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 Dhat syndrome is a name given to certain symptoms experienced by men who fear that something is seriously wrong with them because some sticky substance is passing before, during or after urination. Such fears can lead to psychosomatic symptoms (physical symptoms caused by mental fears) but in reality Dhat syndrome is NOT a disease or disorder. Every man including you and me pass some sticky fluid with or without urination. This is a normal feature of male sexual response. It's called precoital fluid. That is, it is a fluid that passes through the urinary tube before the release of semen to neutralize the effect of urine therein, so that the spermatozoa in the semen will remain safe and healthy. It's a nature's ingenious arrangement. This happens whenever you get sexually aroused, because the body thinks that you are going to ejaculate soon. It's not a syndrome.
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What Is Dhat Syndrome And Its Treatment?
Dhat syndrome is a condition found in the cultures of the Indian subcontinent in which male patients report vague psychosomatic symptoms of fatigue, weakness, anxiety, loss of appetite, guilt, and sexual dysfunction, attributed by the patient to loss of semen in nocturnal emission, through urine or masturbation. Male patients think that they suffer from premature ejaculation or impotence, and believe that they are passing semen in their urine.

Somatic symptoms like weakness, easy fatiguability, palpitations, insomnia, low mood, guilt and anxiety are often present. Males sometimes report a subjective feeling that their penises have shortened. These symptoms are usually associated with an anxious and dysphoric mood state.

The patients who presented with symptoms of Dhat syndrome were mostly young, recently married, belonging to average or low socioeconomic status (perhaps a student, laborer or farmer by occupation), from rural area and from family with conservative attitudes towards sex.

Patients having Dhat syndrome can be further divided into three categories.

Dhat alone – Patients attributed their symptoms to semen loss; presenting symptoms – hypochondriacal, depressive or anxiety symptoms
Dhat with comorbid depression and anxiety – Dhat was seen as an accompanying symptom
Dhat with sexual dysfunction– Erectile dysfunction (22-62%) and premature ejaculation (22-44%) were the most commonly associated psychosexual dysfunctions; while depressive neurosis (40-42%), anxiety neurosis (21-38%), somatoform/hypochondriasis (32-40%) were the most reported psychiatric disorders in the patients having diagnosis of Dhat syndrome.
Young males are most often affected, though similar symptoms have been reported in females with excessive vaginal discharge or leucorrhea, which is also considered a “vital fluid”.

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The word “Dhat” derives from the Sanskrit language word dhatu, meaning “metal,” “elixir” or “constituent part of the body” which is considered to be “the most concentrated, perfect and powerful bodily substance, and its preservation guarantees health and longevity.”

Since then, myth prevalent among people of the Indian subcontinent is that “it takes 40 days for 40 drops of food to be converted to one drop of blood, 40 drops of blood to make one drop of bone marrow and 40 drops of bone marrow form one drop of semen.”

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Regarding composition, majority of patients believed that Dhat consisted of semen, followed by pus, sugar, concentrated urine, infection or “not sure.” Majority considered masturbation and/or excessive indulgence in sexual activities as important causative factor, followed by venereal diseases, urinary tract infections, overeating, constipation or worm infestation, disturbed sleep or genetic factors.

Majority got the information about Dhat syndrome from friends, colleagues or relatives. Fear of semen loss and its cure are propagated by vaids and hakims and advertised everywhere on walls, on television, in newspapers and on roadside hoardings in most of the northern Indian cities. Most of the patients prefer to visit STD clinics, urologists and physicians rather than approach 

psychiatrists.

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