Patient's question:
1. My penis is only 2 cm long in a normal state and 2.5 cm in diameter. When erect, it measures only 11.2 to 11.7 cm long and 3.5 cm in diameter. Is this considered a small penis?2. I heard that semen volume determines fertility. My semen volume is only a tablespoon or so. Do I still have the ability to reproduce?
3. My girlfriend and I want a child, but since she is working and studying at the same time, she doesn’t want to spend too much time on sex. She thinks it’s enough as long as she gets pregnant. So, I adopted this method: I masturbate before going to bed, quickly insert my penis into her vagina when I’m about to orgasm, and then ejaculate. With this method, will my girlfriend
Doctor's answer:
Hello, it should be normal!The penis is the male copulatory organ, serving both urinary and seminal functions. It consists of three parts: the head, the body, and the root. The posterior part is called the "penile root," the middle part is the "penile body," and the anterior part is the "penile head." The penile head is rich in nerve endings and is the primary erogenous zone in males, usually covered by the foreskin. The foreskin is a circumferential fold that surrounds the penile head. There is a circular groove between the head and the body, known as the "corona." A frenulum, called the "penile frenulum," is attached between the inferior part of the penile head and the penile body. This frenulum and the skin of the penile body are highly sensitive to touch and stimulation.
The penis is primarily composed of two corpora cavernosa and one corpus spongiosum, which are surrounded by fascia and skin. The corpora cavernosa are arranged on the dorsal side and separate at the posterior end, forming the "penile crura," which attach to the inferior and ischiopubic branches. The corpus spongiosum is located on the ventral side of the corpora cavernosa and contains the urethra. Its anterior dilated portion is the "penile head" (also known as the glans), and its posterior dilated portion is the "urethral bulb." Each corpus cavernosum is covered by a dense connective tissue layer called the "tunica albuginea," specifically the tunica albuginea of the corpus cavernosum and the corpus spongiosum. The cavernosa are internally composed of numerous trabeculae and sinuses, which are actually vascularly connected. During sexual arousal, the sinuses fill with blood, causing the penis to become rigid and erect. The roots of the cavernosa are attached to muscles, which, when contracted, can assist in urination, penile erection, and ejaculation.
For Chinese individuals, a penis shorter than 12 cm in length and less than 3.1 cm in diameter in the erect state (non-erect length is not considered) is classified as micropenis. Those exceeding this measurement are considered normal. The shortness of the penis is influenced by the following factors:
1. Genetic influence is the most fundamental;
2. Improper medication use during pregnancy affecting male hormone secretion, leading to insufficient sperm production;
3. Lack of nutrients and elements for healthy sexual function, resulting in congenital developmental issues;
4. Insufficient intake of zinc, male hormones, vitamin E, and related proteins during adolescence, with inadequate postnatal supplementation, failing to promote sexual organ growth;
5. Internal coldness, fear of cold, and insufficient yang energy in the body, causing the penis to not fully protrude and partially retract into the abdomen;
6. Excessive sexual activity, physical weakness, or frequent masturbation during adolescence, leaving no energy for the kidneys to develop sexual organs, resulting in a short penis;
7. Conditions such as orchitis, cryptorchidism, incomplete testicular development, and endocrine imbalances, leading to insufficient male hormones;
8. Excessive foreskin, lacking necessary growth space, hindering penile development and growth.
### Normal Semen
According to the World Health Organization's standards for normal semen, the normality of semen can be assessed from the following aspects:
(1) Semen volume: Normal ≥ 2 ml. A volume greater than 7 ml is considered excessive, not only reducing sperm density but also making it more likely to flow out of the vagina, thereby lowering total sperm count. This is common in seminal vesiculitis. A volume less than 2 ml is considered too low, but typically below 1 ml is deemed excessively low. In such cases, the small contact area between semen and the female reproductive tract, or its viscosity hindering sperm entry into the cervix, may lead to infertility. This is often seen in severe accessory gland inflammation, low testosterone levels, ejaculatory duct obstruction, or retrograde ejaculation.
(2) Color: Normal is grayish-white or slightly yellowish. Milky white or yellow-green indicates inflammation in the reproductive tract or accessory glands. Pink, red, or the presence of red blood cells under a microscope indicates hematospermia, commonly caused by inflammation of the accessory glands or posterior urethra, though occasionally seen in tuberculosis or tumors.
