Retrograde Ejaculation

Retrograde ejaculation is a serious rare type of ejaculation disorder. This occurs when sperm travels backwards and empties into the bladder rather than out the urethra. Men with retrograde ejaculation do not produce semen, but they still experience the feelings associated with orgasm. While this condition is not harmful to your health, it leads to infertility. Often called a dry orgasm, retrograde ejaculation treatment is aimed at restoration of fertility.


What are the symptoms of retrograde ejaculation?

Retrograde ejaculation does not affect your ability to develop an erection or to have an orgasm. However, the semen does not come out of the penis. The main symptoms of retrograde ejaculation are:


  • Producing cloudy urine after sex or when you first get up (due to semen in it).
  • Producing no semen or only a small amount during ejaculation.
  • Inability to get your female partner pregnant.


What causes retrograde ejaculation?

If you and your spouse/partner have had unprotected intercourse for 12 months or more, and have been unable to conceive, you should consult a fertility specialist. Retrograde ejaculation is caused by nerve damage or problems with the muscles surrounding the neck of the bladder. This is the area where the urethra connects to the bladder (called the bladder neck). Damage to this region of the bladder often occurs as a complication from bladder or prostate surgery.

During the male orgasm, the vas deferens transports sperm to the prostate where it mixes in with other fluids to produce liquid ejaculate. When the bladder neck muscle tightens, it prevents semen from entering the bladder. A damaged bladder neck does not function tightly, so the semen backflows into the bladder.


Who gets retrograde ejaculation?

Retrograde ejaculation is rare, but it is often caused by:

  • Bladder surgery
  • Prostate surgery
  • Damaged nerves due to diabetic neuropathy
  • Nerve damage related to multiple sclerosis
  • Side effects to certain medications used to treat mood disorders, prostate enlargement, and high blood pressure
  • Radiation therapy used to treat cancer of the pelvic region


What is the treatment for retrograde ejaculation?

Retrograde ejaculation usually does not require treatment, unless it affects fertility. For many cases, treatment is related to the underlying cause of retrograde ejaculation. Drugs often work to treat retrograde ejaculation treated by nerve damage. Medications are used for nerve damage related to multiple sclerosis, diabetes, surgeries, and other conditions. These drugs include chlorpheniramine, brompheniramine, imipramine, ephedrine, phenylephrine, and pseudoephedrine.

Retrograde ejaculation medications keep the bladder muscle closed with ejaculation. However, when combined with other medications, they can have serious side effects. Be sure to notify the doctor of all medications you are talking. Additionally, these medications may increase the heart rate or blood pressure, so use with caution.

Drugs usually do not help when retrograde ejaculation is related to surgery caused by permanent physical changes of the male anatomy. In addition, certain drugs can actually contribute to retrograde ejaculation, such as alpha blockers and medicines for mood disorders.

Alterations in orgasm are linked to reduction in physical and emotional satisfaction, which may lead to stress for the couple. Retrograde ejaculation is a challenging problem for couples who wish to conceive a child. Assisted reproductive technology can help. Talk with the fertility specialist and ask questions to assure you fully understand your options. Make sure your partner and you both understand the fertility procedures.