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Low ejaculatory volume: Symptoms, Causes, Treatment and Home Remedies

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Symptoms, Causes, Treatment and Home Remedies

Weak Ejaculation: Symptoms, Causes, Treatment and Home Remedies

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Medically reviewed by Judith Marcin, M. D. — By Stephanie Watson — Updated on February 24, 2023

If you’re experiencing problems with ejaculation, age is a likely culprit. Seeing your doctor for diagnosis and treatment can help.

What is weak ejaculation?

If you don’t ejaculate with as much force as you used to, it’s likely because you’re growing older. Just as age weakens your muscles and changes your eyesight, it can reduce both the strength and volume of your ejaculation.

Every ejaculation releases semen from your body through your penis. The process happens in two stages:

  • During the first stage, called emission, semen (sperm-containing fluid) collects in the urethral bulb at the base of your penis.
  • During the second stage, called expulsion, muscles around your urethra squeeze to push the semen out through your penis.

A problem in the first stage of this process can reduce the amount of semen you ejaculate. A problem with the second stage can reduce the force with which semen is expelled.

Weak ejaculation is largely subjective, meaning it’s often noticed by the person. Orgasm intensity varies from man to man. Though ejaculation may feel weaker than normal to you, it may not be a problem unless it impacts your enjoyment of sex. A weaker orgasm may not feel as satisfying as a stronger one.

A bigger issue is if you ejaculate less fluid or sperm. This can be a problem if you plan to have children. Other common age-related problems are trouble getting an erection (erectile dysfunction) or having an orgasm (anorgasmia).

Sexual problems can be hard to discuss, even with your doctor. Yet being open about what’s happening can help you find a solution and prevent weak ejaculation from affecting your sex life.

Any condition that affects the muscles and nerves controlling ejaculation can lead to a weaker-than-normal orgasm.

Weakened pelvic muscles

Age takes its toll on the muscles that push semen out of your body. When these muscles weaken, the force of your ejaculation can decline.

Low hormone levels

A satisfying sex life relies on male hormones called androgens. As you get older, levels of these hormones decline. A significant drop in levels can lead to weaker orgasms.

Retrograde ejaculation

Each time you ejaculate, semen travels down your urethra and out through your penis. A valve acts like a gate between your bladder and urethra. It prevents semen from getting into your bladder.

If this valve stays open, semen can travel back into your bladder instead of flowing out of your penis. This condition is called retrograde ejaculation. Your orgasms may be weak or completely dry.

Causes of retrograde ejaculation include:

  • surgery to treat prostate or testicular cancer, an enlarged prostate gland, or a weak urine stream
  • drugs used to treat prostate enlargement, high blood pressure, and depression
  • nerve damage caused by diseases like multiple sclerosis or diabetes
  • spinal cord injury

Perceived ejaculate volume reduction (PEVR) means you release less semen than you once did. PEVR is a common type of ejaculatory dysfunction in men.

PEVR can be a side effect of treatment for cancer and other conditions. Or it may be a sign of a problem with male hormone production. PEVR typically occurs alongside other problems with ejaculation and erection.

Low ejaculate volume has been linked to these conditions:

  • radiation of the prostate gland for cancer
  • medications used to treat an enlarged prostate gland, high blood pressure, and depression
  • diabetes
  • problem with the testes that leads to low or no male hormone production

How your doctor treats weak ejaculation depends on what caused it. A few drugs can help treat retrograde ejaculation by keeping your bladder closed while you ejaculate. These can include:

  • brompheniramine (Veltane)
  • chlorpheneriamine (Chlor-Trimeton)
  • ephedrine (Akovaz)
  • pseudoephedrine (Sudafed)
  • imipramine (Tofranil)
  • midodrine (ProAmatine, Orvaten)

If an alpha blocker or other drug you’re taking causes weak ejaculation, ask your doctor if you can switch to another medication. If you have diabetes, getting it under the best control possible can also help.

Home remedies

To strengthen the muscles that help you ejaculate, you can try Kegel exercises. During these exercises, you squeeze and release the muscles you use to control urination. One small study showed an improvement in premature ejaculation following 12 weeks of pelvic floor muscle training, including Kegel exercises.

Supplements

A few supplements have been promoted for treating weak ejaculation. However, there’s no evidence these products work. And because many herbal supplements can cause side effects, don’t take anything without first asking your doctor.

A normal sperm count is between 15 million to more than 200 million sperm in each milliliter (ml) of semen. Your doctor will diagnose you with a low sperm count if you have less than 15 million sperm per ml of semen, or you release less than 39 million sperm each time you ejaculate.

Having a low sperm count can reduce your odds of conceiving a child. Here are a few tips to help boost your sperm count.

  • Get 7 to 9 hours of quality sleep each night. Research finds that men who get too little or too much sleep, or who go to bed late, have lower sperm counts and less healthy sperm than those who routinely get enough sleep.
  • Exercise — but not too intensely. Being overweight can reduce both the quantity and quality of your sperm. Exercise may improve semen quality by altering hormone levels. Just limit long-term intense physical training, which may actually reduce your sperm count and quality.
  • Don’t smoke. In addition to causing cancer and heart disease, smoking affects sperm counts and quality. Talk to your doctor about a smoking cessation program, or consider using an app to help you quit for good.
  • Get more antioxidants like vitamins C and E, selenium, and lycopene in your diet. These natural plant substances may protect cells — including sperm — from damage. In one study, higher levels of antioxidants in semen were found in men who had higher sperm counts.
  • Eat fewer trans fats. High levels of these unhealthy fats, which are often found in fried foods and unhealthy baked goods, have been linked to a lower sperm count.

If these methods don’t work, a doctor may prescribe medication to help increase your sperm count. A variety of hormonal treatments like clomiphene citrate (Serophene) and follitropin alfa lyophilisate (Gonal-f) may be used to treat this problem.

However, while many of these treatments are approved for women, use by men is considered “off-label.” That is, although they may be effective for the treatment of male infertility, these medications aren’t approved by the U.S. Food and Drug Administration for this use. If your doctor recommends off-label use of one of these medications, it’s important to take that medication under their supervision. Learn more about off-label medication use.