(3) pH level: The normal pH of semen is 7.2–7.8. Below 7.2 may indicate ejaculatory duct obstruction or urine contamination; above 7.8 may suggest seminal vesiculitis or outdated samples.
(4) Liquefaction time: Normal semen becomes gelatinous due to coagulating enzymes from the seminal vesicles and then liquefies into a liquid within 15–30 minutes under the action of liquefying enzymes from the prostate. If semen remains unliquefied 30 minutes after ejaculation, it is abnormal.
(5) Viscosity: When a glass rod touches liquefied semen and is gently lifted, it forms a semen thread. Normally, its length is less than 2 cm.
(6) Sperm count: Generally expressed as the number of sperm per milliliter of semen. Normal count ≥ 20 × 10^6/ml. Below this value indicates oligospermia, caused by various factors or conditions leading to impaired sperm production, reducing the chance of fertilization and fertility. A sperm count greater than 250 × 10^6/ml is considered hyperospermia, as reduced motility may also lead to infertility.
(7) Sperm morphology: Normal morphology ≥ 50%, otherwise it may result in infertility.
(8) Motility: Sperm with linear, rapid forward movement ≥ 50%.
(9) Viability: Typically assessed within 1 hour after ejaculation, with live sperm ≥ 50%. Common factors or conditions reducing sperm motility and viability include accessory gland inflammation, varicocele, ciliary dysfunction syndrome caused by chronic respiratory infections, antisperm antibodies in semen, or improper sample storage.
(10) White blood cells: Normal semen contains < 1 × 10^6/ml white blood cells. An increased number indicates infection in the reproductive tract or accessory glands.
### Pre-Pregnancy Genetic Screening
Pre-pregnancy genetic screening, similar to routine health checks, can include various tests. Below are explanations of some key items:
Complete Blood Count (CBC): This test measures hemoglobin levels, allowing for early treatment of anemia. It also provides platelet counts, which are related to coagulation function, as childbirth involves bleeding. Individuals with platelet issues should be treated before pregnancy. This test can also measure red blood cell size (MCV). Due to the high prevalence of thalassemia carriers in the Chinese population, carriers have smaller red blood cells (MCV < 80). This is an inherited condition, affecting offspring only if both parents are carriers. Therefore, if the expectant mother has an MCV < 80, the father should also undergo blood testing. If both have MCV < 80, further tests like blood electrophoresis and DNA analysis may be required. If only one has MCV < 80, no further action is needed. This is a genetic condition detectable prenatally, making newborns with thalassemia rare today. Thus, CBC is a cost-effective yet highly informative test.
### Choosing the Best Time to Conceive
Children are our hope and future. Watching the adorable babies around us, have you ever marveled at the beauty and wonder of life? So, how can we have a healthy baby?
1. The Best Age to Get Pregnant
- Women: 25–29 years old
- Men: 25–35 years old
Conceiving during the optimal age ensures better quality sperm and eggs, making pregnancy more likely and reducing the risk of complications. This period is when both partners are at their peak reproductive capacity.
2. The Best Season to Conceive
Many scholars recommend conceiving in late summer to early autumn. This timing avoids the appetite-suppressing effects of summer heat and allows access to abundant fruits and vegetables, facilitating better nutrition and appetite regulation. By the time winter arrives, pregnancy is usually in the second trimester, reducing the impact on fetal organ development. Delivery occurs in late spring to early summer, a favorable time for newborns to adapt to the environment and grow well.
3. Avoiding Factors Harmful to Pregnancy
- Do not conceive during emotional distress: Stress and anxiety can disrupt maternal hormone levels, potentially causing fetal restlessness, hyperactivity, developmental issues, miscarriage, or birth defects.
- Do not conceive during the honeymoon: New couples often experience emotional and physical strain, which may affect fertility.
- Postpone pregnancy if exposed to acute infectious diseases: Conditions like hepatitis, mumps, or influenza should be treated before conception, as these viruses can infect the fetus. Other teratogenic pathogens like rubella virus, cytomegalovirus, toxoplasma, or herpes simplex virus should be cured before pregnancy.
- Avoid high-risk pregnancy in older women: Women over 35 have a higher risk of chromosomal abnormalities, increasing the likelihood of birth defects. The optimal age for childbirth is 24–30.
