Retrograde ejaculation occurs when semen enters the bladder instead of emerging through the penis during orgasm. Although you still reach sexual climax, you may ejaculate very little or no semen. This is called a dry orgasm. Retrograde ejaculation isn't harmful, but it can cause male infertility.
Retrograde ejaculation can be caused by medications, health conditions or surgeries that affect the nerves or muscles that control the bladder opening. If retrograde ejaculation is caused by a drug you're taking, stopping the drug may be an effective treatment. For retrograde ejaculation due to a health condition or as a result of surgery, treatment with drugs may restore normal ejaculation and fertility. But treatment for retrograde ejaculation is generally only needed to restore fertility.
Retrograde ejaculation doesn't affect your ability to get an erection or have an orgasm — but when you climax, semen goes into your bladder instead of coming out of your penis. Retrograde ejaculation symptoms include:
When to see a doctor
If you and your partner have had regular, unprotected intercourse for a year or longer and have been unable to conceive, see your doctor. Retrograde ejaculation may be the cause of your problem if you ejaculate very little or no semen.
During a male orgasm, sperm are released from each of the testicles. A tube called the vas deferens then transports sperm to the prostate, where they mix with other fluids to produce liquid semen (ejaculate). The muscle at the opening of the bladder (bladder neck) tightens to prevent ejaculate from entering the bladder as it passes into the tube inside the penis (urethra). This is the same muscle that holds urine in your bladder until you urinate. With retrograde ejaculation, the bladder neck muscles don't tighten properly. As a result, sperm can enter the bladder instead of being ejected out of your body through the penis.
Several conditions can cause problems with the muscle that closes the bladder during ejaculation. These include:
A dry orgasm is the primary sign of retrograde ejaculation. But dry orgasm — the ejaculation of little or no semen — can also be caused by other conditions, including:
During retrograde ejaculation, semen travels into the bladder instead of exiting the body through the penis. ...
You're at increased risk of retrograde ejaculation if:
Retrograde ejaculation isn't harmful. However, potential complications include:
Preparing for your appointment
You're likely to start by seeing your family doctor. Depending on the likely cause of your dry orgasms and whether you need evaluation and treatment to help you get your partner pregnant, you may need to see a urinary and reproductive specialist (urologist).
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions ahead of time will help you make the most of your time together. List your questions from most important to least important in case time runs out.
When seeing your doctor for dry ejaculation — the primary sign of retrograde ejaculation — some basic questions to ask your doctor include:
If you are trying to get your partner pregnant, you may also want to ask:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Being ready to answer your doctor's questions may save time to go over any points you want to spend more time on. Your doctor may ask:
Tests and diagnosis
When you see the doctor, he or she will probably:
If you have dry orgasms, but your doctor doesn't find semen in your bladder, you may have a problem with semen production. This can be caused by damage to the prostate or semen-producing glands as a result of surgery or radiation treatment for cancer in the pelvic area. If your doctor suspects your dry orgasm is something other than retrograde ejaculation, you may need further tests or a referral to a specialist to find the cause.
Treatments and drugs
Retrograde ejaculation typically doesn't require treatment unless it interferes with fertility. In such cases, treatment depends on the underlying cause. Drugs may work for retrograde ejaculation caused by certain conditions.
If your doctor thinks drugs you are taking may be affecting your ability to ejaculate normally, he or she may have you stop taking them for a period of time. Drugs that can cause retrograde ejaculation include certain medications for mood disorders and alpha blockers — drugs used to treat high blood pressure and some prostate conditions.
Drugs to treat retrograde ejaculation are drugs primarily used to treat other conditions. They include:
These medications help keep the bladder neck muscle closed during ejaculation. While they're often an effective treatment for retrograde ejaculation, all of these medications can cause side effects. Some of the side effects are minor, but others can be more serious.
If medication doesn't allow you to ejaculate semen, you will likely need infertility procedures known as assisted reproductive technology (ART) to get your partner pregnant. With ART, sperm can be recovered from the bladder, processed in the laboratory and used to inseminate your partner (intrauterine insemination). Occasionally, more advanced assisted reproductive techniques may be needed. Many men with retrograde ejaculation are able to get their partners pregnant once they seek treatment.
Coping and support
Retrograde ejaculation can be a challenge if you and your partner want to conceive a child. While most men can get their partners pregnant with infertility treatment, it can be costly and require stressful medical procedures for both you and your partner.
Understanding all of your options and communicating with your doctor and partner can help.
If you need to have surgery that may affect the bladder neck muscle, such as prostate or bladder surgery, or if you have a spinal injury, there's little you can do to prevent retrograde ejaculation. However, there are things you can do to prevent retrograde ejaculation caused by nerve damage from diabetes or the use of certain medications.
Last Updated: 2011-02-17
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