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Updated: 28-November-2023
Introduction
Hyperspermia is a condition when a man produces a larger volume of semen than normal (6.3mL or greater) regularly after 3 days of abstinence.
Semen, the substance a man ejaculates during orgasm, consists of mostly seminal fluid (95%) by volume, as well as the sperm (5%).
However, men with hyperspermia usually have double the amount of seminal fluid which significantly lowers sperm concentration.
Keeping in mind that seminal fluid is made up of secretions from the seminal vesicles, prostate and bulbourethral glands, around 65, 30 and 5% respectively. Therefore, any dysfunction in either of these accessory glands can present as hyperspermia (or hypospermia).
Nevertheless, hyperspermia on average affects 5% of the male population. Even though sexual intercourse extracts a greater volume of semen, compared to masturbation, these males are more likely to be subfertile due to their total sperm count being diluted, poor sperm motility and elevated sperm DNA fragmentation index.
Men with hyperspermia should go and see a doctor if:
- You normally do not produce large volumes of semen. (i.e. temporary hyperspermia)
- Unable to conceive a child despite 1 year of frequent and unprotected intercourse.
Symptoms of Hyperspermia
Symptoms of hyperspermia can include:
- More than average semen volume
- Very high or low sex drive
- Premature or delayed ejaculation
- Pain during ejaculation
- Urinary dysfunction
- Yellow colored semen
More than average semen volume is the first sign of hyperspermia. These men are likely to have either very high or very low sex drive, and premature or delayed ejaculation, depending on the underlying cause of their hyperspermia.
Men may also experience pain in the pelvic region especially during ejaculation. While inflammation of the reproductive organs causes urinary dysfunction like needing to urinate frequently (including at night time), weak urine flow and inability to empty bladder.
Lastly, some men with hyperspermia may also produce yellow coloured semen which is a cause for concern if regular.
Diagnosis of Hyperspermia
Diagnosis of hyperspermia usually involves the following:
- Physical examination
- Semen analysis
- Imaging
- Blood and urine tests
A preliminary diagnosis of hyperspermia is made after an abnormal semen analysis result for semen volume (≥6.3mL) .
The doctor will then request blood and urine tests, plus imaging of the reproductive organs, to help identify contributing factors and make a final diagnosis.
Causes of Hyperspermia
Hyperspermia is mostly caused by:
- Prolonged abstinence
- Inflammation
- Genetics
In many cases, hyperspermia can be caused by prolonged abstinence beyond 3 days, where semen volume continues to increase at a rate of 0.4ml/day.
Inflammation (i.e. infection) of the accessory glands is also known to cause hyperspermia. As expected, the more widespread the infection and or inflammation (biltaeral vs monolateral prostate-vesiculo-epididymitis), the more likely men are to display hyperspermia.
In other cases, genetics is believed responsible for abnormally large seminal vesicles which produce 65% of the total semen volume.
Treatment of Hyperspermia
Hyperspermia can be treated via:
- Regular ejaculation
- Medication
- Assisted Reproductive Technology (ART)
Acute (sudden) hyperspermia is usually treatable according to the cause. Regular ejaculation is recommended in non-inflammatory cases.
While inflammation of the male accessory glands is treated with appropriate medication according to the diagnostic results. This can include antibiotics, probiotics, nonsteroidal anti-inflammatory drugs, glucocorticosteroids, PDE5 inhibitors (e.g. Tadalafil), alpha1-blockers (e.g. alfuzosin) or mast cell stabilizers.
Chronic (genetic) hyperspermia is usually treated using ART such as intrauterine insemination (IUI) or in vitro fertilization (IVF) during conception difficulties. This allows the semen sample to be improved using various laboratory techniques before IUI or IVF.
References
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Lotti F, et al. (2022) The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: Prostate-vesicular transrectal ultrasound reference ranges and associations with clinical, seminal and biochemical characteristics. https://doi.org/10.1111/andr.13217
Weisstanner C, et al. (2022). Distended Seminal Vesicles Are Involved in Specific Cerebral Sexual Arousal: A Pilot Study Using Functional Brain Imaging in Young Healthy Men. https://doi.org/10.1016/j.euros.2022.05.008
Zhu C, et al. (2022). Influence of sperm DNA fragmentation on the clinical outcome of in vitro fertilization-embryo transfer (IVF-ET). https://doi.org/10.3389/fendo.2022.945242
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Ikyernum J, et al. (2019). Semen Profile of Men Presenting with Infertility at First Fertility Hospital Makurdi, North Central Nigeria. https://doi.org/10.5923/j.cmd.20190902.02
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Taniguchi H, et al. (2017). Relationship between volume of the seminal vesicles and sexual activity in middle-aged men. https://doi.org/10.1111/and.12618
Khan M, et al. (2012). Seminal Volume in the Investigation of Male Infertility. https://pubmed.ncbi.nlm.nih.gov/22414356/
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Abid N, et al. (2006). Prevalence of hypospermia and hyperspermia and their relationship with genital tract infection in tunisian infertile men. https://link.springer.com/content/pdf/10.1007/BF03034856.pdf
La Vignera S, et al. (2006). Mono or bilateral inflammatory postmicrobial prostato-vesciculo-epididymitis: differences in semen parameters and reactive oxygen species production. https://pubmed.ncbi.nlm.nih.gov/17213793/
Feingold K R, et al. (2000). Endotext. https://www.ncbi.nlm.nih.gov/books/NBK279008/table/benign-prstate-dsrdr.T.the_composition_o/
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Purvis K, et al. (1986). Ejaculate composition after masturbation and coitus in the human male. https://doi.org/10.1111/j.1365-2605.1986.tb00902.x
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