What is retrograde ejaculation?
In males, urine and ejaculate both pass through the urethra. There’s a muscle, or sphincter, near the neck of the bladder that helps to hold urine in until you’re ready to urinate.
During orgasm, that same muscle contracts to keep ejaculate from entering the bladder. That allows it to flow through the urethra and out the tip of your penis.
In retrograde ejaculation, this muscle fails to contract. Because it stays relaxed, the ejaculate ends up in your bladder. The result is what’s called a dry orgasm. Despite the lack of ejaculate, it feels like a normal orgasm and doesn’t usually affect sexual pleasure.
It’s not a disease or a serious threat to your health.
Continue reading to learn what causes it, when you should see a doctor, and why some men may want to seek treatment.
What are the symptoms?
The main symptom of retrograde ejaculation is that there’s very little or no semen when you have an orgasm. That’s because the semen found its way into your bladder instead of your urethra.
Because the semen becomes mixed with urine, you might also notice that your urine looks a little cloudy right after you’ve had sex.
Another sign of retrograde ejaculation is that you’ve been trying unsuccessfully to conceive a child. This is known as male infertility.
How does it affect fertility?
Retrograde ejaculation impairs your fertility, but it’s not a common cause of infertility. It causes only about 0.3 to 2 percent of infertility problems.
Retrograde ejaculation doesn’t mean that your sperm aren’t viable. Instead, infertility occurs because your sperm isn’t making it to your partner.
What causes it?
While some other problems with ejaculation can have psychological causes, retrograde ejaculation is the result of a physical problem.
It can be caused by anything that affects the reflex of the muscle at the opening of the bladder.
Retrograde ejaculation is a potential side effect of some medications, including those prescribed to treat enlarged prostate, high blood pressure, or depression.
It could also be due to nerve damage caused by certain conditions, such as:
- multiple sclerosis
- Parkinson’s disease
- spinal cord injury
Surgery for prostate cancer can damage nerves that affect the prostate, seminal vesicles, and bladder. A type of surgery called transurethral resection of the prostate (TURP) causes damage to the bladder valve.
The most common causes of retrograde ejaculation are prostate surgery and bladder surgery.
What are the risk factors?
These factors may put you at higher risk of developing retrograde ejaculation:
- multiple sclerosis
- Parkinson’s disease
- a spinal cord injury
- surgery involving your prostate or bladder
- certain medications to treat enlarged prostate, high blood pressure, or depression
How is it diagnosed?
If you’re having frequent dry orgasms, it might be a good idea to see your doctor. Although retrograde ejaculation isn’t harmful to your health, there could be other reasons for dry orgasm. You also could have an underlying condition that should be addressed.
Your doctor will likely want to perform a physical examination to check for obvious abnormalities. To further evaluate your condition, your doctor will assess signs and symptoms such as:
- lack of ejaculate during orgasm
- cloudy urine after orgasm
Be sure to tell your doctor:
- how long and how often you’ve been having dry orgasms
- any other symptoms you may have noticed
- if you’re aware of any preexisting chronic illnesses or injuries
- about any medications you take
- if you’ve been treated for cancer, and what those treatments were
A urine test is a good way to find out if the lack of ejaculate is due to retrograde ejaculation. You may be asked to masturbate before providing a urine sample. If your urine contains a high amount of sperm, the diagnosis will be retrograde ejaculation.
If your post-orgasm urine doesn’t contain semen, there may be an issue with semen production or some other problem. You may need to see an infertility specialist or other doctor for further testing.
Can it be treated?
Retrograde ejaculation doesn’t necessarily require treatment. It shouldn’t interfere with your sexual enjoyment, and it poses no risks to your health. But remedies are available.
When it’s caused by medication, it should resolve once you stop taking the medicine. Don’t stop taking prescribed medications until you speak with your doctor, however. You may have to try going off a drug to see if it helps, but you’ll need to do it safely and understand all your options.
Before prescribing a new medication, your doctor will consider your overall health, including other conditions you may have. A variety of medications can help keep the bladder neck muscle constricted during ejaculation. Some of these are:
- brompheniramine (Ala-Hist, J-Tan, Veltane)
- chlorpheniramine (Aller-Chlor, Chlor-Trimeton, Polaramine, Teldrin)
- imipramine (Tofranil)
- phenylephrine (Children’s Sudafed, Pediacare, Vazculep)
- pseudoephedrine or phenylephrine (Silfedrine, Sudafed, SudoGes, Suphedrin)
If you have severe nerve or muscle damage due to surgery, medications are generally not effective.
If you’re trying to conceive and medication doesn’t help, consider seeing a fertility specialist. It’s possible to retrieve sperm for artificial insemination or in vitro fertilization.
Are there any complications?
Retrograde ejaculation doesn’t cause pain or lead to any serious health complications. It doesn’t stop you from having an erection or an orgasm.
If lack of ejaculate causes you distress, it can certainly interfere with your sexual pleasure.
The major complication is infertility, and that’s only a problem if you want to father a child.
What can I expect?
If you’re having orgasms without ejaculate, it’s worth checking it out with your doctor to examine the cause and rule out underlying disease.
There are no serious risks to your health, nor does it necessarily interfere with your sex life.
Treatment isn’t usually needed unless you’re trying to father a child. If that’s the case, you can pursue your options with a fertility specialist.