Introduction

In the realm of sexual health, various conditions can impact an individual's well-being and satisfaction. One such condition that often goes unnoticed is retrograde ejaculation.

Despite its relatively low public awareness, retrograde ejaculation can significantly affect a man's physical and emotional health. It can be a cause of infertility in men.

This blog aims to shed light on the causes, symptoms, treatments, and psychological impact of retrograde ejaculation, providing valuable insights for those seeking information on this less-discussed aspect of sexual health.

What is Retrograde Ejaculation?

Retrograde ejaculation is a medical condition where semen, instead of being expelled out of the penis during ejaculation, is redirected into the bladder where urine is stored.

This occurs due to the failure of the bladder neck muscles to close properly during orgasm, allowing semen to travel backward into the bladder rather than exiting the body.

So you would still reach the sexual climax but only little or no semen comes out during ejaculation. You may pass a cloudy urine after the sexual activity.

It is sometimes known as a dry orgasm but they are essentially not the same thing. Dry orgasm can be an indication of retrograde ejaculation.

Prevalence of Retrograde Ejaculation

While retrograde ejaculation is considered a rare condition, its prevalence may be underestimated due to underreporting and lack of awareness.

However, approximately 1 in 200 men experiencing fertility issues are affected by the condition.

Who Are More Susceptible to Have Retrograde Ejaculation?

Certain factors can heighten the susceptibility to retrograde ejaculation, including age, underlying medical conditions, and specific medications.

Men with diabetes, multiple sclerosis, or a history of prostate surgery are more likely to experience this condition.

Causes

Retrograde ejaculation happens mainly due to a problem with the bladder neck muscle.

During orgasm, the bladder neck muscle, which controls the bladder opening remains closed to keep the semen from entering the bladder as it flows from the prostate to the tube in the penis (urethra).

In retrograde ejaculation, the bladder neck muscle fails to tighten adequately and the sperm enters the bladder instead of being ejected out through the penis.

Common conditions that may cause retrograde ejaculation are:

• Medications, particularly those prescribed for hypertension (high blood pressure) and prostate conditions.
• Conditions such as diabetes, multiple sclerosis, and spinal cord injuries can affect the nerves that control ejaculation.
• Nerve damage caused by surgical procedures involving the prostate or bladder
• Surgeries in the abdominal area can disrupt the normal anatomy, leading to retrograde ejaculation.

Symptoms

Recognizing the symptoms of retrograde ejaculation is crucial for seeking timely medical intervention. Men with retrograde ejaculation may have the following symptoms:

• Absence of semen during ejaculation, resulting in a dry orgasm.
• Semen entering the bladder may cause urine to appear cloudy after orgasm
• Infertility issues arise as sperm is not released through the usual channel

Diagnosis

Your doctor will inquire about your medical history, and conduct a physical examination.

Then, your doctor may ask you to do the following tests.

• Urine and Semen Analysis
• Ultrasound or retrograde urethrogram to visualize urinary and reproductive structures.
• Urodynamic tests are used to assess bladder and urethral function

Based on these assessments your doctor will recommend appropriate treatment or further evaluation.

Treatments

Medical intervention is often necessary to address retrograde ejaculation.

Treatment options include:

• Adjusting or discontinuing medications that cause retrograde ejaculation.
• Medications that tighten the bladder neck muscles may be prescribed to prevent semen from entering the bladder. Always consult with your doctor before taking any medications.
• For those seeking to conceive, assisted reproductive techniques such as intrauterine insemination (IUI) or in vitro fertilisation (IVF) may be recommended.

The Psychological Impact of Having Retrograde Ejaculation

The psychological impact of retrograde ejaculation should not be underestimated.

You may experience frustration, embarrassment, and a diminished sense of masculinity.

Although retrograde ejaculation itself is not harmful, it can lead to male infertility. You may be finding it hard to get your partner pregnant. Or have less enjoyable orgasms due to concerns about little or no semen.

Speaking with a healthcare professional and emotional support are essential components of coping with the psychological effects of this condition.

Is Retrograde Ejaculation Preventable?

