Panty underwear includes a pouch disposed above the crotch panel and between the leg openings. The pouch has a top opening opposite the wearer's vaginal opening, so that vaginal discharge flows to a sanitary napkin between the bottom of the pouch and the crotch panel. The pouch provides cooling to the wearer's labia and, in some embodiments, to her perineal area. The cooling is provided by either a single generally rectangular cooling pack, or two cooling packs each being rectangular or J-shaped. The sanitary napkin can be internal or external to the pouch. Some embodiments of the underwear are intended for single use. Other embodiments of the underwear are intended to be re-usable, in that the sanitary napkin can be replaced and/or the cooling pack(s) can be re-used. The cooling pack(s) can be sealed with one-time or reusable thermal material therein, or they can be resealable with replaceable thermal material.