Introduction

Men's health issues can be challenging to discuss, yet they are crucial for understanding overall well-being. Penile discharge is one such issue, sparking numerous questions and concerns.

While some discharge during arousal or due to skin cell buildup under the foreskin in uncircumcised men is normal, specific characteristics may indicate an underlying problem.

Even a minor drip or alarming discharge can sometimes signify hidden health issues requiring attention.

This blog delves into the causes, symptoms, diagnosis, and treatment of penile discharge.

We will also shed light on overlooked aspects of men's health that you might not be familiar with and psychological aspects such as sexual frustration, fear about STIs, embarrassment, and stigmatization. 

What is a Penile Discharge?

Penile discharge is a common condition that many men experience at some point in their lives.

It can be characterized by the release of fluids from the penis that are not urine, semen, or pre-ejaculate.

While some cases of penile discharge may not be a cause for alarm, it's important to recognize the common causes of this condition and seek medical attention if necessary.

Symptoms of Penile Discharge

Penile discharge, or discharge from the penis, can be a sign of various medical conditions, including sexually transmitted infections (STIs) such as gonorrhea or chlamydia.

It typically presents as fluid leaking from the urethra, which may be clear, white, yellow, or greenish.

Symptoms of penile discharge include:

Discharge: This is the primary symptom. The discharge's color, consistency, and amount can vary, but it can range from clear to white, yellow, or green. It can also range from thick to thin.

Pain or burning sensation: The discharge can also be accompanied by pain or a burning sensation when urinating or ejaculating, which is a common symptom of penile discharge caused by an infection.

Itching or irritation: Itching or irritation can also occur around the penis due to the presence of the infection. It can cause inflammation and swelling around the penis or the genital area.

Odor: A foul odor can also occur, especially if a bacterial infection is causing the discharge.

Redness or inflammation: Redness or inflammation around the penis can also occur.

Causes of Penile Discharge

Causes of Normal Discharge

Pre-ejaculate (precum): A clear or whitish fluid released from the penis during sexual arousal to lubricate the urethra and prepare for ejaculation. Precum helps neutralize vaginal acidity and create a favorable environment for sperm.

Smegma: A white, cheese-like substance that accumulates under the foreskin of uncircumcised men. It consists of dead skin cells and oils from the penis. Smegma buildup can be prevented by gently washing the penis regularly, retracting the foreskin to clean underneath if possible.

Causes of Abnormal Discharge

Sexually Transmitted Infections (STIs): Numerous sexually transmitted infections (STIs), including common STIs like gonorrhea and chlamydia, trichomoniasis, can result in penile discharge. Unprotected sex with an infected partner is a common cause of these infections.

Urinary Tract Infections (UTIs): UTIs are infections of the urinary system, such as the urethra and bladder, or kidneys. Bacteria usually cause UTIs and can cause cloudy or coloured discharge.

Non-Specific Urethritis (NSU): Another cause of penile discharge is non-specific urethritis, which is inflammation of the urethra without an infectious cause. NSU can be caused by things like irritation, trauma, or chemical exposure.

Prostatitis: Prostatitis is inflammation or infection of the prostate gland and can be either acute or chronic, causing pain or discomfort in the pelvic area.

Balanitis: Balanitis is an inflammation of the head of the penis (glans) and the foreskin (glans). It can be a result of poor hygiene, a fungal infection, or a bacterial infection. Other symptoms of this condition include redness, swelling, and discharge.

Urethral Trauma: An injury or trauma to the urethra can cause discharge (e.g., during vigorous sexual activity, or when inserting foreign objects into the urethra.

Reactive Arthritis: Some types of arthritis (such as Reiter’s syndrome) can cause inflammation of the urethra and result in discharge, joint pain, and inflammation.

Cancer: Penile cancer is a type of cancer that affects the lining of the penis. It’s more common among older men and is often accompanied by other symptoms (e.g. lumps or soreness on the penis).

Diagnosis of Penile Discharge

Diagnosis of discharge from the penis (or urethritis) is based on the presence of neutrophils (a type of white blood cell) or pus cells on a urine swab or on a “first-feed” urine sample (i.e., urine is excreted from the time you start urinating).

From these samples, the infecting organism can be identified.

It is recommended that the patient be seen at the sexual health clinic immediately for a rapid specimen examination, as transferring specimens to the hospital laboratory can result in an incorrect diagnosis.

Color and consistency of discharge do not aid in the identification of NSU.

Diagnosis of gonococcal Urethritis (or NSU) is based on microscopic examination of the discharge from a urine swab.

Psychological Impact of Penile Discharge

Worry About Sexual Health

• Health concerns: The presence of penile discharge can cause anxiety about potential health issues, including STIs or other infections.
• Uncertainty: Worrying about the cause and implications of the symptom can lead to significant stress, particularly if the individual is awaiting a diagnosis or treatment.

Embarrassment and Shame

• Stigma: Men might feel embarrassed or ashamed about experiencing a symptom that is often associated with sexual health issues.
• Social impact: Concerns about what others might think can lead to feelings of shame and social withdrawal.

Fear of Sexual Dysfunction

• Performance anxiety: Men may worry about how penile discharge might affect their sexual performance or how their partners perceive them.
• Relationship strain: Fear of transmitting an infection or causing discomfort can impact intimate relationships.

