Medical News Today: Reasons for discharge in males

Share on Pinterest

Normal discharge includes preejaculate and ejaculate. These are released from the tip of the penis during sexual arousal and intercourse.

Although not strictly penile discharge, smegma is another substance that may build up around the head of the penis.

The sections below will cover these types of normal male discharge in more detail.

Preejaculate

Preejaculatory fluid, or precum, is a thick alkaline mucus produced in the bulbourethral glands. The bulbourethral glands, or Cowper’s glands, are two pea-sized glands located below the prostate gland.

During sexual stimulation, the bulbourethral glands secrete up to 4 milliliters (ml) of preejaculate into the urethra.

Preejaculatory fluid may:

• function as a lubricant for semen
• lubricate the tip of the penis during intercourse
• neutralize acidity left by urine residue in the urethra
• neutralize vaginal acidity

Whereas the bulbourethral glands release preejaculatory fluid, it is the testes that release sperm. Nonetheless, a 2011 study found that some preejaculate contains live sperm. Preejaculatory samples from the participants contained up to 23 million sperm.

Researchers are not sure whether preejaculate is contaminated immediately before ejaculation or contaminated with sperm leftover from a previous ejaculation.

Ejaculate

Ejaculate, or semen, is a milky, cloudy fluid that travels through the urethra and out of the penis following sexual stimulation. This process is called ejaculation, and it usually happens during orgasm.

Healthy sperm concentrations in semen are around 15–150 million sperm per ml of semen.

Sperm are produced in the testes. They then mature inside ducts located behind the testes. These ducts are called the epididymis and the vas deferens.

During sexual stimulation, the sperm mix with seminal fluid to form semen. Seminal fluid is a whitish liquid produced by the prostate glands and glands called the seminal vesicles.

Sperm make up a small part of semen. Semen is composed of the following:

• 1–5% sperm
• around 5% secretions from the bulbourethral glands
• 15–30% secretions from the prostate
• fluid from the seminal vesicle

Smegma

Smegma is a thick, white substance made up of skin cells, skin oils, and moisture. It is secreted by the sebaceous glands in the skin around the genitals. In males, smegma tends to build up between the head of the penis and the foreskin.

Smegma is a natural lubricant that helps keep the genitals moist and enables the foreskin to retract during sexual intercourse.

However, smegma buildup may produce a foul odor and can act as a breeding ground for bacteria. Washing the penis once per day with clean, warm water will help reduce smegma buildup.

That said, males should avoid washing the penis too frequently with soap or shower gel, as these products can cause irritation and soreness.

The presence of male discharge at times other than sexual stimulation may signal an underlying health concern. We describe some of these in the sections below.

Balanitis

Balanitis refers to inflammation of the skin around the head of the penis. When the inflammation also affects the foreskin, it is known as balanoposthitis.

Some symptoms of balanitis include:

• thick, lumpy discharge that is either white or yellow
• an unpleasant smell
• a red, inflamed rash or swelling
• irritation, soreness, itching, or burning
• pain when urinating

Many factors can cause balanitis, including:

• Poor hygiene: The area underneath the foreskin requires regular cleaning. Dead skin cells, urine residue, and sweat provide the ideal environment for irritation-causing bacteria to breed.
• Allergies: Urine, soaps, condoms, and lubricants can irritate the skin on the penis.
• Skin conditions: Eczema, psoriasis, or lichen sclerosus may cause redness and inflammation.
• Infection: Bacterial or fungal infections can make the head of the penis sore, tender, and itchy.
• Sexually transmitted infections (STIs): STIs such as herpes simplex virus (HSV) can cause blistering and inflammation in the area around the genitals.

Both circumcised and uncircumcised males can develop balanitis. However, one 2017 study found that balanitis is 68% less prevalent among circumcised males than uncircumcised males.

Trichomoniasis

Trichomoniasis is a common infection that affects around 3.7 million people in the United States. The parasite Trichomonas vaginalis causes trichomoniasis.

Around 70% of people with trichomoniasis do not experience any symptoms. If symptoms do occur in males, they may include:

Urethritis

Urethritis is characterized by inflammation of the urethra, and it can be infectious or noninfectious.

Urethritis often develops as a result of an STI. If it develops due to gonorrhea, it is called gonococcal urethritis. If the cause is unknown, it is called nongonococcal urethritis.

Over 40% of people with nongonococcal urethritis do not experience symptoms.

However, some males may experience the following symptoms:

• cloudy or white discharge from the tip of the penis
• irritation and soreness at the urethral opening
• a burning sensation when urinating
• a frequent need to urinate
• testicular pain or swelling

The following pathogens can also cause urethritis:

• Neisseria gonorrhoeae
• Chlamydia trachomatis
• Mycoplasma genitalium
• Trichomonas vaginalis
• HSV
• Epstein-Barr virus
• adenovirus

C. trachomatis is the most common cause of nongonococcal urethritis. It accounts for around 15–40% of cases.

Urethritis can also result from vigorous sex, masturbation, and urinary tract infections (UTIs).

UTIs

UTIs are a common type of bacterial infection. They affect part of the urinary system. The urinary system includes the bladder, kidneys, and urethra.

UTIs occur when bacteria from the skin or rectum enter the urethra and cause infection in the urinary tract.

UTIs tend to be more common in females, who have shorter urethras that are closer to the rectum. This makes it easier for bacteria to enter the urethra and reach the bladder and kidneys.

However, males can also develop UTIs. Males with a UTI may experience symptoms such as:

• cloudy urine that contains pus
• red, pink, or brown urine that contains blood
• pain or a burning sensation when urinating
• a need to urinate more than usual
• strong-smelling urine
• nausea or vomiting

Factors that increase the risk of developing a UTI include:

A person cannot pass a UTI to a sexual partner. However, the person may experience pain and discomfort during sex.

STIs

STIs can spread from person to person as a result of unprotected sexual activity and genital contact.

STIs that may cause abnormal penile discharge include:

Chlamydia

Chlamydia is the most reported STI in the U.S. However, most people with chlamydia are unaware that they have it, as it often does not cause any symptoms.

C. trachomatis is the cause of chlamydia. These bacteria can infect the urethra, rectum, and throat.

In males, chlamydia may cause the following symptoms:

• white, cloudy, or watery penile discharge
• itching or burning at the tip of the penis
• a burning sensation when urinating
• testicular pain

Gonorrhea

Gonorrhea is a common infection in the U.S., particularly among adolescents and young adults.

N. gonorrhoeae is the cause of gonorrhea. These bacteria can infect the urethra and rectum. Sometimes, the infection may also affect the eyes, throat, and joints.

Symptoms of gonorrhea in males include:

• white, yellow, or green penile discharge
• inflammation of the foreskin
• pain or a burning sensation when urinating
• swelling in one testicle

A male should see a doctor if they experience discharge from the penis that is not any of the following:

• urine
• preejaculate
• ejaculate
• smegma

To determine what is causing the penile discharge, a doctor may:

• ask about the person’s symptoms
• make a note of their medical and sexual history
• examine the affected area of the penis
• ask for a urine sample to identify signs of a UTI
• swab the affected area and analyze the swab for bacteria and viruses

After identifying the cause of the discharge, the doctor will determine the best course of treatment.

Discharge from the penis that happens during sexual arousal, as a result of sexual intercourse, and after ejaculation is normal.

Abnormal discharge tends to:

• have an unusual color
• have a foul odor
• occur without sexual activity
• be accompanied by pain, burning, or other symptoms

In these instances, the discharge could be a sign of a medical condition that needs evaluation and treatment. It is important to make an appointment with a doctor.