Semen is a whitish fluid that contains seminal fluid and sperm. It is generally expelled from the penis when a man ejaculates. But men may experience semen leakage at other times, such as when they are urinating or sleeping.

Leaking semen isn’t always a problem, but there are times when it can signal a health problem that needs medical attention.

Sexual Arousal

Sometimes, men leak semen when they’re sexually aroused, before or after ejaculation. It usually is not a cause for concern.

Before ejaculation, men might discover a clear fluid called pre-ejaculate or “precum.” This fluid is not semen, but it is possible for sperm cells to mix with it. A woman can become pregnant from pre-ejaculate, so couples should use condoms for the entire duration of intercourse if they wish to avoid pregnancy.

Nocturnal Emissions

Nocturnal emissions or “wet dreams” occur when a man ejaculates during sleep, as the result of some kind of sexual stimulation or sexual dream. Wet dreams are normal and quite common in adolescents and young adults. They do not represent any dysfunction and usually become less frequent as a man gets older.

Leakage With Urination

Some men leak semen while they urinate. This might happen if a man has recently ejaculated and still has semen in his urethra. In this case, this is not something to worry about.

However, seeing semen mixed in urine may indicate the presence of retrograde ejaculation, a condition in which semen travels backward into the bladder instead of forward out of the penis during the ejaculatory reflex. In those cases, the semen exits the body with the urine later, which is not harmful, but this condition may cause fertility issues. Common causes of retrograde ejaculation are the use of alpha-blockers (for benign prostatic hyperplasia) and diabetes mellitus. Treatment options must be discussed with your health care professional. 

Side Effects of Medications

Certain drugs, such as selective serotonin reuptake inhibitors (SSRIs – a type of antidepressant) have sexual side effects, including semen leakage.

If this happens, men should speak to their doctor. Adjusting the medication dose or changing the medication altogether might help. However, patients should never make such changes on their own. It is important to have a doctor’s guidance concerning any medication changes.

Semen leakage can be a symptom of prostatitis – inflammation of the prostate gland. Men may have other symptoms as well, such as pain and problems with urination. Prostatitis can usually be treated with medications, but needs proper evaluation by a doctor.

Prostate Cancer

Some men with prostate cancer leak semen, too.

Nervous System Injury

Men might leak semen if their nervous system is damaged in some way, such as through a spinal cord injury, brain tumor, diabetes, or multiple sclerosis.

Men should always see their doctor if they have other symptoms along with semen leakage, such as pain, bloody semen or urine, or discharge that looks or smells unusual.

Dhat Syndrome

Men with dhat syndrome feel especially anxious if they have semen leakage, such as through urine, masturbation, or nocturnal emissions. Patients may eventually become fatigued, have trouble concentrating and remembering information, feel guilt, and develop other sexual problems.

Dhat syndrome is called a “culture bound syndrome.” It primarily affects men in the Indian subcontinent (India, Sri Lanka, and Bangladesh).

Resources

• Healthline.com
  Roland, James
  “What Causes Semen Leakage and How to Treat It”
  (Reviewed: May 4, 2018)
  https://www.healthline.com/health/mens-health/semen-leakage#leakage-after-urination

• International Society for Sexual Medicine
  https://www.issm.info/sexual-health-qa/what-is-pre-ejaculate-or-precum/

• Medical News Today
  Leonard, Jayne
  “What to know about semen leakage”
  (Reviewed: September 19, 2019)
  https://www.medicalnewstoday.com/articles/326393.php

• Psychology Today
  Griffiths, Mark D., Ph.D.
  “Dhat Syndrome Explained”
  (October 22, 2015)
  https://www.psychologytoday.com/us/blog/in-excess/201510/dhat-syndrome-explained

• Urology Care Foundation
  “What are Prostatitis and Related Chronic Pelvic Pain Conditions?”
  https://www.urologyhealth.org/urologic-conditions/prostatitis-(infection-of-the-prostate)