While some diseases and medical conditions affect people all over the world, there are some that are prevalent only amongst a certain cultural group or region. Dhat roga or Dhat syndrome is one such culturally bound syndrome that affects men in the Indian subcontinent region including India, Sri Lanka, Bangladesh and Nepal. In some cases, it may also affect the women of this region.The word ‘Dhat’ originates from the Sanskrit word ‘Dhatu’ meaning ‘elixir of the body’. The condition was first described in 1960 by Dr Narendra Wig as a condition marked by psychosomatic symptoms such as fatigue, anxiety and sexual dysfunction caused by the passing of a whitish fluid or whitish particles that are believed to be semen in the urine. Other symptoms that person with this condition might express include weakness, lack of appetite, poor concentration and guilt.How dhat is different from sperm leakage and premature ejaculation?Dhat is the name given to the collective symptoms, such as sexual, psychological, and physical related to the passing of a whitish fluid, believed to be semen in urine. This is usually followed by psychological distress and anxiety due to semen-loss in patients. The word ‘dhat’ is derived from the Sanskrit word ‘dhatu’ which means ‘metal’ and/or ‘elixir’. Whereas, sperm leakage is a sexual dysfunction which happens due to weak parasympathetic nerves. What happens here is that seminal fluid oozes out of a flaccid penis. This is said to happen due to over masturbation. Dhat, on the other hand, is passing of seminal fluid in urine. And, premature ejaculation is something that happens at the time of coitus. In this, the male is unable to sustain an erection long enough for penetration and ‘comes’ prematurely. In this condition, penetrative sex doesn’t happen or happens for too short a period of time to satisfy the partner.In the dhat syndrome, males usually believe that they have premature ejaculation and suffer from impotence apart from just leaking the white seminal fluid during urination. This loss frightens them into developing a sense of depression as the fear of semen loss is very strong in the subcontinent. Young men from a rural background or of a lower socioeconomic status typically complain of this syndrome. It may be further categorised under three heads:Only Dhat: In this case, the patients present with hypochondriacally oriented symptoms attributed to the loss of semenDhat accompanied by anxiety or depression: In this case depression or anxiety is the core condition that may be accompanied by DhatDhat accompanied by sexual dysfunction: In such cases, the patient may complain of erectile dysfunction, premature ejaculation or other psychosexual dysfunction conditions such as depressive neurosis, somatoform/ hypochondriasis or anxiety neurosis.Symptoms reportedFatigue and listlessnessAppetite lossLack of physical strengthPoor concentration and forgetfulnessGuiltSexual dysfunctionCommon misconceptions about the diseaseThere are a number of misconceptions about dhat. Most patients think that the semen loss during urination will make them impotent or someway weaker sexually. This anxiety can be traced back thousands of years to certain Ayurvedic treatises in which the loss of a single drop of semen, the most precious body fluid, was enough to weaken the whole body. This cultural belief leads to a lot of stigma, guilt and depression related to dhat.The morbid hypochondriacal fear that is associated with dhat syndrome is also stuff that myths are made of. Patients believe that dhat will irreversibly harm their bodies and they will be unable to produce male offspring, and that dhat will cause a death of offspring at an early age, lead to the birth of a malformed fetus; or cause anaemia, leprosy, tuberculosis, permanent impotency, and shrinking of the penis.Factors apart from reproductive health which results in Dhat rogaNerves are responsible for keeping the semen locked in during a normal state in men. When nerves get weak, semen is discharged during urination or while doing normal activities in the form of a white discharge, called dhat.This problem further strains other organs like liver and a poorly functioning liver increases weakness related to muscles and also reduces energy levels, fat metabolism, and contaminates blood.Prostatitis, a disease of the prostate gland which secretes seminal fluids can also aggravate dhat.A weak digestive system, prone to constipation and piles also causes dhat. This is seen as a white discharge while defecation.Modern science has not been able to understand an organic evolution of this condition and hence has no form of medication to treat it. Hence, it is often considered a neurotic condition. According to Ayurveda, apart from excessive masturbation and a weak reproductive health, conditions such as weak digestion, constipation and prostatitis can also trigger the symptoms of Dhat roga.Ayurveda believes that the body always functions as a complete entity and hence no condition can be isolated and treated. Hence when treating diseases, it approaches it through changes in the person’s diet, exercise and lifestyle, mental health and overall physical health. In the case of treatment for Dhat roga, it is important for the doctor to first correct the patient’s erroneous beliefs and listen to the person before medicating him.Tips and treatments in AyurvedaAyurveda postulates leading a controlled sexual life to counteract dhat.Charaka samhita postulates that semen is all pervasive within the body like "oil in the sesamic seed" and suggests one ejaculation per week in summer and 168 total yearly ejaculations as the optimal sexual frequency for males.Over-indulgence in sex and especially masturbation can cause an imbalance in the dhatus with a resultant physical illness called dhat.Ayurvedic cureUse herbs which enhance energy and performance of the reproductive system. These herbs will remove debility and weakness and will elevate levels of testosterone hormone in the body to rejuvenate and re-energize the reproductive system.These pills also contain herbs which strengthen, repair and stimulate nerves and maintain an optimum supply of energy throughout the day to prevent semen discharge with urine.Shilajit is a herb that is known for enhancing sexual potency. Shilajit capsules come loaded with herbs which supplement minerals and nutrients in a bio-available form to remove deficiencies improving the functioning of organs and muscles to counteract fatigue.Regular counselling is often advocated in such cases along with anti-anxiety and anti-depression medication. Medication may also be prescribed to keep semen from leaking into the urine. The patient is also taught to relax so as to ensure the smooth functioning of the genitourinary system. If you wish to discuss about any specific problem, you can consult a Sexologist.