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About Arthur Goldstein, M.D.
Expertise
Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience
I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations
American Medical Association, American Urological Association, American College of Surgeons
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You are here: Experts > Health/Fitness > Urology > Urology > Yellow-ish somewhat odorous pre-ejaculate
Expert: Arthur Goldstein, M.D.
Date: 10/2/2008
Subject: Yellow-ish somewhat odorous pre-ejaculate
Question
I am a 24 year old male. I am currently on Accutane 80 mg
daily (2 x 40 mg) and because of this my triglyceride count
is quite high (255 at least blood test). I have been on
Accutane for a bit over 3 months so far. I am from Bossier
City, Louisiana, US.
I've noticed that underwear has yellow-ish stains in front
when I wake up. To investigate I masturbated and noticed
that my pre-ejaculate is no longer clear but a solid color
with a yellow tint to it. When I wipe it on a tissue it
stains it yellow. It also has a slight unpleasant odor to
it. My semen is white and has not changed.
I am currently not sexually active (last sexual intercourse
was a bit over 4 years ago :(). My diet is not anything out
of the ordinary compared to any other college student. I
can't think of anything that has drastically changed in the
past few months except for my starting to take Accutane. My
hair has started to thin more recently and I can see my
scalp through my hair now which I hear has to do with
problems with testosterone metabolism.
Thank you
Answer
Arthur, pre-ejaculate ("precum") is a normal secretion of a mucous like material from the paired Cowper glands that empty into a man's proximal urethra. The glands are analogous to the Bartholin glands located at vaginal introitus. The discharge they produce is in response to sexual arousal. The amount of pre-ejaculate varies with each individual but will be greater if one has not been sexually stimulated for a while. The function of a man's pre-ejaculate is to lubricate the urethra thus allowing the semen to be discharged more easily. This discharge theoretically does not contain sperm although small amounts could possible leak into it. The Cowper glands gradually become smaller with age and the secretion, likewise, lessens over time. If the color of this secretion has changed and is malodorous, you may have an infection in the urethra.
Discharge from the urethra is a common symptom that is called "urethritis". If thick and discolored (ie yellow, brown, green, etc.) it
may be due to gonorrhea (GC) or another STD. As the color of the discharge is not totally reliable and because of your sexual history, it is unlikely that you have a STD. A clear or slightly opaque discharge is usually not due to GC or a STD but to non-venereal bacteria (like Staph or Strep) or a parasite called Trichomonas. These are referred to as "non-specific urethritis" or NSU.
In order to determine the cause, it is necessary to see your family physician or a urologist. The etiology of this type of urethritis can be determined by culturing & microscopically examining the discharge. If the culture demonstrates a bacterial infection, an appropriate antibiotic is prescribed. Trichomonas is treated with medication the most common being Flagyl.
Another common cause of NSU is fluid seeping out of the prostate gland. The prostate gland manufactures the major component of your semen in response to sexual stimulation. When a man becomes sexually aroused (foreplay, dreams, fantasies, etc.) and does not ejaculate, this fluid accumulates in the prostate gland. In such an instance, stool can push on the congested prostate causing a discharge of its fluid from the urethra (it acts like a massage of the gland). Likewise, as one urinates, the bladder contracts to expel urine. As the bladder squeezes out the last few drops, it also compresses the prostate. If the latter is congested, prostatic fluid will appear at the end of urination. Prostatic fluid discharge is also often noted just with sexual arousal in men with congested glands. This type of discharge is not in itself harmful and in itself does not require antibiotic therapy. However, chronic congestion of the prostate may predispose to inflammation of the prostate gland, so called prostatitis. Periodic ejaculation in moderation (1-2 times a week) will help to prevent this phenomenon from happening.
The bottom line is that you need to see a physician (ideally a urologist) so that a proper diagnosis can be made. After this, appropriate treatment can be instituted. Good luck.
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