It can be difficult to talk about sexual problems with your doctor. But only by having this conversation can you get help with ejaculation issues.

See your doctor if:

  • Your ejaculations are weak or contain less fluid than usual.
  • You can’t get an erection.
  • You have pain during or after sex.
  • There’s blood in your semen.
  • Your urine is cloudy after you orgasm.

Problems with ejaculation are common in men, particularly as they age. If your sexual function has changed in any way, see a doctor for proper evaluation and treatment.

Last medically reviewed on May 1, 2018

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

  • Alwaal A. (2015). Normal male sexual function: emphasis on orgasm and ejaculation. Fertility and Sterility.DOI:  
    10.1016/j.fertnstert. 2015.08.033
  • Ask the doctor: Weak ejaculation: Cause for worry? (2014).
    health.harvard.edu/mens-health/ask-the-doctor-weak-ejaculation-cause-for-worry
  • Cancer can affect a man’s ability to ejaculate. (2017).
    cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-men-with-cancer/ejaculation-and-treatment.html
  • Chavarro JE. (2014). Trans fatty acid intake is inversely related to total sperm count in young healthy men. DOI:
    10.1093/humrep/det464
  • Chudnovsky A. (2013). Copious pre-ejaculation: Small glands – major headaches. DOI:
    10.2164/jandrol.107.002576
  • Corona G. (2011). Perceived ejaculate volume reduction in patients with erectile dysfunction: psychobiologic correlates [Abstract]. DOI:
    10.2164/jandrol.110.010397
  • Dabaja AA, et al. (2014). Medical treatment of male infertility. DOI:
    10.3978/j.issn.2223-4683.2014.01.06
  • Diabetes and sexual and urologic problems. (2008).
    niddk.nih.gov/health-information/diabetes/overview/preventing-problems/sexual-urologic-problems
  • Ducharme S. (n.d.). Ejaculation problems: Too fast, too slow or not at all?
    bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/
  • Esakky P. (2016). Paternal smoking and germ cell death: A mechanistic link to the effects of cigarette smoke on spermatogenesis and possible long-term sequelae in offspring. DOI:
    10.1016/j.mce.2016.07.015
  • Jensen TK. (2013). Association of sleep disturbances with reduced semen quality: A cross-sectional study among 953 healthy young Danish men. DOI:
    10.1093/aje/kws420
  • Jiann B-P. (2016). The office management of ejaculatory disorders. DOI:
    10. 21037/tau.2016.05.07
  • P. (2017). The impact of intense exercise on semen quality. DOI:
    Jóźków10.1177/1557988316669045
  • Killick SR. (2011). Sperm content of pre-ejaculatory fluid. DOI:
    10.3109/14647273.2010.520798
  • Lepor H. (2005). Pathophysiology of lower urinary tract symptoms in the aging male population.
    ncbi.nlm.nih.gov/pmc/articles/PMC1477625/
  • Liu M-M. (2017). Sleep deprivation and late bedtime impair sperm health through increasing antisperm antibody production: A prospective study of 981 healthy men. DOI:
    10.12659/MSM.900101
  • Mayo Clinic Staff. (2015). Kegel exercises for men: Understand the benefits.
    mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074
  • Mayo Clinic Staff. (2016). Retrograde ejaculation.
    mayoclinic.org/diseases-conditions/retrograde-ejaculation/symptoms-causes/syc-20354890
  • Mayo Clinic Staff. (2017). Low sperm count.
    mayoclinic.org/diseases-conditions/low-sperm-count/diagnosis-treatment/drc-20374591
  • Pastore AL, et al. (2014). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. DOI:
    10.1177/1756287214523329
  • Rosety MA. (2017). Exercise improved semen quality and reproductive hormone levels in sedentary obese adults. DOI:
    10.20960/nh.549
  • Silberstein T. (2016). Antioxidants and polyphenols: Concentrations and relation to male infertility and treatment success. DOI:
    10.1155/2016/9140925
  • What causes ED? (n.d.).
    urologyhealth.org/urologic-conditions/erectile-dysfunction/causes

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Feb 24, 2023

Written By

Stephanie Watson

Edited By

Kerry Weiss

May 1, 2018

Written By

Stephanie Watson

Edited By

Kerry Weiss

Medically Reviewed By

Judith Marcin, MD

Share this article

Medically reviewed by Judith Marcin, M. D. — By Stephanie Watson — Updated on February 24, 2023

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    Semen analysis, also known as the sperm count test, analyzes the health of a man’s sperm. Semen is the fluid containing sperm that is released during…

    READ MORE

  • Kegel Exercises for Men: Do They Work?

    Medically reviewed by Graham Rogers, M.D.

    Kegel exercises are used to treat a variety of conditions in women, but research suggests they may also help men. Learn how Kegel exercises might…

    READ MORE

  • Everything You Should Know About Retrograde Ejaculation

    Medically reviewed by Graham Rogers, M.D.

    Learn what causes retrograde ejaculation, how to treat it, and the effects if has on fertility.

    READ MORE

  • Pelvic Floor Dysfunction

    Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI

    Pelvic floor dysfunction is a condition that affects your ability to control your pelvic floor muscles. Learn about the symptoms and treatment options.

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Symptoms, Causes, Treatment and Home Remedies

Weak Ejaculation: Symptoms, Causes, Treatment and Home Remedies

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      • IBD
      • Migraine
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Medically reviewed by Judith Marcin, M. D. — By Stephanie Watson — Updated on February 24, 2023

If you’re experiencing problems with ejaculation, age is a likely culprit. Seeing your doctor for diagnosis and treatment can help.

What is weak ejaculation?

If you don’t ejaculate with as much force as you used to, it’s likely because you’re growing older. Just as age weakens your muscles and changes your eyesight, it can reduce both the strength and volume of your ejaculation.

