Retrograde ejaculation, also known as a dry orgasm, is not harmful but can causemale infertility.
There are several causes, including bladder or prostate surgery, nerve damage, and certain medications.
Retrograde doesn’t necessarily need treatment unless it affects your ability to conceive.
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Semen is the thick, white fluid made by theprostate glandandseminal vesicles.
It carriesspermout of the body.
Retrograde ejaculation can happen acutely after a recent procedure or new medication.
It can then becomechronic(ongoing).
When the person masturbates, very little (if any) semen is produced.
Even so, retrograde ejaculation can be a source of anxiety for people trying to conceive.
Related Conditions
Retrograde ejaculation is a form ofaspermia.
This is a group of conditions characterized by the lack of semen during ejaculation.
Causes
Retrograde ejaculation is because of the redirection of the normal flow of semen.
With retrograde ejaculation, something interferes with this reflex.
It is only later during urination that the semen will be expelled from the body in urine.
There are several causes for retrograde ejaculation, some of which are more easily treated than others.
How Common Is Retrograde Ejaculation?
The actual prevalence of retrograde ejaculation is unknown as it is often left unreported.
With that said, around 4% of males with infertility are found to have retrograde ejaculation.
With retrograde ejaculation specifically, dysautonomia impairs the contraction of the bladder neck muscles.
Dysautonomia can occur on its own in the absence of other diseases, referred to asprimary dysautonomia.
Dysautomia can also occur as a result of another disease, referred to assecondary dysautonomia.
This typically involves diseases that damage autonomic nerves.
When blood sugar is left uncontrolled, diabetes can cause progressivenerve damagethat undermines the function of the bladder neck.
Some studies suggest that 1 in 3 maleswith diabetes age 35 to 55 have ejaculatory problems as a result.
Other forms of secondary dysautonomia linked to retrograde ejaculation includemultiple sclerosis (MS)and Parkinson’s disease.
One of the most common surgeries to cause retrograde ejaculation istransurethral prostate resection (TURP).
Retrograde ejaculation can also occur afterretroperitoneal lymph node dissection.
Some studies suggest that retrograde ejaculation affects 17% to 29% of males with spinal cord injuries.
Diagnosis
Retrograde ejaculation is usually diagnosed with a urine specimen collected after ejaculation.
For this test, your healthcare provider will ask you to empty your bladder and then masturbate to climax.
You will then provide a fresh urine sample for the lab to check.
If there is a high volume of semen in the sample, you have retrograde ejaculation.
This can ensure there are no anatomical causes of your symptoms.
Based on the findings, other tests may be ordered.
Treatment
Retrograde ejaculation usually doesn’t require treatment unless it causes infertility.
In such cases, the treatment can vary based on the underlying cause.
Some “fixes” may be easier than others.
This is especially true if you and your partner are trying to get pregnant.
Medications can help tighten the bladder neck and increase the output of semen during ejaculation.
This, in turn, can help improve the odds of pregnancy.
While potentially useful, they can cause side effects like drowsiness, dizziness, and blurred vision.
This would involve collecting enough sperm to facilitate pregnancy, after which the sample is delivered to the partner’suterus.
The sperm collection can be accomplished by masturbating to climax and immediately urinating into a container.
Sperm can be recovered by spinning the urine in a centrifuge.
The retrieved sperm can then be injected into the partner’s uterus duringovulationby a medical practitioner.
While retrograde ejaculation does not make getting pregnant impossible, the chances are reduced.
If IUI doesn’t accomplish pregnancy,in-vitro fertilization (IVF)and other procedures may be explored.
This is a bigger issue than some people recognize.
Others say their orgasms were far more intense when semen volumes were greater.
The simple solution, of course, is to talk.
The same is even more true if you and your partner are trying to get pregnant.
It is an otherwise harmless condition but one that can lead to infertility.
Treatment is generally not needed unless retrograde ejaculation causes infertility.
In such cases, medications can help tighten bladder muscles and increase semen output.
Infertility treatments like intrauterine insemination (IUI) can also improve the odds of conceiving.
2018;15(11):1600-1608. doi:10.1016/j.jsxm.2018.08.014
