Part 29: Definition, Causes, and Pathological Assessment of Nocturnal Emission

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Nocturnal emission

Nocturnal emission refers to ejaculation that occurs without sexual intercourse or masturbation. For adult men, 1-3 nocturnal emissions per month, with no discomfort or only mild fatigue the following day, are considered normal physiological phenomena. However, if the frequency of nocturnal emissions increases to more than 2 times per week, or even several times a night, accompanied by certain changes in sexual function and neuropsychiatric symptoms, it is considered pathological nocturnal emission. Nocturnal emission can be further divided into wet dreams and spermatorrhea. The former refers to ejaculation during a sexually aroused dream; generally, as long as it is not too frequent, it will not cause symptoms and is a normal sexual physiological phenomenon. The latter refers to nocturnal emission without dreams, or even spontaneous leakage of semen while awake; it is mostly a pathological phenomenon.

What are the causes of nocturnal emission?

The conditions that trigger nocturnal emission are called inducing factors. Some inducements exist in a single way, while others are caused by multiple factors. Common ones include: prolonged absence of nocturnal emission, which increases the sensitivity of the seminal vesicles to testosterone; extreme fatigue after strenuous physical or mental labor, resulting in deep sleep and enhanced activity of the subcortical centers; exposure to pornography, movies, and television, especially during the day when sexual awareness is strong; and the influence of certain strongly sexually stimulating environments; a full bladder, penile erection, frequent and rapid eye movements; irritation and itching caused by phimosis or smegma; stimulating the genitals; lying on one's back; a warm bed; and pressure on the genitals from heavy bedding; tight pants restricting the erect penis; strong sexual desire during puberty, which makes the penis easier to erect; and excessive sexual activity such as fantasizing, masturbation, and overindulgence, which causes prostate congestion and pathological excitation of the spinal ejaculation center.

Is nocturnal emission after exercise a medical condition?

There are three main reasons why the frequency of nocturnal emission increases after exercise:

1. Exercise accelerates blood circulation, which enhances the function of various organ systems, including the reproductive organs. After exercise, the blood flow through the testes, prostate, and seminal vesicles increases, resulting in more semen and a higher frequency of nocturnal emissions.

2. After physical exercise, the reverse activity of the central nervous system and the function of the autonomic nervous system are enhanced, the excitability of the erection center increases, which can easily cause sexual nerve reversal, leading to congestion of the sexual organs, generating sexual impulses, and thus nocturnal emission.

3. Some young men may experience nocturnal emissions due to wearing tight sportswear, prolonged stimulation or friction from certain sports equipment, excessive fatigue after exercise, or being covered with too thick a blanket.

In short, a slight increase in the frequency of nocturnal emissions after exercise is not a sign of illness or physical weakness, and there is no need to worry.

Nocturnal emission after marriage is a pathological condition.

From puberty onwards, a boy's reproductive organs produce semen continuously. When the semen volume reaches saturation, it is released through nocturnal emission. Therefore, nocturnal emission is a form of ejaculation that occurs outside of sexual intercourse. Generally speaking, after marriage and the commencement of normal sexual activity, nocturnal emission will significantly decrease or cease.

Some men, even after marriage and living together, typically have sexual intercourse 1-2 times a week and ejaculate successfully, still experience nocturnal emissions, sometimes quite frequently. Medically, if, under normal sexual conditions after marriage, nocturnal emissions occur every few days or more than 4 times a month, it should be considered pathological. So, what aspects might be causing this? The causes can generally be sought from the following aspects:

1. Psychological disorder: Although there is normal sexual life after marriage, one is still very addicted to sexual stimulation and focuses too much on sexual issues. There is a continuous excitation focus in the brain, which makes a series of sexual nerves under its command very excited and active, which can easily induce nocturnal emission.

2. Urogenital diseases: Many urogenital diseases in men, such as phimosis, redundant foreskin, urethritis, prostatitis, seminal vesiculitis, etc., cause congestion and edema in the affected organs due to inflammation and other irritations, leading to increased glandular secretion. The adjacent sexual organs also become congested, especially the penis, which is easily stimulated during sleep and prone to spontaneous erection, often resulting in nocturnal emission.

3. Physical Condition and Pathological State: Modern medicine believes that when a person is weak, the central nervous system may become dysfunctional, and sexual function may sometimes be disordered, leading to nocturnal emission or impotence. Traditional Chinese medicine believes that the human body is an organic whole. Although the five internal organs each have their own functions, they coordinate and complement each other, and they also influence each other pathologically. The production and circulation of semen in men are related to important organs such as the heart, liver, and kidneys. If these organs are diseased or their functions are not ideal, their relationship will be disrupted, inevitably leading to physical weakness and potentially inducing nocturnal emission. In addition, overwork, malnutrition, congenital deficiency, mental fatigue, and invasion of pathogenic factors can all lead to dysfunction of the heart, liver, and kidneys, causing a physical condition and inducing nocturnal emission.

It should be noted that newlywed men often have a strong libido and frequent sexual urges. If they only have sexual intercourse at the usual frequency, they often cannot achieve sufficient release, so they are prone to nocturnal emissions, which is naturally not considered pathological. This condition usually disappears on its own as the novelty wears off.

Does nocturnal emission affect fertility?

Nocturnal emission refers to ejaculation without sexual intercourse. Semen is a mixture of sperm produced by the testes and secretions from the seminal vesicles, prostate gland, and urethral glands. Its main components are water, small amounts of protein, fat, and carbohydrates. Occasional nocturnal emission has no impact on health. It is mostly normal for unmarried men, and even married men who have not had sexual intercourse for a long time may experience it. Nocturnal emission generally does not adversely affect fertility. However, if it is accompanied by premature ejaculation or erectile dysfunction, the inability to have sexual intercourse will naturally affect fertility. Occasional nocturnal emission, with normal sexual intercourse, will not have any impact on fertility.