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Pre-ejaculate on the glans of the penis

Pre-ejaculate (also known as pre-ejaculatory fluid, pre-seminal fluid or Cowper's fluid, and colloquially as pre-cum) is a clear, colorless, viscous fluid that is emitted from the urethra of the penis during sexual arousal and in general during sexual activity. It is similar in composition to semen but has distinct chemical differences. The presence of sperm in the fluid is variable from low to absent. Pre-ejaculate functions as a lubricant and an acid neutralizer.

Origin and composition

The fluid is discharged from the urethra of the penis during arousal, masturbation, foreplay or at an early stage during sexual intercourse, some time before the individual fully reaches orgasm and semen is ejaculated. It is primarily produced by the bulbourethral glands (Cowper's glands), with the glands of Littré (the mucus-secreting urethral glands) also contributing. [1] [2] The amount of fluid that is issued varies widely among individuals. Some individuals do not produce any pre-ejaculate fluid, [3] while others emit as much as 5  ml (0.18 imp fl oz; 0.17 US fl oz). [1] [4]

Pre-ejaculate fluid contains chemicals associated with semen, such as acid phosphatase, but other semen markers, such as gamma-glutamyltransferase, are absent. [5]

Function and risks

Pre-ejaculate neutralizes acidity in the urethra caused by residual urine, creating a more favorable environment for the passage of sperm. [2] The vagina is normally acidic, so the deposit of pre-ejaculate before the emission of semen may change the vaginal environment to promote sperm survival. [1] Pre-ejaculate also acts as a lubricant during sexual activity, [1] and plays a role in semen coagulation. [1]

Low levels or no sperm exists in pre-ejaculate, although studies examined small samples of men. [4] [6] Two contrary studies found mixed evidence, including individual cases of a high sperm concentration. [7] [8] There is evidence – dating to a 1966 Masters and Johnson study [9] – that pre-ejaculate may contain sperm that can cause pregnancy, which is a common basis of argument against the use of coitus interruptus (withdrawal) as a contraceptive method. [4] [6]

Studies have demonstrated the presence of HIV in most pre-ejaculate samples from infected men. [6] [10] [11]

Overproduction

In rare cases, an individual may produce an excessive amount of pre-ejaculate fluid, which may be treatable by a 5-alpha-reductase inhibitor, such as finasteride. [1]

References

  1. ^ a b c d e f Chudnovsky, A.; Niederberger, C.S. (2007). "Copious Pre-Ejaculation: Small Glands—Major Headaches". Journal of Andrology. 28 (3): 374–5. doi: 10.2164/jandrol.107.002576. PMID  17251594.
  2. ^ a b Chughtai B, Sawas A, O'Malley RL, Naik RR, Ali Khan S, Pentyala S (April 2005). "A neglected gland: a review of Cowper's gland". Int. J. Androl. 28 (2): 74–7. doi: 10.1111/j.1365-2605.2005.00499.x. PMID  15811067. S2CID  32553227.
  3. ^ Vazquez E (1997). "Is it safe to suck?". Posit Aware. 8 (4): 15. PMID  11364482.
  4. ^ a b c Zukerman Z.; Weiss D.B.; Orvieto R. (April 2003). "Short Communication: Does Preejaculatory Penile Secretion Originating from Cowper's Gland Contain Sperm?". Journal of Assisted Reproduction and Genetics. 20 (4): 157–159. doi: 10.1023/A:1022933320700. PMC  3455634. PMID  12762415.
  5. ^ Gohara WF (1 February 1980). "Rate of decrease of glutamyltransferase and acid phosphatase activities in the human vagina after coitus". Clinical Chemistry. 26 (2): 254–7. doi: 10.1093/clinchem/26.2.254. PMID  6101549.
  6. ^ a b c "Researchers find no sperm in pre-ejaculate fluid". Contraceptive Technology Update. 14 (10): 154–156. October 1993. PMID  12286905.
  7. ^ Killick SR, Leary C, Trussell J, Guthrie KA (2011). "Sperm content of pre-ejaculatory fluid". Human Fertility. 14 (1): 48–52. doi: 10.3109/14647273.2010.520798. PMC  3564677. PMID  21155689.
  8. ^ Kovavisarach, E.; Lorthanawanich, S.; Muangsamran, P. (2016). "Presence of Sperm in Pre-Ejaculatory Fluid of Healthy Males". J Med Assoc Thai. 99 (Suppl 2): S38–41. ISSN  0125-2208. PMID  27266214.
  9. ^ Masters, W.H. (1966). Johnson, V.E. Boston, MA: Little, Brown and Company. p. 211.
  10. ^ Pudney J, Oneta M, Mayer K, Seage G, Anderson D (1992). "Pre-ejaculatory fluid as potential vector for sexual transmission of HIV-1". Lancet. 340 (8833): 1470. doi: 10.1016/0140-6736(92)92659-4. PMID  1360584. S2CID  7106584.
  11. ^ Ilaria G, Jacobs JL, Polsky B, et al. (1992). "Detection of HIV-1 DNA sequences in pre-ejaculatory fluid". Lancet. 340 (8833): 1469. doi: 10.1016/0140-6736(92)92658-3. PMID  1360583. S2CID  43112865.