Dhat syndrome

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Dhat syndrome is a condition found in the cultures of the Indian subcontinent in which male patients report that they suffer from premature ejaculation or impotence, and believe that they are passing semen in their urine.

In traditional Hindu spirituality, semen is described as a 'vital fluid'. The discharge of this 'vital fluid', either through sex or masturbation, is associated with marked feelings of anxiety and dysphoria. Often the patient describes the loss of a whitish fluid while passing urine. At other times, marked feelings of guilt associated with what the patient assumes is 'excessive' masturbation are noted.

This is based on an old Hindu belief that it takes forty drops of blood to create a drop of bone marrow and forty drops of bone marrow to create a drop of sperm.

Symptoms

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'.

Premature ejaculation and impotence are commonly seen. Other somatic symptons 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.

Culture-bound Syndrome?

Some doctors believe dhat syndrome to be either a culture-bound presentation of clinical depression as a somatized set of symptoms or a result of Western doctors' misinterpretation of patients' descriptions of their condition. It is very common in Pakistani culture as well. Most of them come with the complaints of "drops" .. and become extremely anxious about it and see it as loss of "male power". it is often related with obsessive ruminations and somatoform symptoms. Others see it as a distinct clinical entity which is less culture-bound than these critics assert, and describe it as one form of a syndrome of "semen-loss anxiety" which also occurs in other Eastern cultures as jiryan and shen-k'uei, as well as in Western cultures.

Treatment

Cognitive Behaviour Therapy is the mainstay of treatment.

At other times counseling, anti-anxiety and antidepressant medications have been shown to be of use.