Retrograde ejaculation refers to the entry of semen into the bladder instead of going out through the urethra during ejaculation.
Retrograde ejaculation is not life threatening but is one cause of male infertility.
Retrograde ejaculation may cause a couple to experience problems, including infertility, as most sperm fail to enter the partner’s vagina, lowering the chances of conception. To induce pregnancy, the male’s urine may be centrifuged and the isolated sperm injected directly into the woman.
Taoists and Indian Yogis and some fields of alternative medicine recommend and teach deliberate retrograde ejaculation as a way of “conserving the body’s energy”. One manner of achieving this is by applying pressure to the perineum during orgasm. It was believed that doing this caused the sperm to travel into the head and nourish the brain, or that energy is conserved physically by keeping the sperm (and thereby, the “intelligence” that created it) in the body.
Although you still reach sexual climax,
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 signs and symptoms include:
During a male orgasm, sperm is released from each of the testicles. From each testicle, sperm then travels through a tube called the vas deferens. The vas deferens leads into the prostate, where sperm mixes with semen. The muscle at the opening of the bladder (bladder neck) tightens to prevent semen 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.
• Retrograde ejaculation is a common side effect of medications, such as tamsulosin, that are used to relax the muscles of the urinary tract, treating conditions such as benign prostatic hyperplasia. By relaxing the bladder sphincter muscle, the likelihood of retrograde ejaculation is increased.
The medications that mostly cause it are antidepressant and antipsychotic medication; patients experiencing this phenomenon tend to quit the medications.
• Retrograde ejaculation may be caused by prior prostate or urethral surgery, diabetes, some medications, including some drugs used to treat hypertension (high blood pressure) and some mood-altering drugs. The main reason is that the bladder neck does not close off so semen goes backwards into the bladder rather than forward out of the penis.
The condition is relatively uncommon and may occur either partially or completely. The presence of semen in the bladder is harmless. It mixes with the urine and leaves the body with normal urination. Men with diabetes and those who have had genitourinary tract surgery are at increased risk of developing the condition.
• Retrograde ejaculation can be caused by medications, health conditions or surgeries that affect the nerves or muscles that control the bladder opening.
Several conditions can cause problems with the muscle that closes the bladder during ejaculation. These include:
Surgery such as bladder neck surgery or prostate surgery.
Side effect of certain medications used to treat high blood pressure, prostate enlargement and mood disorders.
Nerve damage caused by a medical condition such as diabetes, multiple sclerosis or a spinal cord injury
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:
Surgical removal of the prostate (prostatectomy)
Surgical removal of the bladder (cystectomy)
Radiation therapy to treat cancer in the pelvic area
You’re at increased risk of retrograde ejaculation if:
You have diabetes or multiple sclerosis
You’ve had prostate or bladder surgery
You take certain drugs for high blood pressure or a mood disorder
You had a spinal cord injury
Causes of Retrograde Ejaculation
The following medical conditions are some of the possible causes of Retrograde Ejaculation. There are likely to be other possible causes, so ask your doctor about your symptoms.
• Previous surgery to the prostate
• Diabetes mellitus
• Multiple sclerosis
• Blood pressure medication
• Abdominal, pelvic or genital surgery (see Abdominal symptoms)
• Antidepressant drugs
• Previous radiation for treatment of prostate cancer
• Little or no semen discharged from the urethra during the male sexual climax (during ejaculation)
• Possible infertility
• Cloudy urine after sexual climax
Exams and Tests
A urinalysis performed on a urine specimen that is obtained shortly after ejaculation will reveal a large amount of sperm in the urine.
Medications do not help retrograde ejaculation if there has been permanent damage to the prostate or the testes from radiation. Medications also do not help if prostate surgery has resulted in damage to the muscles or nerves. Medications only work if there has been mild nerve damage caused by diabetes, multiple sclerosis or mild spinal cord injury.
If retrograde ejaculation is caused by drugs, your doctor may recommend that you stop taking such drug. This can make the problem go away.
Retrograde ejaculation caused by diabetes or after genitourinary tract surgery may be treated with epinephrine-like drugs (such as pseudoephedrine or imipramine).
If retrograde ejaculation is caused by medications, discontinuation of the medication often restores normal ejaculation. If retrograde ejaculation is caused by surgery or diabetes, it is often not correctable.
Maintaining good blood sugar control may help prevent this condition in men who have diabetes. Avoiding drugs that cause retrograde ejaculation will also prevent this condition.
Medications used to treat retrograde ejaculation include
• Tricyclic antidepressants.
These medications tighten the bladder neck muscles and prevent semen from going backwards into the bladder. However, the medications do have many side effects and they have to be taken at least 1–2 hours prior to sexual intercourse.