To understand semen leakage, we first have to understand semen. When a man ejaculates, the whitish fluid that’s released from the penis is called semen. It’s made up primarily of seminal fluid, which is produced by the prostate and the seminal vesicles. Seminal vesicles are the small glands located behind the prostate. A small percentage of semen is made up of sperm.

Semen is generally thought to only leave the penis during sex or masturbation. But sometimes, semen can exit the end of a penis without the person being sexually aroused.

Semen leakage is a common occurrence during sexual activity. There are also conditions that may cause semen leakage. Some may have a direct cause that can be treated, while others don’t necessarily require any medical intervention at all.

Semen leakage or any other concerns related to your reproductive system should be discussed with your primary doctor or a urologist.

In addition to conscious sexual arousal, other common causes of semen leakage include:

  • nocturnal emissions
  • medication side effects
  • prostate problems
  • nerve injury

These conditions can also have other symptoms. Here’s what you need to know about the other symptoms and how to treat these underlying causes:

Sexual arousal

Leaking semen when aroused or simply having sexual thoughts is normal for many young men. It can be a little messy and uncomfortable, but it doesn’t indicate any sexual problems or other conditions on its own.

Some semen may also leak out just prior to ejaculation or right afterward.

Another type of fluid can also leak out during sexual arousal. It’s called pre-ejaculatory fluid, also known as “pre-cum.” This fluid often leaks out prior to ejaculation. Pre-cum is chemically different from semen and can act as a lubricant during intercourse. However, it may still contain sperm, so wearing a condom before any type of sexual activity or contact is recommended.

Since some active sperm can still be released when unexpected, practicing the withdrawal method — where you “pull out” your penis from your partner’s vagina prior to ejaculation — isn’t a highly effective birth control method. Using the withdrawal method without a condom can also expose you to sexually transmitted infections (STIs).

Treatment

Semen leakage or leakage of pre-ejaculatory fluid due to sexual arousal usually requires no treatment. In fact, this is both common and normal.

On the other hand, if you’re experiencing premature ejaculation, this is a different concern. Premature ejaculation involves ejaculating sooner than you and your partner would like, or being unable to delay your ejaculation during intercourse. This can occur due to an underlying condition, although most often it’s a psychological reason.

Treatments for premature or early ejaculation may include:

  • Behavioral changes. Your doctor may suggest that you start masturbating an hour or two before having intercourse.
  • Physical therapy and exercise. By doing pelvic therapy and practicing Kegels, you can help control your ability to start and stop. This may help delay ejaculation.
  • Certain medications. You may use a topical desensitizing cream which will reduce stimulation and help to delay orgasm. Your doctor may also prescribe a selective serotonin reuptake inhibitor (SSRI), which can be effective, especially when used in combination with behavioral and physical therapy.

If erectile dysfunction (ED) is also an issue, additional medications may also help. These include:

If you believe you’re experiencing premature ejaculation or any type of ED, see your doctor. They can come up with the right treatment plan to meet your needs.

Nocturnal emissions

Nocturnal emissions, also known as “wet dreams,” are most common during adolescence and sometimes into a man’s 20s. Most men have nocturnal emissions at some point in their lives.

A nocturnal emission is an involuntary ejaculation of semen that occurs when you’re sleeping. It can happen if your genitals become stimulated from bedsheets or during a sexual dream. A wet dream may result in some semen leakage, rather than a full ejaculation.

In any event, nocturnal emissions are quite common once a boy hits puberty.

Treatment

Most men and boys don’t need any treatment for nocturnal emissions. They usually become less frequent as you move into your 20s. They may be more frequent, however, during periods in which you’re having less sexual intercourse or are masturbating less often.

Increased sexual activity may lead to a decrease in nocturnal emissions. If you have questions about nocturnal emissions, talk with your doctor.

Medication side effects

Medications, such as antidepressants, mood stabilizers, and some hormone treatments may also cause semen leakage.

SSRIs, a group of antidepressants, can be associated with semen leakage and other sexual side effects. These other effects include:

  • low libido (reduced sex drive)
  • delayed ejaculation
  • erectile dysfunction

These side effects will depend on the type of SSRI, its dosage, and its combination with other medications. If you’re on one of these medications, you should weigh the pros and cons of taking these drugs and their side effects.

Treatment

When it comes to treating depression, the current recommendations state that both psychotherapy and medication are effective choices. Between 30-40 percent of people may improve with just one of these treatments — either just psychotherapy, or just medication. However, a combination of both is believed to be most effective.

