In general, normal men ejaculate 2-6 ml each time, and the volume of one ejaculation is negatively correlated with the frequency of ejaculation. If the ejaculate volume is still less than 1.5ml after 5-7 days of abstinence, it is considered as a decrease in semen volume.
What is semen made up of?
Semen consists of spermatozoa and seminal plasma, of which 95% is seminal plasma. Seminal plasma consists of a mixture of secretions from the epididymis, vas deferens, seminal vesicles, prostate gland and urethral bulb gland. Among them, the secretions of the prostate and seminal vesicle glands are the most abundant. In addition to water, fructose, protein and fat, it also contains a variety of enzymes and inorganic salts and zinc. Seminal plasma is the medium for sperm activity.
What are the effects of low semen volume?
A low semen volume cannot fully neutralize the acidic vaginal secretions, which affects the survival and vitality of sperm, and the reduced semen volume (insufficient seminal plasma) leads to the failure to generate sufficient semen pools in the posterior vaginal fornix after sexual intercourse, which is not conducive to the upward movement of sperm into the woman’s cervical canal, leading to infertility. The amount of semen that accumulates in the posterior urethra before ejaculation is not enough to produce sufficient swelling in the posterior urethra, thus making the sexual euphoria during ejaculation not strong, or the ejaculation threshold decreases.
What can cause low semen volume?
1. Obstruction of the ejaculatory duct area
It includes atresia or narrowing of the ejaculatory duct, which is mostly caused by ejaculatory duct cysts, inflammatory obstruction of the ejaculatory duct, and congenital atresia of the ejaculatory duct. Since sperm and seminal vesicle secretion have to enter the urethra for discharge, the last outlet is the ejaculatory duct, which means the ejaculatory duct is formed after the confluence of the abdomen of the vas deferens and the seminal vesicle duct. The last outlet is the ejaculatory duct, which is the confluence of the abdomen of the vas deferens and the vesicular duct to form the ejaculatory duct.
2. Seminal vesicle deficiency or seminal vesicle prostate dysfunction
The secretion of seminal vesicles accounts for about 60% of the semen volume, so the semen volume of patients with congenital seminal vesicle deficiency is mostly less than 1ml; if the seminal vesicles or prostate gland is hypoplastic, inflammatory or androgen deficient and the secretion function is reduced, the semen volume will become less.
3. Hypothalamus, pituitary gland or testicular interstitial cell lesions or dysfunction
The endocrine disorder causes poor development of epididymis, prostate gland and seminal vesicle gland, resulting in insufficient semen secretion due to lower gonadotropins or reduced androgens. In addition, endocrine disorders such as hypothyroidism can also lead to abnormal semen secretion and discharge functions.
4. Diverticula or urethral stricture in the urethra
The presence of diverticula or urethral stricture in the urethra may cause semen to be partially stored in the diverticula and not all of it is discharged, or it may be blocked in the narrow area and not all of it is discharged, resulting in less semen.
5. Reproductive tract infection
Various types of bacteria, viruses, mycoplasma, parasites, tuberculosis, gonococcus, etc. can cause inflammation of the genitourinary tract, resulting in damage to the function of the accessory gonads, causing obstruction of the semen output duct, or a decrease in the secretion and excretion of the prostate gland and seminal vesicles, resulting in a decrease in the amount of semen, which is not conducive to the survival of sperm and reduces the chances of natural pregnancy in those with a severe deficiency.
6. Sampling errors
This includes other methods of sperm collection such as in vitro sperm, sperm collection with condom, and substandard sperm collection containers (generally standard sperm collection cups with graduated lines should be used), and partial omission of the collected specimen.
7. Short abstinence time
Including the usual sexual life is too frequent, the examination is not in accordance with the abstinence time requirements.
8. Insufficient sexual stimulation
The poor environment of the semen collection room causes mental tension in the patient, insufficient sexual stimulation by masturbation, insufficient orgasm, insufficient erection and ejaculation due to situational impotence.