Every ejaculation releases semen from your body through your penis. The process happens in two stages:

  • During the first stage, called emission, semen (sperm-containing fluid) collects in the urethral bulb at the base of your penis.
  • During the second stage, called expulsion, muscles around your urethra squeeze to push the semen out through your penis.

A problem in the first stage of this process can reduce the amount of semen you ejaculate. A problem with the second stage can reduce the force with which semen is expelled.

Weak ejaculation is largely subjective, meaning it’s often noticed by the person. Orgasm intensity varies from man to man. Though ejaculation may feel weaker than normal to you, it may not be a problem unless it impacts your enjoyment of sex. A weaker orgasm may not feel as satisfying as a stronger one.

A bigger issue is if you ejaculate less fluid or sperm. This can be a problem if you plan to have children. Other common age-related problems are trouble getting an erection (erectile dysfunction) or having an orgasm (anorgasmia).

Sexual problems can be hard to discuss, even with your doctor. Yet being open about what’s happening can help you find a solution and prevent weak ejaculation from affecting your sex life.

Any condition that affects the muscles and nerves controlling ejaculation can lead to a weaker-than-normal orgasm.

Weakened pelvic muscles

Age takes its toll on the muscles that push semen out of your body. When these muscles weaken, the force of your ejaculation can decline.

Low hormone levels

A satisfying sex life relies on male hormones called androgens. As you get older, levels of these hormones decline. A significant drop in levels can lead to weaker orgasms.

Retrograde ejaculation

Each time you ejaculate, semen travels down your urethra and out through your penis. A valve acts like a gate between your bladder and urethra. It prevents semen from getting into your bladder.

If this valve stays open, semen can travel back into your bladder instead of flowing out of your penis. This condition is called retrograde ejaculation. Your orgasms may be weak or completely dry.

Causes of retrograde ejaculation include:

  • surgery to treat prostate or testicular cancer, an enlarged prostate gland, or a weak urine stream
  • drugs used to treat prostate enlargement, high blood pressure, and depression
  • nerve damage caused by diseases like multiple sclerosis or diabetes
  • spinal cord injury

Perceived ejaculate volume reduction (PEVR) means you release less semen than you once did. PEVR is a common type of ejaculatory dysfunction in men.

PEVR can be a side effect of treatment for cancer and other conditions. Or it may be a sign of a problem with male hormone production. PEVR typically occurs alongside other problems with ejaculation and erection.

Low ejaculate volume has been linked to these conditions:

  • radiation of the prostate gland for cancer
  • medications used to treat an enlarged prostate gland, high blood pressure, and depression
  • diabetes
  • problem with the testes that leads to low or no male hormone production

How your doctor treats weak ejaculation depends on what caused it. A few drugs can help treat retrograde ejaculation by keeping your bladder closed while you ejaculate. These can include:

  • brompheniramine (Veltane)
  • chlorpheneriamine (Chlor-Trimeton)
  • ephedrine (Akovaz)
  • pseudoephedrine (Sudafed)
  • imipramine (Tofranil)
  • midodrine (ProAmatine, Orvaten)

If an alpha blocker or other drug you’re taking causes weak ejaculation, ask your doctor if you can switch to another medication. If you have diabetes, getting it under the best control possible can also help.

Home remedies

To strengthen the muscles that help you ejaculate, you can try Kegel exercises. During these exercises, you squeeze and release the muscles you use to control urination. One small study showed an improvement in premature ejaculation following 12 weeks of pelvic floor muscle training, including Kegel exercises.

Supplements

A few supplements have been promoted for treating weak ejaculation. However, there’s no evidence these products work. And because many herbal supplements can cause side effects, don’t take anything without first asking your doctor.

A normal sperm count is between 15 million to more than 200 million sperm in each milliliter (ml) of semen. Your doctor will diagnose you with a low sperm count if you have less than 15 million sperm per ml of semen, or you release less than 39 million sperm each time you ejaculate.

Having a low sperm count can reduce your odds of conceiving a child. Here are a few tips to help boost your sperm count.

  • Get 7 to 9 hours of quality sleep each night. Research finds that men who get too little or too much sleep, or who go to bed late, have lower sperm counts and less healthy sperm than those who routinely get enough sleep.
  • Exercise — but not too intensely. Being overweight can reduce both the quantity and quality of your sperm. Exercise may improve semen quality by altering hormone levels. Just limit long-term intense physical training, which may actually reduce your sperm count and quality.
  • Don’t smoke. In addition to causing cancer and heart disease, smoking affects sperm counts and quality. Talk to your doctor about a smoking cessation program, or consider using an app to help you quit for good.
  • Get more antioxidants like vitamins C and E, selenium, and lycopene in your diet. These natural plant substances may protect cells — including sperm — from damage. In one study, higher levels of antioxidants in semen were found in men who had higher sperm counts.
  • Eat fewer trans fats. High levels of these unhealthy fats, which are often found in fried foods and unhealthy baked goods, have been linked to a lower sperm count.

If these methods don’t work, a doctor may prescribe medication to help increase your sperm count. A variety of hormonal treatments like clomiphene citrate (Serophene) and follitropin alfa lyophilisate (Gonal-f) may be used to treat this problem.

However, while many of these treatments are approved for women, use by men is considered “off-label.” That is, although they may be effective for the treatment of male infertility, these medications aren’t approved by the U.S. Food and Drug Administration for this use. If your doctor recommends off-label use of one of these medications, it’s important to take that medication under their supervision. Learn more about off-label medication use.

It can be difficult to talk about sexual problems with your doctor. But only by having this conversation can you get help with ejaculation issues.

See your doctor if:

  • Your ejaculations are weak or contain less fluid than usual.
  • You can’t get an erection.
  • You have pain during or after sex.
  • There’s blood in your semen.
  • Your urine is cloudy after you orgasm.

Problems with ejaculation are common in men, particularly as they age. If your sexual function has changed in any way, see a doctor for proper evaluation and treatment.

