Adult Section: Nocturnal Emission, Varicocele, and Frequency of Sexual Intercourse

46. ​​Is it normal to still experience nocturnal emissions after marriage?

As everyone knows, when a man's semen accumulates to a certain level in his body, it will be expelled through nocturnal emission under the regulation of mental and neurological factors. This is what traditional Chinese medicine calls "sperm overflowing when full." So, is it normal for a man to still experience nocturnal emission after marriage?

The average age of first ejaculation in teenagers is about 14 years old, and it marks the beginning of puberty in boys. For unmarried men, 1-2 ejaculations per month, or occasionally a few more, are considered normal. After marriage and the establishment of regular sexual activity, the frequency of ejaculation will significantly decrease or cease. However, if ejaculation still occurs after marriage with regular sexual activity, it requires a case-by-case analysis.

Newlywed young men often experience a surge in sex hormones, leading to frequent sexual urges, strong libido, and a high volume and rapid production of sperm and semen. A frequency of 1-2 sexual encounters per week may not be sufficient to fully satisfy their sexual desire, resulting in nocturnal emissions. This should not be considered pathological. As men age, their sex hormone levels gradually decline, libido decreases, and nocturnal emissions will naturally cease after marriage. However, if a man continues to experience frequent nocturnal emissions despite regular sexual activity after marriage, then this is abnormal. Generally speaking, nocturnal emissions after marriage can be categorized into several situations.

(1) Physical weakness refers to situations such as excessive indulgence after marriage, overwork, insufficient nutrition, and being in the recovery period of an illness.

(2) Excessive indulgence in sexual stimulation: If a person is too focused on sexual stimulation after marriage, or excessively consumes pornographic stimulation (such as frequently watching pornographic films or reading pornographic books), a continuous sexual excitation focus will exist in the cerebral cortex, causing a series of related nerves to become excited and active, resulting in nocturnal emission.

(3) If couples live apart, and sexual activity is frequent after marriage, nocturnal emission may occur if the couple temporarily lives apart or if the frequency of sexual activity changes for some reason, resulting in fewer sexual encounters and the strong sexual desire cannot be fully "released".

Many people may worry that nocturnal emission will affect their health. In fact, seminal plasma is over 90% water. The nutrients it contains, such as fructose, sorbitol, albumin, and cholesterol, as well as inorganic salts like sodium, zinc, magnesium, potassium, and chlorine, and vitamin B₁₂, are present in negligible amounts. Sperm only accounts for 0.1% of semen, and the amount of semen ejaculated at one time is only 2-5 ml. These insignificant substances will not affect health. However, if nocturnal emission occurs too frequently after marriage, it is abnormal and a doctor should be consulted promptly.

47. What are those worm-like things you feel in your scrotum?

One patient complained of a heavy feeling in his scrotum, with something resembling earthworms inside. This was more noticeable after standing for a while and disappeared when lying down. Could it be intestinal worms? Actually, no. This is a common condition called varicocele.

Varicocele refers to the abnormal dilation, elongation, and tortuosity of the pampiniform plexus within the spermatic cord, and is classified as primary or secondary. The main causes are external compression during spermatic vein return, or the absence or dysfunction of spermatic vein valves, leading to impaired venous return and accumulation on the scrotal surface, forming a worm-like appearance. Because standing affects venous return, it often becomes more noticeable after prolonged standing.

Long-term varicocele can cause increased testicular temperature, insufficient perfusion, and hypoxia. Simultaneously, metabolic products secreted by the adrenal glands and kidneys, such as steroids, catecholamines, and serotonin, can flow retrogradely through the spermatic veins into the testes, affecting testicular blood supply and thus impairing spermatogenesis. Current research indicates that patients with unilateral varicocele and a normal spermatic cord on the other side may also experience infertility or abnormal sperm quality. This may be because there are communicating vessels between the testes, allowing metabolic products from the affected testis to flow to the contralateral testis, affecting its spermatogenesis.

Currently, the treatment of varicocele varies depending on factors such as whether the patient has infertility or abnormal semen quality, the presence of clinical symptoms, the degree of varicocele, and the presence of other complications. Surgical treatment is currently the primary approach. Surgical methods include traditional open surgery (common approaches include the retroperitoneal approach and the transperitoneal groove approach), microsurgery, laparoscopic surgery, and interventional embolization. For secondary varicocele, the underlying disease should be actively identified and treated.

48. How often is it appropriate to have sex?

We all know that the body is in a relatively fatigued state after sexual activity because it is a relatively strenuous activity. Sexual arousal causes a series of physiological changes in multiple systems of the body, including the nervous, circulatory, respiratory, digestive, and urinary systems. However, if the body is in an unhealthy state or does not exercise regularly, sudden sexual activity may trigger a myocardial infarction. Especially after a long period of abstinence from sex, sudden sexual activity can disrupt the body's balance and lead to various diseases.

Regular and harmonious sexual activity is a booster for life. It not only releases sexual energy in the body, but also activates various tissues and organs, creating a virtuous cycle. Current research has confirmed the benefits of regular sexual activity.

(1) Regular sexual activity can lead to longevity. Men who have sex twice or more per week have a 50% lower chance of dying prematurely than those who have sex once or less per month. In particular, those with high-frequency sexual activity have half the probability of developing coronary artery disease, such as stroke and cerebral thrombosis, compared to those with infrequent sexual activity.

(2) Regular sexual activity can reduce the incidence of breast cancer. Oxytocin in the human body is fully released during orgasm and high excitement. This substance can protect the mammary glands, especially for women who have never been pregnant. High-quality and regular sex can make up for the lack of childbirth.

(3) Regular sexual activity can reduce the incidence of prostate cancer.

(4) Regular sexual activity can strengthen a person's immune system and resist colds. What kind of sexual activity is considered regular? Actually, it mainly depends on the body's condition. Generally speaking, for those under 35 years old, 1 to 2 times a week is appropriate; for those between 35 and 50 years old, about once a week; and for those over 50 years old, if their physical condition permits, 1 to 2 times a month.