Low Semen Volume: Causes and Concerns in Urology

Low semen volume?

In the past, I frequently engaged in masturbation, often ejaculating even when there was little to no semen left.
Typically, after a maximum of one week of rest, my semen volume would return to normal.
However, at the beginning of this year, I noticed a decrease in semen volume, so I began to abstain and control my masturbation frequency.
From around April or May of this year until September, I refrained from masturbation.
When I finally did, I noticed that after ejaculation, only one or two drops of yellowish fluid would slowly leak out.
On October 14, I masturbated again, and the same thing happened: after ejaculation, only one or two drops of yellowish fluid would slowly come out.
That afternoon, I visited a urologist, who scheduled me for a transrectal ultrasound of the prostate and semen analysis in November.
I have not experienced any symptoms of prostatitis such as painful urination, difficulty urinating, frequent urination, or nocturia.
Additionally, I used to have a lifestyle that included smoking, drinking, and staying up late, but I quit drinking in May of this year and smoking in August, although I still tend to stay up late.
The doctor suggested the following possibilities: 1.
Long-term masturbation may have increased my stimulation demand, leading to reduced ejaculation volume when not sufficiently aroused.
2.
The yellowish color of the semen warrants a semen analysis to check for inflammation.
3.
The transrectal ultrasound will assess for any obstruction in the ejaculatory ducts or prostate calcification.
4.
Retrograde ejaculation is a concern, and since I have to wait until November for the tests, I am quite worried.
Therefore, I would like to ask the doctor: 1.
Based on your experience, which of the four potential causes seems most likely given my situation? Are there any other possibilities? What treatment options are available? 2.
Given that I do not have any inflammatory symptoms, how likely is it that there is inflammation? Could this indicate prostatitis? Would this lead to a decrease in semen volume? 3.
What is the likelihood that I have prostate calcification? What causes calcification? Could this lead to a decrease in semen volume? 4.
Is obstruction of the ejaculatory ducts common? There should be two ejaculatory ducts, right? Would obstruction of just one lead to a decrease in semen volume? 5.
I found online that tumors could potentially cause obstruction of the ejaculatory ducts or prostate calcification.
Is this true? What is the likelihood of having a tumor? I am very concerned.
Thank you.

Fenhong Bao, 30~39 year old female. Ask Date: 2020/10/18

Dr. Cai Zhuorong reply Urology

Current medical knowledge regarding the effects of masturbation is still limited, and research in this area is sparse.
There has been some research on abnormalities related to ejaculation, specifically delayed ejaculation, anejaculation, and retrograde ejaculation.
Seminal fluid is produced by the prostate gland and seminal vesicles, with the majority coming from the seminal vesicles, and it travels through the ejaculatory duct to reach the urethra.
As for the multiple questions you raised, evidence-based medicine does not provide clear answers.
In addition to semen analysis and ultrasound, blood tests may be considered to rule out endocrine abnormalities.

Reply Date: 2020/10/18

More Info

Understanding low semen volume can be a complex issue, especially when considering various potential causes and concerns in urology. Based on your description, it seems you have been experiencing a significant change in your semen volume, which can be distressing. Let’s address your questions systematically.

1. Potential Causes of Low Semen Volume:
- Frequent Masturbation: It is possible that frequent ejaculation can lead to temporary reductions in semen volume. The body needs time to replenish seminal fluid, and if you were previously engaging in frequent masturbation, it might have contributed to the reduced volume you are experiencing now.
- Psychological Factors: Anxiety or stress can also affect sexual arousal and ejaculation. If you are feeling anxious about your sexual health, this could potentially impact your semen volume.

- Prostate Health: Conditions such as prostatitis (inflammation of the prostate) can affect semen production. Even in the absence of typical symptoms like pain or difficulty urinating, inflammation can still occur.

- Obstructions: Issues such as retrograde ejaculation (where semen enters the bladder instead of exiting through the penis) or blockages in the ejaculatory ducts can lead to reduced semen volume.

2. Semen Color and Inflammation:
- The yellow color of your semen may indicate the presence of certain substances or could be a sign of infection or inflammation. However, the absence of other symptoms like pain or discomfort makes it less likely that you have a severe infection. It’s essential to wait for the results of your semen analysis to get a clearer picture.

3. Prostate Calcification:
- Prostate calcification can occur due to various reasons, including chronic inflammation or previous infections. It is not uncommon and may not necessarily lead to reduced semen volume unless it is significant enough to obstruct the ducts.
4. Ejaculatory Duct Obstruction:
- Yes, there are two ejaculatory ducts, and obstruction in either one can lead to reduced semen volume. This condition is not extremely common but can occur due to various factors, including congenital issues or inflammation.

5. Concerns About Tumors:
- While tumors can potentially cause obstructions or other issues within the reproductive system, they are relatively rare. The likelihood of a tumor being the cause of your symptoms is low, especially if you do not have other concerning symptoms. However, it is essential to follow up with your healthcare provider for appropriate evaluations.

Next Steps:
- Follow-Up Tests: The tests your doctor has scheduled, including the transrectal ultrasound and semen analysis, are crucial for diagnosing the underlying cause of your symptoms. These tests will provide valuable information about your prostate health and any potential obstructions.

- Lifestyle Changes: Since you have made significant lifestyle changes by quitting smoking and drinking, continue to focus on maintaining a healthy lifestyle. Regular exercise, a balanced diet, and adequate hydration can positively impact your overall health and potentially improve your sexual health.

- Mental Health: If anxiety or stress is a concern, consider speaking with a mental health professional. They can help you develop coping strategies to manage anxiety related to sexual health.

In conclusion, while there are several potential causes for your low semen volume, many of them can be addressed with appropriate medical evaluation and lifestyle changes. It is essential to communicate openly with your healthcare provider about your concerns and follow through with the recommended tests to ensure you receive the best possible care.

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