Last medically reviewed on May 1, 2018

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

  • Alwaal A. (2015). Normal male sexual function: emphasis on orgasm and ejaculation. Fertility and Sterility.DOI:  
    10.1016/j.fertnstert. 2015.08.033
  • Ask the doctor: Weak ejaculation: Cause for worry? (2014).
    health.harvard.edu/mens-health/ask-the-doctor-weak-ejaculation-cause-for-worry
  • Cancer can affect a man’s ability to ejaculate. (2017).
    cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-men-with-cancer/ejaculation-and-treatment.html
  • Chavarro JE. (2014). Trans fatty acid intake is inversely related to total sperm count in young healthy men. DOI:
    10.1093/humrep/det464
  • Chudnovsky A. (2013). Copious pre-ejaculation: Small glands – major headaches. DOI:
    10.2164/jandrol.107.002576
  • Corona G. (2011). Perceived ejaculate volume reduction in patients with erectile dysfunction: psychobiologic correlates [Abstract]. DOI:
    10.2164/jandrol.110.010397
  • Dabaja AA, et al. (2014). Medical treatment of male infertility. DOI:
    10.3978/j.issn.2223-4683.2014.01.06
  • Diabetes and sexual and urologic problems. (2008).
    niddk.nih.gov/health-information/diabetes/overview/preventing-problems/sexual-urologic-problems
  • Ducharme S. (n.d.). Ejaculation problems: Too fast, too slow or not at all?
    bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/
  • Esakky P. (2016). Paternal smoking and germ cell death: A mechanistic link to the effects of cigarette smoke on spermatogenesis and possible long-term sequelae in offspring. DOI:
    10.1016/j.mce.2016.07.015
  • Jensen TK. (2013). Association of sleep disturbances with reduced semen quality: A cross-sectional study among 953 healthy young Danish men. DOI:
    10.1093/aje/kws420
  • Jiann B-P. (2016). The office management of ejaculatory disorders. DOI:
    10. 21037/tau.2016.05.07
  • P. (2017). The impact of intense exercise on semen quality. DOI:
    Jóźków10.1177/1557988316669045
  • Killick SR. (2011). Sperm content of pre-ejaculatory fluid. DOI:
    10.3109/14647273.2010.520798
  • Lepor H. (2005). Pathophysiology of lower urinary tract symptoms in the aging male population.
    ncbi.nlm.nih.gov/pmc/articles/PMC1477625/
  • Liu M-M. (2017). Sleep deprivation and late bedtime impair sperm health through increasing antisperm antibody production: A prospective study of 981 healthy men. DOI:
    10.12659/MSM.900101
  • Mayo Clinic Staff. (2015). Kegel exercises for men: Understand the benefits.
    mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074
  • Mayo Clinic Staff. (2016). Retrograde ejaculation.
    mayoclinic.org/diseases-conditions/retrograde-ejaculation/symptoms-causes/syc-20354890
  • Mayo Clinic Staff. (2017). Low sperm count.
    mayoclinic.org/diseases-conditions/low-sperm-count/diagnosis-treatment/drc-20374591
  • Pastore AL, et al. (2014). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. DOI:
    10.1177/1756287214523329
  • Rosety MA. (2017). Exercise improved semen quality and reproductive hormone levels in sedentary obese adults. DOI:
    10.20960/nh.549
  • Silberstein T. (2016). Antioxidants and polyphenols: Concentrations and relation to male infertility and treatment success. DOI:
    10.1155/2016/9140925
  • What causes ED? (n.d.).
    urologyhealth.org/urologic-conditions/erectile-dysfunction/causes

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Feb 24, 2023

Written By

Stephanie Watson

Edited By

Kerry Weiss

May 1, 2018

Written By

Stephanie Watson

Edited By

Kerry Weiss

Medically Reviewed By

Judith Marcin, MD

Share this article

Medically reviewed by Judith Marcin, M. D. — By Stephanie Watson — Updated on February 24, 2023

Read this next

  • Semen Analysis and Test Results

    Medically reviewed by Alana Biggers, M.D., MPH

    Semen analysis, also known as the sperm count test, analyzes the health of a man’s sperm. Semen is the fluid containing sperm that is released during…

    READ MORE

  • Kegel Exercises for Men: Do They Work?

    Medically reviewed by Graham Rogers, M.D.

    Kegel exercises are used to treat a variety of conditions in women, but research suggests they may also help men. Learn how Kegel exercises might…

    READ MORE

  • Everything You Should Know About Retrograde Ejaculation

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main indicators and their norms

Do not understand what all the terms in the spermogram mean? Our article will help you decipher the results and understand which indicators are important when evaluating sperm to optimize your chances of pregnancy.

Spermogram is the main type of test carried out to assess the quality of male sperm. The results of this analysis can help identify the causes of male infertility and determine whether the quantity and quality of sperm is within the norm.

The main semen parameters include semen volume, semen concentration, sperm motility and shape. The norms of these indicators may vary depending on age, health status and other factors, therefore, the results of the spermogram should be interpreted only with a doctor.

If you are planning a pregnancy or have difficulty with it, do not hesitate to contact a urologist-andrologist for a consultation and spermogram appointment.

Spermogram: what is it?

Spermogram is a study that provides information about the parameters of a man’s sperm. It is one of the most important research methods in determining male reproductive health.

During a spermogram, parameters such as the concentration of sperm, their movement and shape are evaluated. Each of these parameters has its own normative values, which are determined by medical practice.

In order to carry out the analysis, it is necessary to donate semen and prepare accordingly. For example, you must abstain from sex for at least 2-5 days, as well as avoid drinking alcohol and smoking for a few days before taking the test.

The main purpose of a spermogram is to determine a man’s ability to have a child and to identify the presence of possible diseases associated with impaired sperm function. The results of the research are dedicated to the norms set by medical authorities, which are determined on the basis of hundreds of thousands of studies and practices of medical care.

Prescribing and conducting a spermogram

A spermogram is a laboratory study that is carried out to assess the main characteristics of male sperm.

The main task of the spermogram is to assess the quality of sperm and determine its ability to fertilize the egg. Also, a spermogram can help identify the cause of infertility and prescribe an effective treatment.