Depression

• Isolation: Persistent anxiety and stress related to health concerns can contribute to feelings of depression, particularly if the individual feels isolated in dealing with the issue.
• Hopelessness: If the condition is chronic or difficult to treat, it can lead to feelings of hopelessness and a negative outlook on one's sexual health and overall well-being.

Impact on Self-Esteem

• Body image: Concerns about penile discharge can affect a man's body image and self-esteem, leading to a negative perception of their own body and sexual health.
• Self-worth: Men may feel less confident and less desirable, affecting their overall sense of self-worth.

Relationship and Communication Issues

• Trust Issues: Fear of disclosing the issue to a partner can lead to secrecy and mistrust in relationships.
• Communication breakdown: Difficulty in discussing sexual health openly with a partner can strain relationships and reduce emotional intimacy.

Addressing the Psychological Impact

To mitigate these psychological effects, it is important for men experiencing penile discharge to:

• Seek medical attention: Consult a healthcare provider to diagnose and treat the underlying cause of the discharge.
• Open communication: Talk openly with a partner about the issue to foster understanding and support.
• Mental health support: Consider counseling or therapy to address anxiety, depression, or other emotional impacts.
• Education: Educate themselves about potential causes and treatments to reduce fear and misinformation.

Treatment for Penile Discharge

Treating penile discharge can depend on the source of the infection. Some common treatments include:

Antibiotics: Antibiotics can treat bacterial STIs like gonorrhea, infections like a UTI or prostatitis, trichomoniasis, and cases of nonspecific urethritis or balanitis caused by bacteria.

Antifungal: Antifungal medicines are used to treat fungal infections, such as yeast infections. Yeast infections are caused by an overgrowth of the fungus Candida albicans.

Steroid creams or ointments: Inflammation caused by allergies or other skin conditions can be reduced by using ointments. For instance, you may be prescribed steroid creams for irritant dermatitis. This is a condition that causes your penis to become red, itchy, and painful. Steroids can cause side effects, so it is important to use them only under the supervision of your doctor.

Consultation with a Psychologist for spontaneous healing: Consultation with a psychologist is essential for treating the mental health implications of penile discharge among men. Psychoeducation and counseling help patients understand the potential causes and consequences of their symptoms, such as infections, stress-related conditions, etc.

Here are some things you can avoid to prevent further irritation and promote healing:

Avoid sexual activity: Sexual activity should be avoided until treatment is finished so that the infection doesn’t spread to your partner.

Maintain good hygiene: Wash your penis daily in warm water with a mild soap. Avoid harsh soaps and douches that irritate your penis. Use a mild cleanser for sensitive skin instead.

Avoid harsh chemicals or perfumes in the genital area: Avoid harsh chemicals or fragrances in your genital area, such as laundry detergent, soap, or lotion. These can irritate your already irritated skin and slow down the healing process.

Wear loose-fitting cotton underwear: Wear loose-fitting cotton underwear instead of tight-fitting synthetic ones. Cotton underwear is breathable and helps keep your skin dry and comfortable, unlike tight-fitting synthetic materials.

Resist scratching the itchy area: Do not scratch your itchy area, as scratching can irritate your skin further and increase the risk of infection. Use a cold compress if itching is an issue.

Complications Associated with Penile Discharge

If left untreated, the complications associated with penile discharge are:

• Infertility
• Life-threatening infections after bacteria spreads to the rest of the body
• In the case of an untreated UTI, damage to kidneys or bladder
• A higher likelihood of penile cancer
• Spreading the infection to sexual partners

Conclusion

Penile discharge can be a concerning symptom that may indicate various underlying health conditions, ranging from infections to sexually transmitted diseases.

Treatment for penile discharge includes antibiotics, avoiding sex during treatment, using a condom when having sex, encouraging sexual partners to receive treatment, or maintaining better penile hygiene.

Untreated penile discharge can cause life-threatening bacteria all over the body, infertility, organ damage, or a higher risk of penile cancer, so it is recommended to visit the doctor if one has an abnormal penile discharge.

FAQs

Can you have penile discharge without having an STI?

Yes, there are many causes of penile discharge, and some of them are not STIs. Some of the causes of non-STI penile discharge are smegma, UTIs, and balanitis.

What does chlamydia penile discharge look like?

Chlamydial discharge is typically white, whereas gonorrheic discharge is yellow or green.

Does smegma contain sperm?

Smegma doesn’t have any sperm in it. It’s a natural compound made from dead skin cells and oils and other body secretions that build up under the foreskin of the penis.

Can penile discharge cause infertility?

STIs like gonorrhea and chlamydia, both of which cause penile discharge, could increase the chances of infertility if left untreated.

What is the colour of penile discharge?

Penile discharge can be white or clear, but it can also be yellow, green, or even blood-coloured depending on the cause.

Will penile discharge go away?

It depends on the cause of the discharge. If it’s caused by irritation, it may resolve on its own, but if it’s due to an infection, it may require treatment.

References

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• Dr. Petronio Mela (2023). Discharge in Men: Understanding Causes, Symptoms, and Treatments. Available at https://www.drpetroniomelo.com.br/en/male-discharge-causes-symptoms/. (Accessed 25/03/2024).
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• Healthline (2023). Is Male Discharge Normal? Available at https://www.healthline.com/health/male-discharge-normal. (Accessed 25/03/2024).