Unexplained Nocturnal Emissions: Causes and Concerns

How could this happen?

Hello, doctor! I am a person with a psychoneurosis.
My issue is that about two months ago, I experienced a strong urge to urinate but tried to ignore it while sleeping.
Later, while I was asleep, I began to have sexual fantasies and, unexpectedly, I ejaculated, and the volume was somewhat significant, even though I hadn't engaged in any sexual activity.
This has happened two more times under similar circumstances, both times while I was sleeping with my head down on the table, and I again had sexual fantasies that led to ejaculation.
It's very strange that this is happening without any sexual activity.
I recall you mentioned in a response to someone else that this could be related to "sensitivity of the autonomic nervous system." Is this what I am experiencing? Or could I have developed premature ejaculation? I am currently taking psychiatric medication; could this be a side effect? Or is this related to my psychoneurosis? This has never happened to me before! Which department should I consult for treatment? (P.S.
I haven't had sexual intercourse in a long time.) Thank you for reading my question.

Ayeh, 20~29 year old female. Ask Date: 2004/06/14

Dr. Lai Lunxiang reply Neurology

You are 25 years old and haven't had sexual intercourse for a long time.
Being young and physically fit, this is normal, so don't worry about it.
However, please avoid holding in your urine.

Reply Date: 2004/06/14

More Info

Understanding unexplained nocturnal emissions can be perplexing, especially when they occur without direct sexual stimulation or activity. Nocturnal emissions, commonly referred to as "wet dreams," are a normal physiological phenomenon, particularly in males. They can occur during sleep and are often accompanied by sexual dreams or fantasies, but they can also happen without any conscious sexual thoughts.

The causes of nocturnal emissions can vary widely. In your case, it seems that the emissions are linked to your mental state and possibly the medications you are taking for your mental health condition. Stress, anxiety, and changes in mental health can affect your body's physiological responses, including sexual arousal and ejaculation. The autonomic nervous system, which controls involuntary bodily functions, can become more sensitive in individuals dealing with psychological issues, leading to unexpected physiological responses during sleep.

It's also important to note that the medications used to treat mental health disorders can have side effects that influence sexual function. Some psychiatric medications, particularly certain antidepressants and antipsychotics, can alter libido, sexual performance, and even ejaculation patterns. If you suspect that your medication might be contributing to these nocturnal emissions, it would be wise to discuss this with your prescribing physician. They can evaluate your medication regimen and make adjustments if necessary.

Regarding your concern about premature ejaculation (早洩), it's essential to differentiate between nocturnal emissions and issues related to ejaculation during sexual activity. Premature ejaculation typically refers to a lack of control over ejaculation during sexual intercourse, which is not the same as experiencing nocturnal emissions. The fact that you have not engaged in sexual activity for a while may also contribute to the occurrence of these emissions, as the body can still respond to sexual stimuli, even if they are not consciously recognized.

If these nocturnal emissions are causing you distress or if you have further concerns about your sexual health, it may be beneficial to consult with a healthcare professional who specializes in sexual health or mental health. A urologist or a psychiatrist with experience in sexual health can provide insights tailored to your situation. They can help you understand whether your experiences are within the realm of normal physiological responses or if they warrant further investigation.

In summary, nocturnal emissions can be influenced by a variety of factors, including psychological state, medication side effects, and individual physiological responses. They are generally considered a normal occurrence, but if they are causing you anxiety or concern, seeking professional guidance is a prudent step. Understanding the interplay between your mental health, medication, and sexual function can help you navigate this experience more effectively.

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