauna protocol.

What the Evidence Does Not Show

The current state of affairs:

• There are no randomised clinical trials comparing “sauna with scrotal ice pack” versus “sauna without ice pack” on sperm count, motility, morphology, DNA integrity, hormones, or pregnancy outcomes.
• There are no guidelines from urology or andrology societies recommending crotch icing in sauna as a standard protective behaviour.
• There are no symptom-based rules – no validated checklist saying that if the groin feels a certain way in the sauna, scrotal cooling must be deployed.

What the biohacker community emphasises instead: strategic heat modulation. Avoid chronic hot tub exposure, eliminate tight underwear that traps heat, and use sauna at frequencies that align with your fertility window if conception is a near-term objective.[9] The testes evolved to operate within a narrow thermal gradient – if in doubt, play by the rules.

Where Ice Might Fit (And Where It Does Not)

Here's where it gets tactical. There's a mechanistic case for active cooling during acute heat exposure. If you can keep scrotal temperature closer to baseline while pushing sauna intensity, you theoretically reduce the thermal load on spermatogenesis. For men concerned about their semen parameters, strategic cooling during heat exposure could offer a layer of insurance in an otherwise high-stress environment.

However, without documented trials, this remains a hypothesis, not a requirement. Over-aggressive local cooling may also introduce new stresses: rapid vasoconstriction, discomfort, or even skin injury without a clear, quantified benefit.

For most men, the strategy is simple:

• Use saunas sensibly (sensible temperature, duration, and frequency).
• Avoid unnecessary, chronic sources of genital heat stress in daily life.
• Wear a towel or loose clothing in the sauna to dissipate heat naturally.
• Seek advice from a healthcare professional if there is a history of infertility.

Women, Ovaries, and the Limits of Analogy

Here, the analogy breaks down.

Ovaries are deep pelvic organs. They reside within the regulated core, surrounded by tissue, vasculature, and the broader organisation of the abdomen cavity. Sauna heat still matters – particularly in pregnancy, where hyperthermia is appropriately cautioned against.[3][4]

Designing a Fertility-Conscious Sauna Ritual

If fertility is on the horizon, it is reasonable to let the evidence reshape the sauna ritual.

A fertility-conscious approach might look like this:

• Control the dose. Choose temperatures and durations that feel sustainable. Resist the impulse to turn every session into a maximalist endurance test.
• Protect the gradient. Avoid thick, insulating clothing over the groin. Traditional naked sauna use, as seen in Finland, allows the scrotum to do what it is designed to do: release heat.
• Reduce background heat stress. Limit hot tubs, remove laptops from laps, and break up long sedentary periods, especially in the months leading up to conception.
• Seek data when needed. If conception is not occurring as expected, semen analysis, scrotal temperature profiling and targeted cooling can be considered under medical guidance.[1][8]

Conclusion

An ice pack in the sauna is not a universal protocol. Instead, it is a targeted intervention for a specific problem. The evidence doesn't support scrotal cooling for every sauna session. What it does support is strategic heat modulation. Not the blind pairing of fire and ice.

BON CHARGE

This content is for general education and is not medical advice. Our products are not intended to diagnose, treat, cure, or prevent any disease. Always follow product instructions and consult a qualified healthcare professional for guidance tailored to you. Individual results may vary.

References

1. Jung, A. et al. Improvement of semen quality by nocturnal scrotal cooling and moderate behavioural change to reduce genital heat stress in men with oligoasthenoteratozoospermia. Reproduction 121, 595–603 (2001).
2. Wang, C. et al. Effect of increased scrotal temperature on sperm production in normal men. Fertility and Sterility 68, 334–339 (1997).
3. Hannuksela, M. L. & Ellahham, S. Benefits and risks of sauna bathing. American Journal of Medicine 110, 118–126 (2001).
4. Laukkanen, J. A. & Laukkanen, T. Sauna bathing and systemic health: A review of the evidence. Mayo Clinic Proceedings 93, 1111–1121 (2018).
5. Henderson, H. B. et al. The cardiometabolic health benefits of sauna exposure in individuals with high-stress occupations: A mechanistic review. International Journal of Environmental Research and Public Health 18, 1105 (2021).
6. Garolla, A. et al. Seminal and molecular evidence that sauna exposure affects human spermatogenesis. Human Reproduction 28, 877–885 (2013).
7. Zumstein, V. et al. Stay cool! Special underwear for cyclic cooling significantly decreases scrotal skin temperature. Central European Journal of Urology 74, 468–470 (2021).
8. Benidir, T. et al. Evaluation of patient compliance with the use of scrotal cooling devices. F&S Reports 2, 289–295 (2021).
9. Shefi, S. et al. Wet heat exposure: a potentially reversible cause of low semen quality in infertile men. International Brazilian Journal of Urology 33, 50–56 (2007).