Dhat Syndrome Origin and Various Myths | IASH

Dhat Syndrome

• Dhat syndrome is a culture‑bound syndrome characterized by excessive concern about loss of semen, vague somatic symptoms such as fatigue, weakness and loss of appetite prevalent in Indian subcontinent natives.
• The patient attributes the symptoms to loss of semen in urine or through masturbation or excessive   sexual activity.  
•  Patients with Dhat syndrome experience somatic, anxiety and depressive symptoms and often     present with sexual dysfunction.

Origin of Dhat Syndrome and Various myths related to this syndrome

·         The word ‘Dhat’ derives from the word ‘Dhatu’ which means the elixir of life in Sanskrit. Traditional medicinal system of Ayurveda had considered semen as the most precious among the seven ‘Dhatus’ in human body.

·         It had been believed that it takes 40 drops of blood to be converted into one drop of semen. Hence, conservation of semen was important by all means. There have been attempts to explain how this belief system arose in the Indian psyche.

·         One explanation was that these people do not understand the complex anatomy and physiology of penis and believe that the blood that is collected in the cavernous spaces during erection gets converted into semen and thus, they are losing blood (and, thus energy) with each sexual activity.

Sexuality is considered a taboo in India, and sexual matters are generally not discussed in Indian families. The tabooed nature of sex and discussions related to it in Indian cultural context make it difficult for them to have discussions with peer groups, which prevents normalization of the experience of semen loss. There is lack of sufficient research work on the treatment of Dhat syndrome and treatment offered to the patients suffering from it continues to be esoteric, unstructured and without standardization.

Epidemiological Aspects

Dhat syndrome is widely prevalent in the natives of Indian subcontinent including Nepal, Bangladesh, Srilanka, Pakistan. The patient presenting with Dhat syndrome is typically more likely to be recently married; of average or low socio-economic status (perhaps a student, labourer or farmer by occupation), comes from a rural area and belongs to a family with conservative attitudes towards sex.

Treatment

·         Sex education and relaxation exercises have also been a part of intervention programs.

·         The cognitive behavioral therapy (CBT) has found effective in the treatment of depression, anxiety disorders and somatoform and other medically unexplained symptoms. Since patients with Dhat syndrome experience overlapping symptoms of these disorders, it can be proved that they would respond to CBT aimed at reducing symptoms experienced by them. CBT also appears to be most relevant intervention in view of faulty beliefs and misconceptions about the origin of their symptoms and sexual functioning. CBT would also address distinct illness behavior shown by patients with Dhat syndrome.

·         Antidepressants are also advocated for patients with Dhat syndrome having depressive symptoms.