For the test, a man needs to donate sperm to a specially equipped laboratory. Semen is collected by masturbation into a sterile container. Before collecting sperm, it is necessary to refrain from sexual intercourse for 2-5 days in order to maximize the quality of sperm.

The obtained semen is placed under a microscope and evaluated on the basis of the following parameters: the number of spermatozoa per semen volume unit, their motility and shape. The study is carried out using special solutions that help assess the concentration of spermatozoa.

As a result of the spermogram, you can obtain data on the quality and quantity of sperm, as well as their mobility and shape. The norms of all parameters are strictly defined, and deviations from them may indicate possible problems with the fertility of a man.

Terms and conditions for taking the analysis

To obtain reliable results of the spermogram, it is important to follow certain rules and conditions when passing it.

Before taking the test, you must do the following:

  • 3-5 days of abstinence from sexual intercourse and masturbation;
  • abstinence from alcohol and smoking 2-3 days before analysis;
  • avoid physical activity during the day before the test.

The analysis is given in a special sterile dish, which is issued in the laboratory. Fresh ejaculation must be provided. The man must stimulate sexual arousal and receive the ejaculate directly into the container.

The received material must be delivered to the laboratory promptly, within an hour after collection. Semen dislocation is disturbed at temperatures above 37°C, so you can not bring a sample in thermal thermoses or leave it in a car in the sun.

After passing the test, you can return to normal life, including sexual, but intimate hygiene must be observed.

Main indicators of semen analysis

Semen volume is the amount of fluid released during each ejaculation. The normal volume is 2 to 5 ml. A decrease in volume may indicate a violation of the secretory function of the reproductive system.

Sperm concentration is the number of sperm per unit volume. The normal concentration is from 20 to 200 million spermatozoa per 1 ml. A decrease in concentration may indicate a violation of the process of their formation or release.

The motility and shape of spermatozoa are the main indicators that determine their viability and ability to fertilize an egg. Normal motility is more than 50% of spermatozoa with active motility. The normal form of sperm is more than 30%. A deviation from the norm may indicate problems in the development or functioning of the male reproductive system.

Total sperm count is the number of sperm in all semen. The normal number is over 40 million sperm per ejaculate. A decrease in this indicator may mean a decrease in the number of spermatozoa or a deterioration in their quality.

Quantities:

Total sperm count is the number of sperm in 1 ml of ejaculatory fluid. The norm is from 15 to 200 million / ml. If the indicator is below 15 million / ml, then this is considered a low concentration of spermatozoa, which can lead to problems with fertilization.

Locomotive activity – the speed and ability of spermatozoa to move. It is evaluated by two parameters: movement (motility) and activity (progressive). Movement rates from 25% to 50%, and progressive activity from 20% to 45%. If the indicators are below the norm, then this indicates a violation of spermatogenesis, possible infectious diseases, as well as poor sperm quality in general.

Sperm morphology is an assessment of the shape and size of spermatozoa. Based on morphology, the proportion of spermatozoa with the correct shape and size, as well as with abnormalities, is determined. The normal form of spermatozoa should be between 4% and 14%. If the morphology indicator is below the norm, then this may indicate problems with fertilization.

Ejaculate volume is the amount of fluid released during ejaculation. The norm is from 1.5 to 5 ml. If the volume is below normal, then this may indicate problems with the function of the prostate or seminal vesicles.

The pH value of is the level of acidity of the ejaculatory fluid. The norm is from 7.2 to 8.0. If the pH value is beyond the norm, then this may indicate inflammatory processes in the genitourinary system.

Viscosity is an estimate of the density and viscosity of the semen. Normal viscosity should allow sperm to move easily and move freely. If the liquid is too viscous, then this can lead to problems with the penetration of sperm into the uterus.

Armed Forms are types of spermatozoa with some granules supplied with substances necessary to penetrate the egg. The assessment of this indicator is additional and may increase the chances of pregnancy.

Semen volume

Semen volume is one of the main indicators of the semen analysis and reflects the number of spermatozoa in the ejaculate. It is usually measured in milliliters (mL) and is an important indicator for evaluating male reproductive health.

The normal semen volume is between 1.5 and 5 ml, and it is desirable that the value is closer to the upper limit of normal.

  • If the semen volume is less than 1.5 ml, then this is less than the lower limit of the norm and may indicate disorders in the male reproductive system.
  • If the volume of semen is more than 5 ml, then this is above the upper limit of the norm, but is not a pathology.

A decrease in semen volume can be associated with various factors such as infections, hormonal disorders, stress, prostate disease and other diseases. An increase in semen volume, in turn, may be associated with excessive masturbation or sexual activity, but is not a pathology.

Comparison of normal and abnormal semen volume

Index
Normal range
Pathological range
Semen volume 1.5-5 ml Less than 1.5 ml or more than 5 ml

9 0010 Sperm concentration

Sperm concentration is the number of spermatozoa in one milliliter of ejaculate. This indicator is one of the most important in the spermogram, since the ability of a man to conceive a child depends on it. The normal concentration of sperm in the ejaculate is between 15 million and 200 million per milliliter. If the sperm concentration is below normal, then this can lead to infertility.

Depending on the concentration of sperm, a man can be divided into three categories:

  • Normospermia – sperm concentration is normal
  • Oligospermia – sperm concentration is below normal

    • 9 0041 Azoospermia – absence of spermatozoa in the ejaculate

Oligospermia and azoospermia can be caused by various reasons, such as infections, hormonal disorders, fever in the scrotum, bad habits and other factors, therefore, if abnormalities in sperm concentration are found, it is necessary to consult an andrologist.

Category
Sperm concentration

90 125 less than 15 million/ml

Normospermia 15-200 ppm
Oligospermia
Azoospermia no spermatozoa

Ejaculate sperm count

One of the most important indicators of spermogram is the number of spermatozoa in the ejaculate.

The total number of spermatozoa in the ejaculate is determined by multiplying the concentration of spermatozoa by the volume of the ejaculate.

