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Hypospermia is a condition in which a man has an unusually low ejaculate (or semen) volume, less than 1.5 ml. It is the logical opposite of hyperspermia. It should not be confused with oligospermia, which means low sperm count.
Normal ejaculate when a man is not drained from prior sex and is suitably aroused, is around 1.5-6 ml, although this varies greatly with mood, physical condition and sexual activity. Of this, around 1% by volume is sperm cells. Hypospermia would only usually be a factor in infertility if the two conditions (hypospermia and oligospermia) are combined. The U.S. based National Institutes of Health defines hypospermia as a semen volume lower than 2 mL on at least two semen analyses.
The presence of high levels of fructose (a sugar) is normal in the semen and this comes almost entirely from the seminal vesicle. The seminal vesicles, major contributors to ejaculate volume, render semen pH basic. Thus, low fructose may indicate problems in the prostatic pathway, while low semen pH may indicate problems related to the seminal vesicles. Obstruction of the seminal vesicles result in low semen volumes since they normally produce 70% of the seminal plasma.
The diagnosis of infertility begins with a medical history and physical exam by a physician, physician assistant, or nurse practitioner. Typically two separate semen analyses will be required. The provider may order blood tests to look for hormone imbalances, medical conditions, or genetic issues.
The history should include prior testicular or penile insults (torsion, cryptorchidism, trauma), infections (mumps orchitis, epididymitis), environmental factors, excessive heat, radiation, medications, and drug use (anabolic steroids, alcohol, smoking).
Sexual habits, frequency and timing of intercourse, use of lubricants, and each partner's previous fertility experiences are important.
Loss of libido and headaches or visual disturbances may indicate a pituitary tumor.
The past medical or surgical history may reveal thyroid or liver disease (abnormalities of spermatogenesis), diabetic neuropathy (retrograde ejaculation), radical pelvic or retroperitoneal surgery (absent seminal emission secondary to sympathetic nerve injury), or hernia repair (damage to the vas deferens or testicular blood supply).
A family history may reveal genetic problems.
In medicine, hyperspermia is a condition in which a male has an abnormally large ejaculate (or semen) volume. Males with hyperspermia usually have higher sex drives than males that do not. It is the opposite of hypospermia, and is generally defined in humans when the ejaculate is over 5.5 ml.
A few cases of photosensitivity (hypersensitivity to ultraviolet light-induced skin redness and/or lesions) associated with bicalutamide have been reported. In one of the cases, bicalutamide was continued due to effectiveness in treating prostate cancer in the patient, and in combination with strict photoprotection (in the form of avoidance/prevention of ultraviolet light exposure), the symptoms disappeared and did not recur. Flutamide is also associated with photosensitivity, but much more frequently in comparison to bicalutamide.
Several case reports of interstitial pneumonitis (which can progress to pulmonary fibrosis) in association with bicalutamide treatment have been published in the medical literature. Interstitial pneumonitis with bicalutamide is said to be an extremely rare event, and the risk is far less relative to that seen with nilutamide (which has an incidence rate of 0.5–2% of patients). In a very large cohort of prostate cancer patients, the incidence of interstitial pneumonitis with was 0.77% for nilutamide but only 0.04% (4 per 10,000) for flutamide and 0.01% (1 per 10,000) for bicalutamide. An assessment done prior to the publication of the aforementioned study estimated the rates of pulmonary toxicity with flutamide, bicalutamide, and nilutamide as 1 case, 5 cases, and 303 cases per million, respectively. In addition to interstitial pneumonitis, a single case report of eosinophilic lung disease in association with six months of 200 mg/day bicalutamide treatment exists. Side effects associated with the rare potential pulmonary adverse reactions of bicalutamide may include dyspnea (difficult breathing or shortness of breath), cough, and pharyngitis (inflammation of the pharynx, resulting in sore throat).