Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.
In this segment, Dr. Mistry and Donna Lee answer a listener question about semen. Our listener asks, "Upon discharge, I noticed my semen color is greenish gray for the last 10 months, approximately. Do I need to be worried? My last blood work showed up that all is well with my blood. Not eating anything different from before, and then this started happening." This is a great question, and one Dr. Mistry hears often from his patients. While many people assume that semen is the main component of ejaculate, it is actually composed of material from the prostate gland. Ejaculate stored in the seminal vesicles exits through the urethra, and in the course of this journey out of the body, color change can occur for a variety of reasons. Most often, discolored ejaculate is a sign of prostate infection. It is very rarely associated with fertility. Red ejaculate is generally from blood in the sperm, also called hematospermia, and this is usually caused by prostate infection. If you ejaculate and your sperm is red, then don't ejaculate again for a while, it may be a darker red or brown at that time. Any discolored ejaculate must be discharged before normalcy can return. A greenish discharge may be associated with venereal infections like chlamydia or gonorrhea, but not in every case. In addition, smelly ejaculate can signify an infection, and should be evaluated by a urologist. Usually a semen culture can help identify the cause. In other situations, placing a tiny camera in the bladder to rule out other causes of infection may be necessary. If the ejaculate is highly suspicious, a PSA and an MRI of the pelvis and seminal vesicles is usually helpful in ruling out serious illness. If you or someone you love is concerned about the appearance or quality of their ejaculate, please give us a call today!
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Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.
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Speaker 1:
Welcome back to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.
Dr. Mistry:
Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my amazing cohost, Donna Lee.
Donna Lee:
That was it?
Dr. Mistry:
That was it.
Donna Lee:
Oh, wow. I really needed an insult at the beginning to feel like I knew it was going on. Now I'm totally thrown.
Dr. Mistry:
You're learning computers. It's okay. They're very complicated.
Donna Lee:
I am an adult.
Dr. Mistry:
I'm a board certified urologist. This is a men's health show. We talk about everything that affects you from the nipples to the knees.
Donna Lee:
That's right. Nipples to knees. And everything's attached.
Dr. Mistry:
That, and yeah, that's right--because you're not just one part of your body.
Donna Lee:
That's right.
Dr. Mistry:
The whole thing like is connected to one another.
Donna Lee:
Mhmm. Especially the penis.
Dr. Mistry:
It is the center of life. I'm I'm, I'm studying a lot of, like, ancient societies, and the phallus is really a very important part of so many of them.
Donna Lee:
That's why Egyptian things are are so tall and pointy, right?
Dr. Mistry:
They're compensating for something. As I said, I'm a board certified urologist. This show is brought to you by NAU Urology Specialists. That's the urology I group that I started in 2007. We're coming up, next year is going to be our 15th year in practice.
Donna Lee:
Wow! I see some gray hairs, too, to prove it.
Dr. Mistry:
You know, I still think of myself as the young gun on the, on, you know? Coming into town.
Donna Lee:
Really?
Dr. Mistry:
Yeah. I still think of myself as like a brand new guy.
Donna Lee:
Not the old dude who started 15 years ago?
Dr. Mistry:
I still introduce myself to people like,"Yeah, we've known you for 10 years.""No, I just, I just got into town."
Donna Lee:
"I just started."
Dr. Mistry:
"I just started." We are the second biggest urology group in town. That means we try a little harder.
Donna Lee:
We're a little cuter on the weekends.
Dr. Mistry:
I still don't understand that reference.
Donna Lee:
Because you're, you know, when you're the second cutest girl in school, you try harder on the weekends. Cause you know, the boys are looking a little, it's a little easier on the weekend to get a little...you know what I mean?
Dr. Mistry:
Lockhart was a weird place to grow up. You know what I'm saying? Especially if you knew, if you were the second prettiest girl in town.
Donna Lee:
I was actually not in any of the categories.
Dr. Mistry:
There were like six girls, so...
Donna Lee:
There were a thousand girls and they were all very pretty.
Dr. Mistry:
I bet they are. Your questions, your participation as a patient in our clinic, these are the kinds of things that keep both the show and our practice moving along. We are open to see patients. We are seeing new patients. We take almost all insurances. We take Medicare, we see new things all the time. We treat patients in the hospital. We treat patients in the clinic. We have four physicians. Who else?