The normal number of spermatozoa in the ejaculate is more than 15 million per 1 ml of fluid. However, if the sperm concentration is below this level, then the chances of conception can be significantly reduced.

In addition, it is also important to take into account the total number of spermatozoa in the ejaculate. Ideally, their number should be at least 39 million.

Low sperm count may be due to various factors such as stress, poor lifestyle, infections or pathologies of the genital organs. It is important to contact a specialist to identify the cause and how this indicator can be improved.

Sperm morphology

Sperm morphology is one of the key indicators of the spermogram and allows you to determine the proportion of normal sperm in the total mass.

The norm for spermatozoa morphology is that at least 4% of spermatozoa must have a normal shape, that is, three-quarters of the length of the head must be even and of the same width, taking into account the neck and tail. Deviations from the normal form of spermatozoa may be associated with problems in their creation or maturation, as well as with the presence of negative factors on the male body.

For a more detailed assessment of spermatozoa morphology, the Kruger classification system of spermatozoa is used, which estimates the proportion of abnormal forms in the total number of spermatozoa and divides it into several categories – normal form, mild, moderate and severe abnormality.

In case of detection of deviations from the norm of spermatozoa morphology, it is necessary to contact a specialist for a detailed consultation and identification of the causes of the problem, as well as the appointment of appropriate treatment.

Sperm motility

Sperm motility is one of the most important indicators of the spermogram. It determines the ability of spermatozoa to move and, consequently, their ability to fertilize an egg.

According to generally accepted standards, sperm motility is measured as a percentage of moving and stationary cells. According to the results of the spermogram, sperm motility can be divided into several categories.

  • Category A – fast and straight spermatozoa, predominantly moving forward, make up 25% or more.
  • Category B Slow and/or non-straight spermatozoa accounting for less than 25% and more than 50% of the total.
  • Category C – immotile spermatozoa accounting for less than 50% of the total.
  • Category D no spermatozoa.

Normal sperm motility is in categories A and B, while categories C and D indicate pathology.

Sperm motility can be measured as a whole or in categories A and B. This indicator can be a useful indicator of sperm quality and is an important factor for those couples who want to conceive a child. If a man has low sperm motility, then he can consult a doctor for additional examinations and treatment planning.

Sperm viscosity

Sperm viscosity is the ability of spermatozoa to stick together inside the ejaculate and form multilayer structures. This indicator is important in assessing the quality of sperm and may reflect the condition of the epididymis, as well as the quality of the prostate fluid.

Normal semen viscosity should be moderate, i.e. should not interfere with the movement of spermatozoa. Too high a viscosity can cause sperm to move more slowly and can also make it difficult for sperm to pass through the female reproductive tract.

Viscosity of semen can be assessed both visually and by measurement with a special apparatus – a viscometer. The normal viscosity of semen should be between 2 and 3 cm in 1 minute.

If the viscosity of the semen exceeds the norm, then it is necessary to pay attention to other indicators of the spermogram, such as the number and motility of spermatozoa, the shape of the head and body of the spermatozoa. If abnormalities are detected, it is necessary to contact a urologist to find out the causes of the violations and prescribe the appropriate treatment.

Qualitative indicators:

Semen volume: Determines the amount of spermatozoa in semen. Typically, the volume of semen during the examination is from 1.5 to 5 milliliters. Its decrease (oligospermia) or increase (polylicia) may indicate a man’s health problems.

Semen Viscosity: This is an indicator that characterizes the ability of sperm to move. If the semen is too viscous, then it is incapable of active movement and can lead to insufficient sperm count in the semen.

Sperm concentration: An indicator that characterizes the number of sperm in 1 milliliter of semen. The normal number of spermatozoa in the semen is from 15 to 200 million per 1 ml.

Sperm morphology: This is an indicator that characterizes the shape of spermatozoa. Spermatozoa must have the correct shape in order to be able to penetrate the egg. Usually there should be more than 30% of sperm with a normal shape.

Environmental reaction

Environmental reaction is an indicator of the acid-base balance of the semen. It affects the ability of sperm to move and intertwine with the egg. Typically, the reaction of the environment in the semen ranges from 7.2 to 8.0 pH units. If the pH level drops, then a change in the shape and mobility of the spermatozoa can occur.

The reaction of the medium can be determined using a test paper or with a pH meter. Usually, when analyzing semen, the reaction of the environment is one of the key indicators.

A change in environmental response can be caused by various factors: changes in diet, stress, bad habits, infection or other diseases.

The reaction of the environment must be normal to ensure the health of the male reproductive system. If the pH level deviates greatly from the norm, then this can lead to infertility and other problems. To restore the normal reaction of the environment, it is necessary to consult a doctor and carry out appropriate treatment.

Sperm viability time

Sperm viability time is the period of time during which the sperm cell can remain viable in the female body and retain the ability to fertilize the egg. This process is influenced by many factors, such as the acidity of the vagina, the presence of inflammatory processes and the presence of antisperm bodies in the body of a woman.

Normal sperm viability is between 48 and 72 hours. However, some spermatozoa can live inside the female body for up to 5 days. This is possible due to the peculiarities of the female reproductive system, namely, the presence in the cervical fluid of nutrients and trace elements necessary for the survival of spermatozoa.

It should also be noted that sperm viability can be significantly reduced when a woman has a bacterial infection, which may explain the difficulty in conceiving a child in some couples.

It is important to understand that each couple may have their own individual duration of sperm viability, so it is recommended to conduct additional research to more accurately determine the factors that affect fertility and the likelihood of conceiving a child.

Functional activity of spermatozoa

Functional activity of spermatozoa is an important indicator in assessing the quality of a man’s sperm. This indicator characterizes the ability of spermatozoa to move and penetrate the egg.

In the process of spermatogenesis, spermatozoa acquire the ability to actively move due to the formation of a tail. This process is complex and requires certain conditions, such as sufficient hormone levels and a certain temperature of the seminal fluid.

