Retrograde Ejaculation - Causes and Treatment

Retrograde Ejaculation – One of the ejaculatory dysfunctions experienced by men. In normal ejaculation, during orgasm, the semen comes out of the testicles through the penis. Instead, if the semen enters the bladder and does not come out of the penis – such a condition is called Retrograde Ejaculation. This is also called Dry Orgasm sometimes. Though not harmful, this condition causes Male Infertility (or Infertility in Men). As no semen / sperm comes out of the penis, impregnating your partner may not be possible.

How do you know that you are suffering from Retrograde Ejaculation?

RE has got nothing to do with getting an erection or having an orgasm. However, you barely ejaculate any sperm/semen during orgasm.  Symptoms of Retrograde Ejaculation are:

1. Inability to get your female partner pregnant. (Male Infertility)
2. Very little or almost no semen ejaculated after having an orgasm during sex or masturbation.
3. As the semen enters the bladder, next time when you urinate, urine looks cloudy because of presence of semen.

Should you be worried if you have RE?

Yes and No, depends on whether you are trying to father a child. If you already have children and not looking for more, you need not worry about this condition. However, you need to see a doctor just to make sure that you don’t have any severe unknown underlying problem that is causing this condition.

If you are trying to make off springs, you should certainly see a sexologist/urologist to get this problem treated.   If you and your female partner are trying for a baby by having unprotected sex, but not successful AND if you are ejaculating very little to no semen, you must see a sexologist near you.

What causes retrograde ejaculation?

During male orgasm, sperm travels through a tube called ‘Vas Deferens’ to the prostate. In the prostate, sperms get mixed with other seminal fluids to produce the ‘ejaculate’. This ejaculate then travels through the penis and comes out during orgasm.  As you already know, penis has only one tube to ejaculate as well as urinate. So, in the body, there exists a ‘gate’ kind of thing which opens only for either urine from bladder to pass through the penis OR the semen from the prostate. This gate has to close tightly when the semen is being ejaculated. If the muscles inside the pelvis area are weak, the bladder gate doesn’t close properly, letting the semen enter the bladder instead of getting ejaculated.

Now, the question is, what caused this weak muscle problem:

1. Surgery, such as ‘bladder neck surgery’ or surgery for testicular cancer or prostate surgery.
2. Side effect of some medications that are used to treat High blood pressure, prostate enlargement and depression.
3. Problems such as diabetes, multiple sclerosis, parkinson’s disease or a spinal cord injury can cause nerve damage that can lead to Retrograde ejaculation.
4. Surgical removal of the prostate can also cause RE
5. Surgical removal of the bladder (Cystectomy)
6. Radiation therapy to treat cancer in the pelvic area.

Who is at risk of getting Retrograde Ejaculation problem?

1. Men suffering from diabetes or multiple sclerosis
2. Men who had prostate or bladder surgery
3. Men taking medicines for high blood pressure or a mood disorder.
4. Men who had spinal cord injury.

If you are suffering from any of the above mentioned conditions or taking medications AND planning for a baby, you must talk to your doctor and if necessary, you need to preserve your semen before any surgery. (Cryopreservation of semen)

Treatment for Retrograde Ejaculation:

Treatment for RE depends on the cause of the problem. If RE is caused due to a surgery that has been performed, then, most likely, no medications would work effectively.

If the problem is caused due to nerve damage or weakening caused due to medications taken for other problems such as Diabetes, High blood pressure etc, your sexologist may prescribe some medications to strengthen the nerves and muscles.   He/She may also suggest to stop/pause the medicines causing the problem depending on your other medical conditions.

Drugs that are used to treat Retrograde Ejaculation are those that are used to treat other conditions such as:

1. Imipramine (Tofranil)
2. Midodrine
3. Chlorpheniramine and Brompheniramine
4. Ephedrine, Pseudoephedrine and Phenylephrine etc.

Treating Infertility in men having Retrograde Ejaculation:

If medications are not helping with your problem and if you are looking for an offspring, your doctor may go for Assisted Reproduction techniques such as IVF, ICSI where the sperm is retrieved from your body and used to inseminate your partner. The technique chosen depends on the fertility conditions of your female partner too.