Problem page - Strange semen

Strange semen

This doc spot looks at

retrograde ejaculation, where semen passes backwards into the bladder
blood in semen

What is semen?
Semen contains activated sperm, and sugar and nutrients to feed the sperm after ejaculation. Made in the testicles, sperm travel through a tube called the vas deferens and emerge through the urethra, the tube that carries urine out of the penis. In a vasectomy, the vas deferens is cut so the sperm can’t get out. Most of the fluid comes from the seminal vesicles, which lie just underneath the bladder, and prostate gland, which surrounds the urethra as it emerges from the bladder, in the pelvis. The released fluid activates the sperm so that they become capable of fertilization.

Retrograde ejaculation
What causes it? After prostate or pelvic surgery, ejaculation sometimes occurs backwards into the bladder instead of out of the penis (‘retrograde ejaculation’). This can also occur if the nerves needed to open the bladder to allow urine to flow out are not working properly. This can be caused by an injury to the pelvic region, or due to diabetes or medication that you may be taking to treat another condition. Drugs used to treat schizophrenia alter the way the nerves of the brain send messages to each other and retrograde ejaculation can be a side-effect. However, it can happen for no obvious reason in a healthy man, and can occasionally cause infertility.

Is it a problem? As little, if any, semen comes out of the penis at orgasm in retrograde ejaculation, the sperm pass out in the urine the next time it is passed. In most men, this is not a problem, and does not affect the enjoyment of sex or the ability to reach orgasm by either the man or his partner.

It only really becomes a problem if the man wants to father children, as there may be too few sperm actually getting into the vagina to allow fertilization of the egg to occur. If this is the case, there are various treatments that might help. Some drugs can reverse the flow of semen, or sperm can be collected from the urine immediately after masturbation and used to fertilize the eggs by IVF or simply inserting them into the woman’s vagina. Needless to say, anyone in this position should consult their GP or family physician for advice on how best to get help.

Blood in semen
Semen is usually a thick, creamy-white liquid. Blood in the semen is common and looks like red streaks in the fluid. Usually caused by infections, bleeding may also be due to inflammation, stones, tumours or prostate enlargement. In younger men, it often clears up on its own within a month, and no treatment is necessary as long as there are no other symptoms such as pain, feeling unwell or losing weight. If the bleeding continues for more than a few weeks, or you are over 40, it should be checked by a doctor. Your GP or family physician will be familiar with this type of problem, so don’t be embarrassed to go and talk to him or her.

Jonathan Belsey and Alison Martin

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