Guide on Retrograde Ejaculation: Causes, Symptoms, & Treatment

Introduction

Usually, the muscles of the bladder tighten at this time, causing the semen to head to the penis. But if the muscle doesn’t contract properly, then the semen could enter the bladder.

The Definition of Retrograde Ejaculation

Retrograde ejaculation can be medically defined as ‘backward passage of semen into the bladder after emission usually due to failure of closure of the bladder neck mechanism, demonstrated by the presence of spermatozoa in the urine after orgasm’ (Hendry et al., 2000).

The prevalence of retrograde ejaculation is unknown but it can be classified as acquired, congenital, or psychological. Although not harmful, one of the retrograde ejaculation symptoms that do remain is the problem of the man and his partner trying to conceive.
Because of the lack of sperm and semen, it becomes a challenge.

What are the Causes of Retrograde Ejaculation?

Retrograde ejaculation causes can be a result of certain diseases or injuries. These are:

• Diabetes – Diabetes can cause a man to develop retrograde diabetes. This would have resulted from poor blood control over a long period that caused neuropathy of the bladder, which is nerve damage.

  The disorder would be called diabetes autonomic neuropathy, where a man loses control of the bladder, and either urinates too much or too little.

• Multiple sclerosis – Approximately 91% of men say that they have difficulty achieving erections during intercourse because they have MS. It varies from man to man. It is an autoimmune disease, often causing scar tissue (sclerosis) to develop.

  Men with MS often receive poor auditory, visual, or sensory sexual cues from the brain. Therefore, the neurological impulses may not convert effectively from the brain to the genitalia.

• Parkinson’s disease – Men often have problems with sexual function caused by Parkinson’s disease. They might experience muscle movement and stiffness, which makes sex difficult.

  Parkinson’s disease can affect the nerves that control the sexual organs, and this can cause a man to experience difficulty in getting or maintaining an erection as well as delayed ejaculation. It can also affect arousal^[1] in both women and men.

• Spinal cord injury – When a man has a spinal cord injury, his ejaculation will likely be affected. Ejaculation becomes even more complex than having an erection. There are very few men with complete SCI who can ejaculate.

  Sometimes, an SCI injury can prevent the neck of the bladder from closing, which means the semen goes into the bladder instead of out the penis.

  Fortunately, retrograde ejaculation doesn’t harm a man, and the semen goes out with the urine.

  However, there is still the chance that semen will come out. Birth control would be required if the couple does not want children.

• Surgery involving your prostate or bladder – Surgery to these areas, for instance in prostate cancer, can damage the nerves that affect the bladder, prostate, and seminal vesicles.

  A surgery known as TURP or transurethral resection of the prostate can cause damage to the valve of the bladder. Prostate and bladder surgery are the most common retrograde ejaculation causes.

What are the Symptoms of Retrograde Ejaculation?

• Dry Orgasm – As a guy, you will wonder why there is no semen present when you ejaculate. The semen went into your bladder instead of out of your penis. It’s known as a dry orgasm.

  Experts say that there could be many reasons for a dry orgasm. It could be the side effects of medicine or having sex that lasts very long, where a man has several orgasms and his semen just gets depleted.

• Cloudy Urine – You will notice that your urine is cloudy after orgasm^[2]. That is because it contains semen in it. Usually, during sex, semen will travel out the body and the penis, but with retrograde ejaculation, the semen backs up into the bladder.

  It is not likely^[3] you will be able to get a woman pregnant because the semen doesn’t come out of the penis but enters the bladder instead.

  Retrograde Ejaculation – doesn’t make getting pregnant impossible. It’s just that the number of available sperm is decreased, making the chances of pregnancy lower.

  It could be that some retrograde ejaculation treatments would simply just be stopping a certain medication. It’s not always that simple though.

• Male Infertility – Retrograde ejaculation can impair a man’s fertility. It doesn’t mean your sperm isn’t viable, it means that infertility occurs because your sperm isn’t arriving into your partner.

  You might wonder at the pain you could experience because repeated retrograde ejaculation can lead to bladder infections^[4], which in themselves, can be painful.

The Diagnosis for Retrograde Ejaculation

• The doctor will ask you important health questions about your retrograde ejaculation symptoms.
• He will want to find out what medications you take.
• He will do a physical examination of your penis, testicles, and rectum.
• Then he will test your urine to check for semen after you have had an orgasm.

All these activities and procedures will normally get done at the doctor’s office. If the doctor finds a high volume of sperm in your urine, he will probably tell you he suspects retrograde ejaculation.

If you do have dry orgasms but there isn’t semen in your bladder, then you might have problems with the production of semen caused by damage to your prostate or semen-producing glands. Further tests might be required if your dry orgasms are not because of retrograde ejaculation.

What are the Treatments of Retrograde Ejaculation?

Retrograde ejaculation doesn’t require treatment unless it concerns fertility.

• Drug Therapy – Medicines can work for retrograde ejaculation that is caused by nerve damage in diseases such as multiple sclerosis, diabetes, certain surgeries, and other conditions and treatments.

  If your doctor thinks there are medicines you are taking that might be affecting your ability to ejaculate normally, then he might ask you to stop taking them for some time.
  Some medications for depression can cause this, or medicines for treating high blood pressure or some prostate conditions.

• Retrograde Ejaculation Treatments for Infertility – These treatments will be because you cannot get your female partner pregnant.

  Semen needs to be ejaculated into your partner’s vagina and then into her uterus to be successful.

  For this, you will need infertility procedures, which are called Assisted Reproductive Technology to get your partner pregnant. Sometimes, sperm can get recovered from the bladder and processed in a lab, and then used to inseminate your partner.

• Surgery – Surgery is available but not usually recommended. It is only recommended when all other methods fail and can have inconsistent results. Your doctor will discuss this with you, if necessary.

• Exercises– Physical activities and training can help great deals when you show signs of retrograde ejaculation symptoms. Additionally, being overweight can cause problems as well.

What Are the Risk Factors Associated with Retrograde Ejaculation?

There are a few risk factors associated with retrograde ejaculation such as:

• Nerve Damage – This would be because you have multiple sclerosis or diabetes.
• Prostate or Bladder Surgery – The removal of any of these parts through surgery is one of the common retrograde ejaculation causes – Around 10-15% of men undergoing this type of surgery can expect to get RE. Often, surgery damages the muscles and nerves of the bladder.
• Medications – You can experience side effects from certain drugs that you take for mood disorders or high blood pressure, or for spinal cord injuries, for example. Then your doctor might recommend that you stop taking them for some time to check.

Are there Any Complications Associated with Retrograde Ejaculation?

Even though retrograde ejaculation isn’t harmful, one of the most potential complications is you will not be able to get a woman pregnant.

Experiencing orgasms with the ejaculation of semen might seem less pleasurable to a guy^[5] and he would worry about whether the woman’s pleasure would be satisfied knowing that no semen is being ejaculated out the penis.

What Should I Expect from My Doctor?

He will ask you what symptoms you have had and how long you have had them. Also, he will ask you about other health problems and surgeries concerning retrograde ejaculation causes, checking whether you have any current health problems such as cancer, or diabetes, for example.

He will find out if you are taking any medications. And you can expect to get a physical examination of your testicles, penis, and rectum.

Conclusion

Naturally, men will be asking if retrograde ejaculation symptoms are reversible. Well, not always, but infertility is treatable. Even if a guy can’t ejaculate at all, a fertility specialist can help.

When it comes to retrograde ejaculation, surgical procedures should be a last resort. There are many treatment techniques, although there are limited published studies.

Therefore, no direct comparisons can be made between the success rates of each method.