There are many ways to reduce the risk of experiencing retrograde ejaculation:

• If your medications or health conditions raise the risk of retrograde ejaculation, consult your doctor to adjust your medications.
• Before surgeries affecting the bladder neck muscle, like prostate or bladder surgery, talk to your doctor about the potential risk of retrograde ejaculation.
• If future family plans are on your mind and surgery is on the cards, discuss semen preservation options with your doctor beforehand.
• Properly manage conditions like diabetes and multiple sclerosis.
• Practice safe sex to prevent complications.
• Attend routine check-ups for early issue detection.
• Maintain a healthy lifestyle with exercise and a balanced diet.
• Strengthening pelvic floor (kegel exercises) muscles may enhance bladder neck control.

When to See a Doctor?

Consult a doctor if

• You may have experienced dry orgasms, cloudy urine after ejaculation, or fertility issues, as these may signal retrograde ejaculation.
• encounter pain or discomfort during sexual activity.
• recent medication changes are affecting your sexual function.

FAQs

Can retrograde ejaculation be cured?

Retrograde ejaculation can be managed effectively with the right medical interventions, but a complete cure may not always be possible.

Is retrograde ejaculation painful?

Retrograde ejaculation itself is not painful, but individuals may experience discomfort due to the underlying causes or emotional distress.

Does retrograde ejaculation affect fertility?

Yes, retrograde ejaculation can impact fertility as the sperm is not released through the usual pathway.

Can medications cause retrograde ejaculation?

Certain medications, particularly those used to treat hypertension and prostate conditions, may contribute to retrograde ejaculation.

Is retrograde ejaculation a common condition?

Retrograde ejaculation is considered rare, but its prevalence may be higher in specific populations with underlying health conditions.

Conclusion

Retrograde ejaculation, though less commonly discussed, can have profound effects on both physical and emotional well-being.

Awareness of the causes, symptoms, and available treatments is essential if you are dealing with this condition.

Seeking professional medical advice and emotional support can significantly contribute to managing retrograde ejaculation and improving the overall quality of life.

References

• Yavetz H, Yogev L, Hauser R, Lessing JB, Paz G, Homonnai ZT. Retrograde ejaculation. Hum Reprod. 1994 Mar;9(3):381-6. doi: 10.1093/oxfordjournals.humrep.a138513. (Accessed 21/12/2023)
  
• Shamloul, R., & Ghanem, H. (2013). Erectile dysfunction. The Lancet, 381(9861), 153-165. (Accessed 21/12/2023)
• Goldstein, I., & Meston, C. M. (2019). Handbook of Sexual Dysfunction. John Wiley & Sons. (Accessed 21/12/2023)
• Turner, T. T., & Lysiak, J. J. (2008). Oxidative stress: a common factor in testicular dysfunction. Journal of Andrology, 29(5), 488-498. (Accessed 21/12/2023)
• Kovac, J. R., Lipshultz, L. I., & Lamb, D. J. (2011). Advances in the understanding of the genetics of spermatogenic failure. BJU International, 108(10), 1764-1776. (Accessed 21/12/2023)
• Practice Committee of the American Society for Reproductive Medicine. (2015). Diagnostic evaluation of the infertile male: a committee opinion. Fertility and Sterility, 103(3), e18-e25. (Accessed 21/12/2023)
• Rowland, D., McMahon, C. G., Abdo, C., Chen, J., Jannini, E., Waldinger, M. D., ... & Torres, L. O. (2010). Disorders of orgasm and ejaculation in men. The Journal of Sexual Medicine, 7(4 Pt 2), 1668-1686. (Accessed 21/12/2023)
• Dorey, G., Speakman, M. J., Feneley, R. C., & Swinkels, A. (2005). Pelvic floor exercises for erectile dysfunction. BJU International, 96(4), 595-597. (Accessed 21/12/2023)
• NIH. (2020). Retrograde Ejaculation. National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed 21/12/2023)
• WebMD, What is Retrograde Ejaculation, Available at: https://www.webmd.com/men/what-is-retrograde-ejaculation. (Accessed 21/12/2023)
• Mayoclinic, Retrograde Ejaculation, Available at: https://www.mayoclinic.org/diseases-conditions/retrograde-ejaculation/symptoms-causes/syc-20354890. (Accessed 21/12/2023)