9. Retrograde ejaculation
① congenital factors of retrograde ejaculation: mainly include congenital bladder neck closure insufficiency, congenital cremasteric cleft and congenital dwelling urethral valves, etc. These congenital disease departments may make the bladder neck hemi-closure or urethral membrane resistance increase and induce retrograde ejaculation during sexual intercourse.
②Medical factors: mainly include various bladder neck and prostate surgeries, thoracolumbar sympathectomy, extensive retroperitoneal lymph node removal and other pelvic surgeries, which lead to nerve root removal or injury, making the bladder neck closure incomplete and retrograde ejaculation occur.
③ Mechanical good factor: It is due to traumatic and inflammatory urethral strictures due to increased urethral resistance, resulting in obstruction of semen during ejaculation, which leads to partial or total retrograde ejaculation.
④Disease factors: diabetes mellitus, cremaster injury, bladder stones, cystitis, urethritis, etc. cause patients to lose the ability to ejaculate or reverse ejaculation with a higher incidence.
⑤Drug factors: Taking adrenergic receptor blocking drugs such as reserpine, pethidine, methiodiazine hydrochloride, benzoper and bromobenzyme can cause smooth muscle contraction incompetence and Thuja ejaculation.
(6) A few congenital malformations: such as cremasteric cleft, congenital urethral valve, bladder diverticulum, bladder neck contracture, etc., can cause retrograde ejaculation.
10. Other factors
The circumcision is too long, the circumcision mouth is narrow so that during sexual intercourse Canton, produce pain, and make sexual interruption of ejaculation can lead to low semen volume.
How to treat low semen volume?
The purpose of treatment for reduced semen volume is generally to address the patient’s fertility requirements, so it is necessary to take appropriate treatment for different etiologies, targeting treatment and, if necessary, assisted reproduction.
1. If congenital sperm vesicle defects cannot be surgically repaired, IVF-ICSI can be performed via testicular or epididymal sperm extraction.
2. obstruction in the ejaculatory duct area can be treated by endoscopic exploration of the seminal tract.
3. Pharmacological treatment of low gonadotropin.
①Gonadotropin. May be injectable chorionic gonadotropin (hCG) combined with injectable urogenital gonadotropin (hMG), intramuscular injection, 2/week for 1-2 years, individual patients for 3 years, regular review of semen and sex hormones.
②Estrogen receptor antagonists: If the patient’s gonadal feedback axis is normal, you can choose clomiphene (clomiphene), tamoxifen treatment, with 3 months, if effective can continue to take until the semen volume returns to normal.
4. Reproductive tract infection
Bacterial culture and drug sensitivity test should be conducted, select sensitive drugs in sufficient quantity and standardized treatment, and review after stopping the drug, and stop anti-infection treatment after the diagnosis is cured, meanwhile the patient’s sexual partner should also be examined and treated to avoid cross-infection.
5. Treatment of retrograde ejaculation
①Psychological guidance and sex education: a relaxed mind, strong self-confidence and encouragement from the sexual partner have a positive impact on the treatment of reverse ejaculation. Conversely, it can aggravate the condition.
(ii) Behavior modification: learning to masturbate in the upright position or having sex in the upright position, and preferably under conditions of proper urine holding.
③Medication: there are no specific drugs available, only symptomatic and empirical treatment.
④Surgical treatment: for congenital diseases, treatment can be given by surgical correction.
⑤ stop using drugs that may cause smooth muscle contraction weakness during ejaculation; actively control systemic underlying diseases such as diabetes and hypothyroidism; perform circumcision for those whose prepuce and prepuce seriously affect sexual ejaculation.
6. to develop good habits of birth ful regular sex life.
In both sides of the physical health, happy atmosphere for sex, you can properly adjust the way of sexual intercourse to improve sexual stimulation to make ejaculation more “adequate”.