Prostatitis and Ejaculation: Symptoms and Treatment Options

Prostatitis and ejaculation?

Hello Doctor: Last month, I noticed that my semen was dark red during masturbation.
After consulting with a urologist, I was diagnosed with prostatitis.
I have been on medication for almost a month now.
One week after starting the medication, the dark brown semen disappeared, but currently, my semen appears white at the front and yellowish at the back during masturbation.
The main issue is that the urologist advised that I should ejaculate once or twice a week to help expel the infection and blood from the semen for faster recovery.
However, when I visited another doctor yesterday, he stated that my symptoms (hematospermia caused by prostatitis) are not suitable for ejaculation.
I would like to ask how ejaculation affects my condition, considering my current semen status with prostatitis.

[Note] 1.
I have taken the antibiotics Bakatar and Doxycycline; I experienced an allergic reaction to the former, and both doctors prescribed me Doxycycline, one in the morning and one at night.
2.
The urologist mentioned that the typical treatment duration for prostatitis is two to four weeks.
If I continue the medication but my semen does not return to white, could this indicate chronic inflammation? Thank you.
Best regards.

James, 20~29 year old female. Ask Date: 2016/07/11

Dr. Xu Wencang reply Urology

Just let it be; if there is no discomfort with hematospermia, it can resolve on its own.
Antibiotics do not necessarily need to be taken for a long duration.
If the body condition is poor, hematospermia can easily recur.

Reply Date: 2016/07/11

More Info

Prostatitis, particularly chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), can be a challenging condition to manage, especially when it comes to symptoms like blood in the semen (hematospermia) and the impact of ejaculation on recovery. Your situation, where you experienced dark red semen initially and now have a mixture of white and yellow semen, indicates that while there may have been some improvement, the condition is still present and requires careful management.

Understanding Prostatitis and Its Symptoms
Prostatitis can manifest in various ways, including pelvic pain, urinary symptoms, and sexual dysfunction. The inflammation of the prostate can lead to changes in the semen, such as discoloration, which can be alarming. The presence of blood in the semen can be due to several factors, including inflammation, infection, or trauma. In your case, the initial dark red color suggests a significant inflammatory process, which seems to have improved with antibiotic treatment.

Treatment Options and Recommendations
1. Ejaculation and Prostatitis: The advice regarding ejaculation can vary among healthcare providers. Some urologists recommend regular ejaculation (1-2 times a week) to help clear the prostate of inflammatory substances and potentially reduce symptoms. This can be beneficial in cases of prostatitis as it may help to relieve pressure and promote healing. However, if you are experiencing significant pain or discomfort during ejaculation, it may be advisable to refrain from it until your symptoms improve. The second doctor’s recommendation to avoid ejaculation could be based on the concern that it might exacerbate inflammation or discomfort.

2. Duration of Antibiotic Treatment: The typical course of antibiotics for prostatitis can range from 2 to 4 weeks, depending on the severity and type of infection. If you have been on doxycycline for a month and are still experiencing symptoms, it is essential to follow up with your urologist. They may consider extending the treatment or exploring other options, including the possibility of chronic prostatitis, which can require a longer treatment duration and a different approach.

3. Monitoring Symptoms: It is crucial to keep track of your symptoms. If the discoloration of your semen persists or if you experience new symptoms, such as increased pain, fever, or changes in urinary habits, you should seek further evaluation. Chronic prostatitis can sometimes lead to persistent symptoms even after initial treatment, and additional diagnostic tests may be necessary to rule out other conditions.

4. Lifestyle Modifications: In addition to medication, certain lifestyle changes can help manage prostatitis symptoms. Staying hydrated, avoiding irritants (such as caffeine, alcohol, and spicy foods), and practicing stress management techniques can be beneficial. Regular physical activity and pelvic floor exercises may also help alleviate symptoms.

5. Follow-Up Care: Regular follow-up with your urologist is essential. They may recommend additional treatments, such as anti-inflammatory medications, physical therapy, or even alternative therapies like pelvic floor relaxation techniques or biofeedback.

Conclusion
In summary, the management of prostatitis, especially with symptoms like hematospermia, requires a tailored approach. While ejaculation may be beneficial for some, it is essential to listen to your body and consult with your healthcare provider about the best course of action. If your symptoms persist despite treatment, further evaluation may be necessary to ensure that you receive the appropriate care. Always prioritize open communication with your healthcare team to navigate this complex condition effectively.

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