Evaluation of the functional activity of spermatozoa is carried out using a microscope and special preparations. The Kruger scoring system is used, in which spermatozoa are evaluated according to the following indicators:

  • The number of moving spermatozoa – the norm is more than 40% of the total;
  • Movement speed — the norm is 25 microns/sec;
  • Features of movement – the norm is rectilinear movement with fast and slow speeds;
  • Head shape – the norm is 80% of spermatozoa with a normal head shape;
  • The degree of sperm concentration – the norm is more than 15 million / ml;
  • Average volumetric concentration – the norm is more than 39 million / ejaculate;
  • Total sperm count – the norm is more than 39 million / ejaculate.

Violation of the functional activity of spermatozoa can be caused by various factors, such as infections, stress, bad habits, and more. This can lead to problems with conception and the birth of a healthy child, so the assessment of the functional activity of spermatozoa is an important step in assessing male reproductive health.

Norms of spermogram indicators

When interpreting the results of a spermogram, doctors pay attention to a number of parameters that indicate the state of the male reproductive system. The norms of spermogram indicators vary depending on the laboratory in which the study is carried out.

Some of the main indicators that are taken into account when deciphering the results of the spermogram include:

  • The number of spermatozoa should be at least 15 million in 1 ml of seminal fluid;
  • Mobility – not less than 40%;
  • Morphology — not less than 4%;
  • Semen volume – at least 1. 5 ml;
  • Semen acidity – within 7.2-7.8;
  • The number of protein bodies – less than 1 million in 1 ml of seminal fluid;
  • Viscosity – must be normal so that spermatozoa can easily penetrate the female genital tract.

If the results of the spermogram do not correspond to the norm in one or more indicators, the man must undergo an additional examination to identify the cause of the violation. In most cases, with violations of spermogram parameters in men, the violation may be associated with an unhealthy lifestyle, stress, environmental influences, as well as the presence of chronic diseases.

Evaluation of the result of the spermogram and its significance for the diagnosis and treatment of infertility

The spermogram is the main method for diagnosing male infertility. It allows you to assess the quality and quantity of sperm in the ejaculate, as well as determine the presence of possible deviations from the norm.

Spermogram results may vary and depend on many factors such as age, lifestyle, presence of diseases, etc. The evaluation of the results is carried out by a specialist and is based on such indicators as the concentration, motility and morphology of spermatozoa, the volume and pH of the ejaculate, the presence of leukocytes and other elements.

Sperm concentration is the amount of sperm contained in one milliliter of ejaculate. The normal value ranges from 15 to 200 million / ml. A low concentration may indicate a violation of spermatogenesis or other health problems in a man.

Sperm motility is the ability of spermatozoa to actively move. The normal value is 40 to 70% moving sperm. Low motility may be due to various factors such as infections, autoimmune diseases, and the presence of antisperm antibodies.

Sperm morphology is the percentage of normal and abnormal forms. The ideal value is considered to be from 14 to 40% of normal forms. Abnormal morphology may indicate various diseases, such as varicocele, gonadotropic imbalance, ovarian syndrome.

It is important to understand that spermogram results are not exhaustive information. They can explain the cause of infertility and help choose treatment methods, but do not guarantee a positive result. Consultation with a specialist and an individual approach to each case are necessary conditions for achieving the desired pregnancy.

Related videos:

Q&A:

What spermogram parameters are important for evaluating male reproductive function?

For the evaluation of male reproductive function, the most important parameters are the concentration and motility of spermatozoa, as well as the number of morphologically normal spermatozoa.

What is the normal concentration of spermatozoa in semen?

The normal value of sperm concentration in semen is from 15 to 200 million/ml. If the sperm concentration is below 15 million / ml, this may indicate problems with male reproductive function.

What does low sperm motility mean and what is the norm?

The normal value of sperm motility is more than 40%. If the sperm motility is less than this value, then they speak of their reduced mobility. This may be due to impaired sperm production, as well as the presence of inflammatory processes in the genitals.

What is the normal volume of semen?

Normal semen volume is 1.5 to 5 ml. If the semen volume is below 1.5 ml, this may indicate a malfunction in the functioning of the prostate gland.

Can damaged or abnormal spermatozoa fertilize an egg?

Yes, damaged and abnormal spermatozoa can fertilize an egg, but the chance of conception in such cases is greatly reduced. Normal morphological parameters of spermatozoa increase the chances of successful conception.

What could be the reasons for the low sperm count?

The reasons for low sperm concentration can be different: impaired sperm production in the testicles, inflammatory processes in the genital organs, metabolic disorders, bad habits, viral infections and other factors.

Is it possible to improve the concentration and quality of sperm?

Yes, the concentration and quality of sperm can be improved. To do this, you need to follow a healthy lifestyle, give up bad habits, eat right, increase physical activity, and avoid stressful situations. You can also take special drugs prescribed by your doctor to improve the quality and quantity of sperm.

Causes and treatments for decreased ejaculate volume

10/25/2022


4-6 minutes

10 451

Contents

  • Causes of low sperm count
  • Diagnostics
  • Treatment to increase sperm count
  • How to increase semen volume?
  • How to improve sperm quality: best practices
  • Abstinence and sperm quality

According to WHO, normal ejaculate volume is 1. 5 ml or more. At the same time, its amount can vary widely, in some cases reaching 15 ml. The question of why little sperm is released worries men primarily because many of them associate the volume of seminal fluid released after ejaculation with the ability to conceive. In fact, the fertility (ability to conceive) of a man does not depend on the amount of ejaculate, but on the concentration of spermatozoa in it¹ , ².

The number of germ cells in sperm changes throughout life. For successful conception, it is necessary that it be more than 15 million per milliliter of seminal fluid. A decrease in sperm count below this level is interpreted as oligozoospermia³.

Causes of low sperm count

There are many health-related factors that can lead to a decrease in the concentration of germ cells in the ejaculate. The most common among them are the following.


  • Varicocele     . The expansion of the veins in the scrotum provokes a violation of blood flow to the testicles, which, in turn, leads to an increase in temperature in them. Any temperature fluctuations negatively affect the production of spermatozoa.

