Hyperspermia: Symptoms, Causes, Diagnosis, Treatment

Hyperspermia is a rare condition that causes males at birth to ejaculate larger than average amounts of semen, the fluid emitted during orgasm. The exact cause of the condition is unclear, but a reproductive gland infection is one possibility.

Genetic factors may also play a role, as several genes are linked to the condition. Hyperspermia affects about 5% of males at birth. It’s rarer than hypospermia, which is when males produce insufficient semen.

The condition causes excess seminal fluid (the liquid part of semen) during ejaculation, which increases the risk of fertility challenges. This means it can be more difficult for partners of males with hyperspermia to become pregnant. However, hyperspermia is considered a benign (not harmful) condition.

There is no direct treatment for hyperspermia, but fertility treatments and lifestyle changes can help address infertility.

Hyperspermia symptoms are mostly seen during ejaculation. However, producing too much semen can affect male fertility.

Excess Semen

Semen, or seminal fluid, is the sperm-containing substance that males at birth secrete during ejaculation. Normal levels of semen that males produce range from 1.5-6 milliliters.

For reference, this amount is between 1/3 and 1.2 teaspoons. Hyperspermia occurs when the volume is above 6 milliliters (0.03 ounces). Other than the amount, the semen looks typical: milky or grayish color, viscous, and thick.     

Fertility Challenges

Hyperspermia doesn’t affect sex drive, but it can cause fertility problems. Researchers have linked larger semen volume with increased time until conception (pregnancy), meaning it takes longer or more tries to become pregnant.

However, hyperspermia doesn’t mean you and your partner can’t conceive. One study found males at birth with hyperspermia had sperm counts in the healthy range. Having a high enough sperm count is important for increasing your chances of achieving pregnancy.

The male sex glands, also known as the gonads or testicles, produce semen. Semen contains about 5% sperm and 95% seminal fluid. The seminal fluid protects the sperm in the vagina as they travel to the egg.

Since sperm count isn’t typically affected in hyperspermia, people with the condition likely secrete semen that has a lower sperm concentration and higher seminal fluid volume. The low concentration of sperm in each ejaculation may be why hyperspermia can cause fertility problems.

Researchers aren’t sure why this happens. In some cases, long periods of abstinence—not having sex or masturbating—can produce temporary hyperspermia.

There’s also evidence that hyperspermia can be caused by a chronic, low-grade bacterial infection of the accessory male reproductive glands—the prostate, seminal vesicles, and bulbourethral glands—which create seminal fluid.

Risk Factors

Though more research is needed, studies have linked increased hyperspermia risk with the following:

• Mutations (changes) in certain genes, which predispose some people to develop this condition
• Changes in male sex hormone levels, which may occur due to medications or health changes
• Prostatitis (prostate infection) or inflammation

When assessing fertility, healthcare providers work to identify the potential causes, such as low testosterone levels. Testosterone is primarily a male reproductive hormone.

To diagnose hyperspermia, a provider will ask about your symptoms and medical history. They may perform the following diagnostic tests:

• Physical exam: The healthcare provider assesses your overall health and symptoms and examines the testicles and penis for signs of inflammation or infection, hernia, or other issues.
• Semen analysis: You provide semen samples for a lab to measure sperm count, structure, and activity level (motility), as well as overall volume and thickness, among other characteristics. If your provider is concerned about semen infection, a semen culture can be completed.
• Blood test: The provider takes blood samples and sends them to a lab to check hormone levels, such as testosterone levels.
• Imaging: Healthcare providers may perform imaging tests to detect physical causes of infertility.

Hyperspermia isn’t harmful to your health. Unless it’s affecting fertility and preventing a desired pregnancy, treatment isn’t necessary.

However, if you and your partner want to conceive, you can receive infertility treatment. Infertility is defined as a couple’s inability to conceive after trying for at least a year. Medications, assisted reproductive therapy (ART), and lifestyle modifications all play a role in treating this condition.

Hormone Therapy

If infertility is caused by hormone imbalance, healthcare providers may prescribe synthetic hormones, stimulating sperm production. These include:

• Aromatase inhibitors, such as Arimidex (anastrozole)
• Serophene (clomiphene)
• Soltamox (tamoxifen)  
• Gonadotropin injections like Pregnyl (human chorionic gonadotropin)   

Assistive Reproductive Technologies

Assistive reproductive technologies involve techniques to perform fertilization in a laboratory. With in-vitro fertilization (IVF), a surgeon removes an egg from the female, applies the male’s sperm to the egg, and transplants the resulting embryo back into the uterus (womb).

Intrauterine insemination (IUI) is a less invasive option. A medical professional injects sperm into the uterus. Surgery to extract healthy sperm from the testicles is necessary in some cases.

Lifestyle Modifications

Your healthcare provider may also recommend certain lifestyle changes to help treat infertility. These include avoiding substances known to decrease sperm count, such as tobacco, alcohol, cannabis, and opioids. Eating a nutritious diet and maintaining a healthy weight can also help.

While you can’t control the amount you ejaculate, certain lifestyle habits may help prevent infertility. These include:

• Eat a well-balanced diet rich in whole grains, fresh vegetables and fruits, and healthy fats
• Maintain a healthy weight, as excess weight can make pregnancy more difficult
• Boost your dietary intake or take supplements of vitamin D, zinc, vitamin C, and lycopene, among other nutrients
• Treat any infections or sexually transmitted infections (STIs) right away
• Avoid cigarette smoking or nicotine use
• Limit alcohol use

Hyperspermia doesn’t cause complications in males with the condition, but researchers have linked it with a higher risk of miscarriage in the partner.

If untreated, male infertility is also associated with several mental health conditions, including:  

• Depression: Feelings of stress and inadequacy can affect relationships and lead to depression in males at birth with infertility. In addition, depression has been linked with lower-quality semen, likely due to its effects on testosterone levels.
• Anxiety disorder: The emotional burden of fertility challenges can lead to anxiety, leading to feelings of panic, helplessness, and despair. For example, one large study showed males diagnosed with infertility had higher rates of anxiety compared to controls.
• Lower self-esteem: Difficulty conceiving may lead to a sense of failure and cause a person to feel inadequate and stigmatized. The same large study noted lower self-esteem was more common in males at birth with infertility compared to controls.

Hyperspermia isn’t harmful to health. However, the condition may affect fertility. The success rates of fertility treatments vary—for example, IVF treatments have a success rate of 50%, and gonadotropin injections lead to pregnancy about 60% of the time.

Fertility challenges can significantly affect the emotional well-being and quality of life of both partners. Resources like counseling or therapy can help you process feelings of depression, anxiety, and low self-esteem. There also are support groups and social media groups or forums devoted to male infertility.