Donna Lee:
We have five mid-levels, our amazing PAs and NPs. We have three physical therapists for pelvic floor dysfunction and we have a sex therapist on site. Dr. Vagdevi, by the way, for our regular listeners, will be on our show very soon. So, she's our sex therapy leader.
Dr. Mistry:
And, it, it speaks strongly to our, our, our approach that we also have integrated a lot of sleep medicine here in the practice. We really believe that the biomechanics, the neurologic, the vascular, all of these different features really make for the total patient and men's health. And we want to have those resources here on site.
Donna Lee:
Everything is connected, again. I keep saying that.
Dr. Mistry:
Yeah. So how do people make an appointment with us?
Donna Lee:
You can call us during the week at 512-238-0762. You can send your questions to armormenshealth@gmail.com, and our website where you can see our smiling faces and hear all of our free podcasts are, it's armormenshealth.com.
Dr. Mistry:
Well, like I said, your questions kind of keep us going. Donna, do we have questions?
Donna Lee:
We do. We have a question that makes me a little uncomfortable. It's about semen. Are you ready?
Dr. Mistry:
Yes.
Donna Lee:
"Dr. Mistry, upon discharge..." Not my husband's semen. It's just...
Dr. Mistry:
Like, like naval?
Donna Lee:
It's about men in the service, military service."Upon discharge, I noticed my semen color is greenish gray for the last 10 months, approximately. Do I need to be worried? My last blood work showed up that all is well with my blood. Not eating anything different from before, and then this started happening. Thank you for your input."
Dr. Mistry:
It's a great question. And you know, when you're a resident as a urologist, you never think people are going to be so focused on the color of their semen. Like not one time in my education...
Donna Lee:
No? Why not? Because it's...
Dr. Mistry:
...was there a booklet of semen color. And what's fascinating is later...
Donna Lee:
Did you say booklet?
Dr. Mistry:
Booklet. I mean, I'm old now, right? We used to have books in our bucket. So, but semen color is, is, is something in which...there are some guys that have no idea what the color of their semen is because they're either ejaculating into a condom or ejaculating into a woman. And there are others that know exactly what color ejaculate they have. Now I don't know if it's because they're masturbating and looking at it or some other thing, because--well, I do know, because I ask always,"How do you, how to look at the color?" But, but let's talk about colors. So in people's minds, a whitish is probably more natural and normal. What makes up an ejaculate is the sperm, which comes from your testicles. But that sperm amount is a very small to almost nothing amount of the volume of the semen.
Donna Lee:
Because the little spermies aren't white. Under a microscope, they're black. I've seen them. They're very cute.
Dr. Mistry:
I think it's just the way the light hits the sperm. I think there are clear probably more likely.
Donna Lee:
Clear?
Dr. Mistry:
Ish.
Donna Lee:
Alright.
Dr. Mistry:
So, but the point is they don't, they don't contribute a lot of volume to the overall semen. So their, their color doesn't matter. Almost all of the ejaculate, all of it comes from the prostate gland. What happens is this gets stored in this organ called the seminal vesicles. So it's not like, you know, because when you ejaculate, it's not like your balls are real big and then they get real small. It's not like all the volume just came from your testicles. Same with the prostate. The prostate doesn't like swell and then get smaller after you ejaculate. But the seminal vesicles do, these are where the semen is stored. And so a lot of things can happen as that semen traverses the urethra to get out of you or develops inside the prostate or the seminal vesicles. And that's where color change can occur. And so if it's, if you have a change in the color of your semen, it's probably more an indicator of prostate health than anything wrong with your reproductive system. And so in most cases, the color that frightens most patients is red.
Donna Lee:
Sure.
Dr. Mistry:
So when they have blood in the semen, we call it hematospermia. And we do get referrals for that all the time. The most common cause of hermatospermia is a prostate infection. The color does something fun. It starts dark bright red, and then it goes like rusty. And then brown.
Donna Lee:
Why is that fun? It sounds terrifying.
Dr. Mistry:
Because it changes. It's almost like a rainbow. If you don't ejaculate it out, that brownness can stay forever. So a guy will be like," Well, I ejaculated and it was red and I got scared, so I didn't for four more months. And then I did it again. And it was brown." I'm like,"Yes, you have to get all that bad humor out of you."