  • Infectious diseases . Some infections are associated with the formation of scar tissue, due to which spermatozoa do not enter the ejaculate. These diseases include inflammation of the epididymis (epididymitis) or the testicle itself (orchitis), as well as some sexually transmitted infections, including gonorrhea and HIV.

  • Problems with ejaculation . Retrograde ejaculation is a condition in which seminal fluid is not ejected from the urethra, but enters the bladder. Many men who suffer from this problem notice that they produce little semen. Causes of retrograde ejaculation include diabetes, spinal injuries, tumors, pelvic surgery, and certain medications.
  • Presence of antisperm antibodies . These are immune system cells that mistake sperm for foreign agents and attack them. The appearance of antisperm antibodies may be due to trauma to the scrotum, the development of varicocele, oncological diseases of the genital organs, obstruction of the vas deferens, cryptorchidism, previous surgical interventions, infections, prostatitis.
  • Hormonal imbalance . The hypothalamus, pituitary gland, and testicles produce hormones that are necessary for the formation of spermatozoa. A change in the level of these hormones can lead to the development of oligozoospermia.

The quantity and quality of spermatozoa may depend on certain environmental factors.

These include:

  • contact with industrial chemicals or heavy metals;

  • exposure to radiation, including x-rays;

  • overheating of the testicles, for example, due to long sitting, wearing tight clothes.

Finally, lifestyle also has an impact on male fertility. Factors that can lower sperm count include:

  • drug use,

  • alcohol abuse,

  • smoking,

  • stress and depression

  • obesity³ , ⁴.

A timely appeal to a urologist or andrologist in many cases allows you to determine the exact cause of oligozoospermia and cope with the problem.

Diagnostics

The most accessible method for diagnosing oligozoospermia is a spermogram – a laboratory study of seminal fluid. The minimum level of sperm concentration in the norm should be 15 million cells per 1 ml of ejaculate. As for the total number of spermatozoa, it must exceed 39million cells in the entire ejaculate⁵.

Treatment to increase sperm count

The choice of treatment depends on the causes that caused oligozoospermia. Your doctor may make the following recommendations.

  • Perform surgery at clinic . In the case of a varicocele or the presence of scar tissue that prevents sperm from entering the ejaculate, the problem can be solved through surgical intervention.

  • Initiate drug therapy . Antibiotics can help clear the infection and prevent scarring.
  • Prescribe hormone therapy . It is advisable to do this with an increased level of testosterone or other hormones.
  • Perform lifestyle adjustment . Losing weight, staying physically active, and quitting bad habits help improve sperm quality³ , ⁴.

If it is not possible to increase the sperm count, the patient may be offered methods of assisted reproductive technologies, such as intrauterine insemination, IVF or ICSI.

How to increase sperm volume?

The volume of ejaculate changes with age. The peak occurs at 20-35 years of age, and the lowest amount of sperm is produced at the age of 55 years and older. Despite popular belief, the volume of seminal fluid (if it is within the normal range) does not affect male fertility in any way. In addition, the amount of sperm is not related to sexual pleasure and orgasm duration for both men and women.

If a man produces very little sperm, this may indicate retrograde ejaculation, when seminal fluid enters the bladder. In this case, surgical intervention is prescribed. In the absence of physical problems, the volume of ejaculate can be increased by drinking enough fluid⁶.

How to improve sperm quality: best practices

The following recommendations can help improve seminal fluid quality and male fertility.

  • Maintaining a healthy weight . Studies have shown that losing weight can help increase sperm volume as well as sperm concentration and motility.

  • Physical activity . Scientists believe that regular outdoor exercise improves sperm quality.
  • Refusal of bad habits . The lowest sperm count was found in men who use drugs, alcohol and tobacco.
  • Limiting the influence of negative factors . Men whose professional activities involve contact with heavy metals, solvents, pesticides, non-aqueous adhesives or paints should follow recommended safety practices.
  • Wearing loose underwear . To ensure air access to the scrotum, it is better to wear loose boxer shorts. Also, preference should be given to cotton, not synthetic underwear⁷.

In addition, to improve the quantity, mobility and morphological qualities of spermatozoa, it is worth taking care of diet correction.

Products that improve sperm quality

Recently, researchers analyzed the available scientific evidence and concluded that the Mediterranean diet helps improve sperm quality.

A man’s diet must include foods such as:

  • fresh vegetables and fruits,

  • chicken and fish,

  • whole grains,

  • low fat dairy products.

At the same time, it is worth limiting the consumption of red meat, processed and fatty foods, sweets, caffeine, potatoes, sugar⁸.

Abstinence and sperm quality

According to the clinical guidelines of the Ministry of Health of the Russian Federation, abstinence intervals exceeding 5 days negatively affect the sperm count. Western scientists believe that if a man has little sperm during ejaculation, abstinence can increase its volume, but negatively affect sperm motility and viability

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The supplement also has a cumulative effect. Therefore, when taken regularly, it can help maintain sexual function, improve blood circulation in the pelvic organs, and prevent prostate congestion¹¹.

References

  1. Churakov A.A. Vascular erectile dysfunction // GBOU VPO Saratov State Medical University. V. I. Razumovsky of the Ministry of Health of Russia Clinic of Professor Churakov. – Saratov. – 2016.
    https://www.vpsaratov.ru/userfiles/sexual_disfunction.pd
  2. Julie Lynn Marks What Is Erectile Dysfunction (ED)? Symptoms, Causes, Diagnosis, Treatment, and Prevention.
    https://www.everydayhealth.com/erectile-dysfunction/
  3. AA Kamalov, SD Dorofeev, EA Efremov, AA Khamzin, SK Kuderinov Erectile dysfunction and cardiovascular diseases // Medicine and Ecology. – 2009. – No. 1.
  4. Hanno Hoppe and Nicholas Diehm Percutaneous Treatment of Venous Erectile Dysfunction.
    https://www.frontiersin.org/articles/10.3389/fcvm.