If these sexual side effects outweigh the benefits of your current antidepressant medication, you should talk with your doctor. In some cases, adjusting the dosage of a medication or switching to a different class of drug may be enough to resolve any side effects. You can also ask them about behavioral therapies that may help.

You should never stop taking an SSRI or other antidepressant without talking to your doctor first. If you have questions about the short- and long-term effects of a particular medication, bring up your concerns with your doctor and find out your options. You can also discuss any alternative treatments that may be possible for you.

Prostate problems

Your prostate is the gland that produces semen to help carry your sperm through your urethra and out of your penis. Your prostate is vulnerable to a number of health problems. Among these problems are prostatitis and prostate cancer.

Prostatitis is an inflammation and enlargement of the prostate. It can be caused by:

  • a bacterial infection
  • any substance that triggers an immune response and inflammation
  • a nerve injury

It’s less clear why prostate cancer develops. However, certain genetic changes seem to play an important role. Like prostatitis, prostate cancer can cause:

  • difficulty urinating
  • pain in the pelvic area
  • changes in ejaculation
  • blood in semen

These prostate problems may also lead to other symptoms, including semen leakage.

Treatment

If you experience any of the below symptoms, you should see a doctor:

A course of antibiotics may be needed to treat prostatitis caused by a bacterial infection.

Prostate cancer is a much more complicated condition to treat. Because prostate cancer is usually slow-growing, no treatment may be recommended at first. An approach known as “active surveillance” includes regular checkups and tests to see if the cancer is progressing.

Surgery to remove the prostate and other treatment options may also be recommended by your doctor. Treatments can vary in their effectiveness and side effects depending on the stage of the cancer.

Injury to the nervous system

When an injury to your nervous system occurs, you may also experience changes in ejaculation, leading to semen leakage. Advanced age, infections, and injuries and surgery to the spinal cord or groin may affect the nerves involved in ejaculation.

Complex interactions between the brain, spinal cord, and nerves must occur in order for ejaculation to happen. Medical conditions that affect nerves, such as diabetes, stroke, or multiple sclerosis, can change sexual function and ejaculation.

Treatment

Treating the underlying cause is the best chance for improvement. Nerve injury from inflammation or infection may get better over time. While nerve damage related to surgery, cancer treatment, or nervous system diseases may be much harder to treat.

Your healthcare team can work with you to create an overall treatment plan that’s right for you.

A common condition that affects some men is leakage after urination. This is usually harmless. However, if you’re concerned that the leaked fluid may not be semen but discharge related to an injury or infection, like an STI, you should see a doctor right away.

There are some other explanations for semen leakage following urination. Some semen may remain in your urethra after the last time you ejaculated. Urinating is simply moving it along.

You may also have retrograde ejaculation. This is a condition in which semen enters your bladder instead of exiting out of your penis. This typically causes urine to be cloudy.

Treatment

If semen leakage after urination occurs infrequently, you may not need any treatment. But if this is an ongoing issue, tell your doctor.

If the condition is due to retrograde ejaculation, you may not need any treatment unless you’re trying to have a child. Any treatment options will also depend on the cause of your retrograde ejaculation. If surgery on your prostate or pelvic area resulted in ejaculation changes, this may be more difficult to treat.

Certain medications have been shown to be helpful though. Midodrine, a medicine used to treat low blood pressure and the allergy medicine chlorpheniramine (Chlor-Trimeton) are commonly used to treat retrograde ejaculation even though they were designed for other purposes.

As with most aspects of sexual function, semen leakage is the subject of many myths and misunderstandings.

Some cultures believe that semen leakage leads to a loss of an important energy. This can cause significant anxiety, distress, and frustration. Luckily, one study showed that behavioral therapy, mindfulness, and improved understanding of normal sexuality and function can all help to improve this outlook.

Occasional semen leakage is usually not a reason to worry. But if the leakage is frequent or the amount of leakage is concerning or causing distress, then see your doctor.

This is especially true if you have other symptoms, such as:

  • blood in your semen or urine
  • foul-smelling semen
  • changes in ejaculation
  • pain when urinating or ejaculating
  • discharge that doesn’t look like healthy or normal semen

These can all be signs of an underlying medical condition.

Semen leakage can be normal, though it can sometimes be messy and uncomfortable. If you’re a young man, you may grow out of it. If you’re older than 40, be sure to ask your doctor about any recommended screenings for prostate health.

If you’ve noticed a change in the amount or frequency of semen leakage or other changes in your ejaculation, take note and talk to your doctor.