Prostatitis, an inflammation of the prostate gland, is a common condition that can affect male sexual health and fertility. As the most prevalent prostate issue for men under 50, it can stem from bacterial infections or have no identifiable cause. The inflammation interferes with the prostate’s functions, which can lead to changes in semen and pain during ejaculation.
The Prostate’s Role in Semen Production
The prostate is a small, walnut-shaped gland located below the bladder. Its primary function is to produce seminal fluid, a milky substance that makes up a large portion of semen. This fluid is biochemically complex and designed to support sperm.
Prostatic fluid contains several components. It has citric acid, which is believed to play a role in liquefying coagulated semen after ejaculation. The fluid also includes enzymes like prostate-specific antigen (PSA), which helps break down the semen’s gel-like structure, allowing sperm to swim more freely. Other substances, such as zinc, are secreted to stabilize sperm chromatin.
Changes in Semen Appearance and Composition
One of the consequences of prostate inflammation is a change in the physical characteristics of semen. The fluid may appear yellowish, a sign that white blood cells or pus are present. Its consistency can also be affected, becoming thicker and clumpier, or conversely, more watery than usual. The volume of ejaculate might also decrease because the inflamed gland may not produce its normal amount of fluid.
An alarming symptom is the presence of blood in the semen, a condition called hematospermia. This can give the semen a pink, red, or brownish tint and is a result of inflammation affecting blood vessels within the prostate or seminal vesicles. While often temporary, its appearance indicates that medical evaluation is warranted.
The inflammation from prostatitis can alter the semen’s chemical environment, making it less hospitable for sperm and affecting fertility. This can negatively impact several sperm health parameters:
- Sperm concentration may be reduced, meaning fewer sperm are in the ejaculate.
- Sperm motility, their ability to move effectively, can be impaired.
- Sperm morphology, or their shape and structure, can be abnormal.
- Sperm DNA fragmentation can occur, where genetic material becomes damaged.
Damaged sperm DNA can compromise embryo development even if fertilization occurs, potentially making a successful pregnancy more difficult.
Ejaculatory Discomfort and Pain
Pain during or immediately after ejaculation is a common symptom of prostatitis. This discomfort occurs because the muscular contractions of orgasm can aggravate the inflamed prostate gland. The pain is described as a burning sensation or a deep ache.
Men may experience this pain directly in the penis, but it is also felt in the perineum, the area between the scrotum and the anus. The discomfort can radiate to the lower back, testicles, or suprapubic region, just above the pubic bone. The intensity can range from mild annoyance to severe pain that causes significant sexual dysfunction and emotional distress.
Semen Analysis in Prostatitis Diagnosis
When prostatitis is suspected, particularly if fertility is a concern, a semen analysis is a useful diagnostic tool. This laboratory test involves examining a sample of ejaculate to evaluate both the fluid and the sperm it contains. For diagnosing prostatitis, technicians look for markers of inflammation and infection within the seminal fluid.
An elevated number of white blood cells, known as pyospermia, is a primary indicator of an inflammatory or infectious process. If bacterial prostatitis is suspected, the semen can be cultured to identify the specific microorganism and guide antibiotic treatment. The analysis also measures sperm health parameters previously discussed, such as count and motility, to assess the impact on fertility.