Male discharge is any fluid from the penis that isn’t urine. It can be a normal bodily fluid or a sign of an underlying health condition. Recognizing the difference between normal and abnormal discharge is important for knowing when to seek medical attention.
Understanding Normal Male Discharge
Normal male discharge includes fluids naturally produced by the body, primarily in response to sexual arousal or during ejaculation.
Pre-ejaculate, also known as precum, is a clear, mucoid fluid that emerges from the penis during sexual arousal. This fluid, produced by the Cowper’s glands, helps to lubricate the urethra and neutralize any residual acidity from urine, preparing the pathway for semen. While typically free of sperm, pre-ejaculate can sometimes contain sperm cells, making pregnancy possible even without full ejaculation.
Semen, or ejaculate, is the white, cloudy, and often gooey substance expelled from the penis during orgasm. It consists of sperm produced in the testes combined with fluids from the prostate, seminal vesicles, and Cowper’s glands. This mixture allows for sperm transport and survival.
Smegma is a thick, white or yellowish substance that can accumulate under the foreskin, especially in uncircumcised men. Composed of dead skin cells, natural oils, and moisture, smegma is considered a skin condition rather than a true discharge. While it aids in lubrication, poor hygiene can lead to its buildup, potentially fostering bacterial growth and causing odor.
Characteristics and Causes of Abnormal Discharge
Abnormal male discharge is any fluid from the penis that occurs outside of sexual activity or shows changes in its color, consistency, or smell. The amount of discharge can vary from a minimal wetness to a copious flow that stains underwear. Such discharge often comes with other symptoms like painful urination, discomfort during sexual activity, itching, burning, swelling, or fever.
Sexually transmitted infections (STIs) are frequent causes of abnormal discharge. Gonorrhea, caused by Neisseria gonorrhoeae, often results in a copious, pus-like discharge (yellow, green, or white), along with painful or frequent urination and testicular tenderness. Chlamydia, caused by Chlamydia trachomatis, can produce a white, cloudy, watery, or clear discharge, sometimes with a foul smell. Many men with chlamydia experience no symptoms, making it a silent infection.
Trichomoniasis, caused by a parasite, can lead to a thin, white, watery discharge, sometimes accompanied by a “fishy” odor. Similar to chlamydia, most men infected with trichomoniasis are asymptomatic. Other bacterial infections like Mycoplasma genitalium and Ureaplasma can also cause discharge, often appearing scarcer than that of gonorrhea or chlamydia.
Beyond STIs, several non-STI conditions can cause abnormal discharge. Urethritis, an inflammation of the urethra, can stem from various bacterial infections not sexually transmitted, viral infections like adenovirus, or even irritation from soaps or physical trauma. Symptoms typically include discharge ranging from clear to purulent, along with itching, tingling, or painful urination.
Balanitis, an inflammation of the head of the penis, is more common in uncircumcised men due to the moist environment under the foreskin. It can be caused by fungal infections, bacterial infections, poor hygiene, or irritants. Discharge from balanitis may be white, thick, or foul-smelling, often accompanied by redness, pain, itching, swelling, and difficulty retracting the foreskin.
A male yeast infection, specifically Candida balanitis, is a fungal infection caused by an overgrowth of Candida. This condition can result in a thick, white discharge resembling cottage cheese, a foul smell, burning, itching, irritation, redness, and sores on the penis. Urinary tract infections (UTIs) in men, while less common, can also cause clear or pus-tinged discharge, frequent and painful urination, cloudy urine, and sometimes fever. Prostatitis, an inflammation of the prostate gland, may also lead to a thick, white, foul-smelling discharge, lower back pain, and frequent urges to urinate.
When to Seek Medical Care
Seek medical attention for abnormal penile discharge, especially if it’s not related to sexual arousal. Consult a doctor promptly if you notice any of the following:
- Changes in discharge color, texture, frequency, or smell.
- Accompanying symptoms like pain, burning during urination, itching, swelling of the penis or testicles, or fever.
- Possible exposure to a sexually transmitted infection.
Self-diagnosis and self-treatment are not recommended, as accurate identification is essential for effective treatment and preventing complications.
Medical Evaluation and Treatment
A medical evaluation for penile discharge typically involves a thorough discussion of symptoms and sexual history, followed by a physical examination. Diagnostic tests are then performed to identify the underlying cause. These tests commonly include urine tests, such as a first-void urine sample or a leukocyte esterase test, and urine cultures to detect bacterial infections. Swab tests of the discharge itself are also frequently conducted, with the sample sent to a laboratory for analysis, including DNA-based testing for common STIs like chlamydia and gonorrhea.
Treatment for penile discharge is tailored to its specific cause. If a bacterial infection, including most STIs, is identified, antibiotics are prescribed. Common antibiotics include azithromycin, doxycycline, ceftriaxone, or cefixime. It is important to complete the entire course of antibiotics as prescribed, even if symptoms improve, to ensure the infection is fully eradicated.
For yeast infections, antifungal medications are used, available as topical creams, ointments, or oral treatments for more severe cases (e.g., miconazole, clotrimazole, nystatin, fluconazole). For non-infectious inflammation (e.g., balanitis, urethritis), treatment may involve steroid creams, avoiding irritants, and improving hygiene. If an STI is diagnosed, partner notification and retesting after treatment are often advised. Avoiding sexual activity during treatment is also recommended to prevent further transmission.