Donna Lee:
Oh my.
Dr. Mistry:
As we say, often in this show, ejaculations good for the prostate.
Donna Lee:
I know.
Dr. Mistry:
And so you just got to get...
Donna Lee:
That's why I stopped making my husband listen to the show.
Dr. Mistry:
He's like,"You gotta help my prostate out, lady."
Donna Lee:
So I cut him off of the show. There's no more ejaculating at the house directly tied to one another.
Dr. Mistry:
Okay. So, so there's that color. Now this, this particular listener is asking about a greenish discharge. Classically, the greenish discharge we would associate with an infection also, but particularly gonorrhea and chlamydia. But that won't last for 10 months. It won't last for 10 months. Some people can have coloration of their semen from foods that they eat. But that's just not that common. There, there was....
Donna Lee:
Like asparagus?
Dr. Mistry:
Maybe. Right? But...
Donna Lee:
That's just urine.
Dr. Mistry:
You know, that, it doesn't turn it really, it just makes it smell funny.
Donna Lee:
Makes it stink.
Dr. Mistry:
Makes it stinky.
Donna Lee:
And if you have bad smelling semen, that is also an infection.
Dr. Mistry:
It could also be a cause of an infection. So for this particular listener, what we would do is something called a semen culture, easy enough. Just like a urine culture, blood culture, we just take that fluid and put it on slides or plates and see what bacteria grow. Now, the problem with the semen culture is that it's going to pick up all the bacteria that is on your penis or on your hand, or, you know, however that specimen is coming out. So we have to take it with a little bit of a grain of salt. But, but usually if there's an overwhelming type of infection, we can see it, and then we can treat it. So although the color itself is not a problem, it's what it could represent underneath. Semen color changes that are like that are not usually indicative of, of prostate cancer. Although there is a slightly increased risk of prostate cancer if you have blood in the semen.
Donna Lee:
Does this hurt at all? Or just sometimes it doesn't hurt if there's a color change?
Dr. Mistry:
Sometimes it does not hurt. About 10% of the time, you can have an infection of your prostate and it not cause any pain at all. Now the last thing is that it could be something wrong with the seminal vesicles, which is separate, but connected to the prostate gland. And what's interesting is the problems with the seminal vesicles are often not diagnosed because you know, you have to have kind of an observant person looking at their own stuff. And so, we would do a prostate exam on you, we would do a semen culture on you, we might put a camera in your bladder to make sure there's nothing else in the urethra that's discoloring the, the semen.
Donna Lee:
A tiny camera, by the way.
Dr. Mistry:
A tiny camera.
Donna Lee:
It's not like a Minolta. Just a little teeny tiny...
Dr. Mistry:
A Minolta.
Donna Lee:
That's the only camera thing I can think of.
Dr. Mistry:
It's not a garden hose. It's the kind of thing like a spy would use to look like it around him, around a door or down a pipe.
Donna Lee:
But smaller.
Dr. Mistry:
But even smaller than that, you know. We're, we're very fancy here. And in, in, in, in cases that we have high suspicion, because we would also do a PSA, we also might do an MRI of your pelvis and seminal vesicles. So that would kind of be what it is.
Donna Lee:
Isn't that a college team? The Seminals? Is that right?
Dr. Mistry:
I think the Seminoles.
Donna Lee:
Oh, okay. I don't know. Anyway. It's a terrible mascot.
Dr. Mistry:
Well have to ask those kids with a terrible mascot.
Donna Lee:
It's a big semen.
Dr. Mistry:
How do people make an appointment or send their complaints?
Donna Lee:
You can reach out to us about your seminal vesicles 512-239-0762. You can email us these questions at armormenshealth@gmail.com, and then you can visit our website at armormenshealth.com. Where can they find our podcasts?
Dr. Mistry:
Anywhere.
Donna Lee:
Everywhere...
Dr. Mistry:
Everywhere.
Donna Lee:
...you listen to free podcasts. And even our website, our podcasts are at the bottom, but you can check us out, and we will give you whatever you need by simply reaching out. Thank you, Dr. Mistry.
Dr. Mistry:
Thank you, Donna.
Speaker 1:
The Armor Men's Health Hour is brought to you by Urology Specialists. For questions, or to schedule an appointment, please call 512-238-0762, or online at armormenshealth.com.