Dear Doc, I'm a 53 year old male. I've begun to notice that after I've masturbated for an extended period that my precum is a bright white and just before I cum there is a pre-ejaculate that is clear but quite thick. Is this just something that comes with age or should I speak to my doctor about it? -Tom (At Right: We all joke about the traditional prostate "finger wave" examination, but for men older than forty, it is not a funny matter.)

HI Tom, Your ejaculate is a mix of fluids that join the sperm on its journey out. The prostate contributes about 30%, a thin white alkaline fluid that neutralizes vaginal acids that can kill the sperm cells. The seminal vesicles produce another 60 percent that is clear and thick and contains amino acids and the sugar fructose to provide the sperm that are only 5% by volume, with energy and texture to aid travel. That clear thick fluid in your precum is probably isolated seminal fluid exiting first. With age, growth of the prostate can change flows.

At 50 you should have your prostate examined and a PSA checked. Extended masturbation should be avoided 24-48 hours prior to a PSA. -Ellar. MD