By Dr Michael Harrington
Last updated 24 April 2026

— Reason 01 —

Nappies smell. And the smell is bacterial.

Most women assume the odour from disposable nappies comes from urine itself. It does not. After two to three hours of wear, the warm, occlusive environment created by the nappy promotes the growth of urease-producing bacteria, which break down urea and release ammonia. The smell you and others detect is not waste, it is a bacterial reaction occurring directly on the skin. This is why no amount of changing pads or scented deodorants will neutralise it for long. The disposable nappy does not mask the problem. It creates it.

— Reason 02 —

Nappies cause permanent skin damage.

Dermatologists have a name for the rash many adult nappy users develop: Incontinence-Associated Dermatitis, or IAD. Disposable nappies trap moisture and heat against the skin, creating irritation, redness, and painful raw patches over time. Studies show that a large percentage of long-term nappy users develop these skin issues within months. Women’s skin, especially after menopause, is often even more sensitive and vulnerable. Many patients simply do not realise the nappy itself is causing the problem.

— Reason 03 —

Nappies significantly increase the risk of UTIs and thrush.

This is something I see almost daily in my practice. The female urethra is naturally more exposed to bacterial migration, and when a disposable nappy traps moisture against the skin for hours, it creates the ideal environment for bacteria and yeast to grow. Recurrent UTIs, thrush, and irritation are far more common in long-term nappy users. Many women assume these infections are simply part of ageing. In reality, they are often directly linked to the nappy they have been wearing.

— Reason 04 —

Nappies actually make leaks worse over time.

This is a point rarely discussed, yet it is essential. When a woman wears a disposable nappy continuously, the pelvic floor gradually becomes less active. Over time, light leakage can progress to moderate or even heavy leakage because the body stops engaging the muscles responsible for bladder control. This is one reason why many clinical recommendations are shifting towards modern absorbent underwear, which helps keep the pelvic muscles active while still providing protection.

— Reason 05 —

Nappies gradually erode a woman's sense of self.

This is the reason I save for last, because it is the one my patients almost never mention out loud. Wearing a nappy changes the way a woman sees herself. Intimacy with a partner becomes guarded. The choice of clothing narrows. Social invitations are quietly declined. Within months, women describe feeling like a patient rather than a woman. And the psychological cost compounds the physical one: anxiety, withdrawal, and in many cases, a measurable decline in quality of life. No medical product should require that price. Modern absorbent underwear was developed precisely so that protection no longer means giving up your femininity.