- Avoid harmful chemical or physical influences: Long-term exposure to environmental teratogens, such as certain medications (steroids, antipsychotics, antitumor drugs), or chemicals (aluminum, chromium, benzene, arsenic, amines), or radiation (X-rays), high noise, extreme temperatures, strong magnetic fields, or electromagnetic radiation, should be avoided before pregnancy.
- Quit smoking and alcohol three months before conception: Smoking contains toxic substances like nicotine and carbon monoxide, which harm sperm quality. Passive smoking can constrict uterine and placental blood vessels, affecting fetal development.
- Women with chronic diseases: Conditions like heart disease, nephritis, hepatitis, tuberculosis, diabetes, hyperthyroidism, or asthma should be treated before pregnancy, with medical advice on timing. Individuals with benign tumors in the pelvic, abdominal, breast, or thyroid areas should be treated or surgically removed if necessary. Recurrent subacute or chronic appendicitis should be treated prenatally to avoid complications during pregnancy.
In summary, when planning to conceive, it is essential to prepare and choose a time when both partners are at their physical and mental peak, reducing the risk of birth defects.
### Ten Factors for the Best Time to Conceive
Every couple wants to have a smart and strong child. Scientific research shows that choosing the right time to conceive is also a crucial factor.
Afternoon Intercourse: The Best Time to Conceive
Studies on daily conception rates reveal that the optimal time for intercourse is 5–7 PM. Research shows that both sperm quantity and quality peak during this period, coinciding with when women are most likely to conceive.
Dr. Cagnacci and colleagues in Italy conducted a study on conception timing, involving over 50 men who provided two semen samples—one at 10:30 AM and another at 5:30 PM. The samples from the afternoon showed higher sperm concentration and a greater proportion of motile sperm. Cagnacci also noted that hormones play a key role in women's fertility, causing most to ovulate between 3–7 PM. Combining these findings suggests a "happy moment" for conception, which may help couples with fertility issues.
### Ten Factors for the Best Time to Conceive
Every couple desires a smart and strong child. Beyond maintaining physical and mental health, scientific research highlights the importance of choosing the right time to conceive. A good conception time includes:
- Positive mental state: Both partners should be relaxed and free from stress or worries.
- No health issues: Women taking long-term oral contraceptives should stop for two months before conception. Both partners should avoid smoking and alcohol for three months before conception and maintain good nutrition.
- Peak physiological condition: Conception should occur when both partners are at their physical, mental, and emotional best, though achieving this simultaneously is challenging.
- Seasonal timing: Conception in July or August and delivery in May or June is ideal. Intercourse frequency should not exceed normal levels in the month before conception, aiming for conception during the woman's fertile period.
- Strong sexual desire: Conception is more likely when both partners have a strong urge for intercourse.
- Timing of intercourse: Morning is preferable over bedtime, as morning energy is higher after rest, and women are more likely to ovulate, while men have higher testosterone levels.
- Favorable weather: Conception is best during pleasant weather. Avoiding horror movies and spending time in beautiful natural environments during conception can be beneficial.
No one can perfectly follow all ten principles, but they serve as a reference for newlyweds. If one factor is most important, it is to be in the best physical and mental state.
### Do Not Miss the Best Age to Conceive
The best time to conceive should not be missed or delayed! The health of your future child depends on your decisions...
Expert Advice: Do not miss the optimal age for childbirth. For humans, the best age is around 25, with 28 being the latest. Fertility declines with age, and late pregnancy increases the risk of chromosomal abnormalities. It also makes it harder to detect and treat issues promptly.
French geneticist Morris's 1989 research found that children born to fathers aged 30–35 are the most. Male sperm quality peaks at 30 and remains high for 5 years.
Women's reproductive organs mature by puberty, but their bodies are still developing before 20. This is also the best time for education, and early pregnancy can strain both mother and child, affecting health, work, and studies. Medically, early childbirth increases the risk of congenital birth defects.
While late marriage and delayed childbirth are encouraged, advanced age negatively impacts fertility. Women over 35 are termed "advanced maternal age," with aging eggs and increased susceptibility to infections, physical/chemical stimuli, and hormonal changes, leading to chromosomal abnormalities.
Physiologists agree that women aged 23–28 are in their optimal reproductive window. During this period, their bodies are fully developed, egg quality is high, and pregnancy is associated with fewer complications, lower delivery risks, and better fetal development. The rates of premature birth, birth defects, and intellectual disabilities are lowest.