Dear Dr. G,

I am so sorry to trouble you with my disorder but I have nowhere to turn to for help. I really need your wisdom and advice regarding my problem.

My problem is every time I am with my girlfriend for example dinner and outing (non-sexual context), I began to produce pre-ejaculate without any control.

Even though I am not thinking anything with sex or engaging in sex but the emission still happens. Furthermore, I also produce more pre-ejaculate talking (by phone) with my girlfriend.

After some time of emission I will start to feel pain in my testes.

My body is out of control and produces pre-ejaculate. I do not know if it’s my brain, hormone or pelvic floor muscle the one causing problem.

I strictly will not engage in any sexual context but pre-ejaculate production still happens. I have to masturbate each time the pre-ejaculate happens to stop the testicular pain.

With this in mind, I really would like to put Dr. G on the spot.

What exactly is pre-ejaculate? Why is it affecting me that badly?

I understand Finasteride is one medicine used to treat emission. Does this medicine have high success rate in stopping this pre-ejaculate emission?

Is there any other medicine or treatment to cure this problem?

Do I have to take medicine for the rest of my life?

Thank you for the platform and your help so much Dr. I also appreciate your work in educating the public on medical matters. Hope to receive good news soon.

Early Edward

Pre-ejaculatory fluid or pre-seminal fluid, also colloquially known as pre-cum is the penile secretion emitted by the Cowper’s gland near the tip of the penis. The emission is generally clear, colourless and slightly viscous liquid. The secretion is also medically termed the Cowper’s secretion, which occurs at different stages of arousal, either during foreplay, masturbation or penetrative intercourse. The most copious amount of pre-cum is emitted just prior to climax and the propulsion of semen.

It is generally believed the pre-ejaculate functions as lubricant during penetration, and acid neutralizer for the optimization of sperm passage. The constituent of pre-ejaculatory fluid is similar to semen, which contains acid phosphatase responsible to neutralize the urethral acidity caused by the urine and the hostile environment of the cervix. Although pre-jaculatory fluid may play a role in procreation and recreation, the importance is questionable as some men do not produce the fluid and continue to enjoy normal sexual and reproductive functions.

The exact amount of pre-cum is rather variable between individuals and various state of the sexual arousal. Although for most men, emission is hardly noticeable, while others can emit as much as 5mls of pre-cum even without sexual thoughts. Such excessive pre-cum is commonly observed in younger men, and the problem diminishing with advancing age. As pre-cummming has no association with sensual feelings, it can be embarrassing and frustrating for the sufferers. The wetness of the undergarments is often mistaken as ejaculate by the partners. In rare cases, some men even reported the squirting of the pre-cum similar to the actual climax. Some men may even encounter scrotal discomfort when experiencing pre-ejaculation emission. This is usually non-threatening and transient in nature.

Many sufferers with copious pre-cum report a significant impact on their sexual confidence! Certain studies have highlighted as many as one in ten young adults or adolescent affected by excessive emission. However, due to the taboo and lack of awareness, the true scale of excessive pre-ejaculate is largely unknown. Majority of sexual health experts believe the there is no correlation between excessive pre-cum and ill health. One theory proposed the high levels of testosterone amongst young men is inducing excessive secretion. Some researchers even stipulate the link of male pattern baldness with excessive pre-ejaculate.

Even though the correlation of high testosterone and over-production of pre-ejaculate is uncertain, attempts have been made to treat excessive pre-cum with medications to suppress androgen. A few case reports have indicated an effective reduction of pre-seminal fluid secretion by reducing the active component of testosterone in circulation. Although the use of medications such as finasteride and dutasteride has demonstrated success in treating such over-production, sadly this is not just wiping off the pre-cum, it can have the potential to wipe out libido and erection all together!

Mahatma Gandhi once said: “Healthy discontent is the prelude to progress!” Indeed, when it cums to the journey of sexual experience, the initial stages of over excitement and arousal may result in the excessive emission, which should be viewed as a nuisance instead of a threat. As the sexual maturation and control are achieved with more experience, the loss of the pre-cum is generally observed. When Dr. G is put on the spot for his views for the treatment of excessive pre-cum with medications, his response is: “The troubling prelude to climax is a healthy discontent, allowing the natural progression of sexual journey is the only way ensuring a dry happy ending!”

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