Should a man worry about retrograde ejaculation?

Ejaculation is pretty straightforward. It involves the release of semen from the urethra and the penis resulting in an orgasm and is considered the final stage of male sexual stimulation.

When a man ejaculates, we all know the outcome of what typically happens.  But what if a man doesn’t have the expected explosion of semen coming out of the penis?  Often referred to as a “dry orgasm,” this condition has a name – retrograde ejaculation.

Men who have retrograde ejaculation will have no problem being able to reach sexual climax but they ejaculate very little to no semen. It is not a harmful condition but it can result in male infertility.

What is happening in retrograde ejaculation?

Retrograde ejaculation is when semen which normally exits out of the penis, instead travels into the bladder.  To understand what is going on in this circumstance, it is necessary to have a brief anatomy lesson. 

When a man has an orgasm, a tube called the vas deferens transports sperm to the prostate, where it mixes with other fluids to produce liquid semen which is what is ejaculated during climax.  The prostate sits between the bladder on one side with the penis on the other side.  When a man is ready to ejaculate, semen will travel out of the seminal vesicle into the prostate.  At this point, the semen can go either of two ways – into the bladder or out through the penis.  In normal conditions, the smooth muscle in the bladder tightens to prevent semen from entering the bladder as it passes from the prostate into the urethra inside the penis.  This same smooth muscle is what holds in urine in the bladder until it is ready to be released. 

In men with retrograde ejaculation, this smooth muscle does not contract and the semen that is ejaculated will travel up into the bladder instead of out the penis.

Symptoms of retrograde ejaculation

The good news for men with this condition is that retrograde ejaculation does not affect his ability to get an erection or to have an orgasm.  What a man may notice though are the following symptoms:

·      Very little to no semen that is ejaculated out of the penis during an orgasm

·      Urine that is cloudy after orgasm because it contains semen

·      Inability to conceive or male infertility

Is retrograde ejaculation a cause for concern?

Usually retrograde ejaculation is not harmful or painful. A man’s body will simply flush out the semen the next time he urinates.  This is why he may notice his urine being cloudy.  However, any man who is experiencing dry orgasms should see a urologist to make sure the condition is not being caused by an underlying medical problem needing attention. One possibility in an otherwise healthy man could be an obstruction or blockage in the urethra which would also cause a slow urine stream. 

The main cause for concern will be the difficulty in conceiving a baby.  If a couple has had regular, unprotected sex for a year or longer without conceiving, they need to see their doctor.  Both the man and woman should be evaluated as retrograde ejaculation might be the cause of the problem of infertility. 

Causes or risk factors for retrograde ejaculation

There are several things that may be causing or putting a man at a greater risk of experiencing dry orgasms:

Causes might include:

·      Side effects of certain medications used to treat high blood pressure, prostate enlargement, and depression

·      Nerve damage caused by a medical condition, such as diabetes, multiple sclerosis, Parkinson’s disease or a spinal cord injury

·      Surgical removal of the prostate (prostatectomy)

·      Surgical removal of the bladder

·      Radiation therapy to treat cancer in the pelvic area

Risk factors putting a man at an increased risk of developing retrograde ejaculation include:

·      Diabetes

·      Multiple sclerosis

·      Spinal cord injury

·      Medications for high blood pressure or depression

The important thing for any man who is experiencing a noticeable change in his ejaculate amount and suspects it might be retrograde ejaculation, is to see a urologist who will ask questions about symptoms, conduct a physical exam and will assess urine for the presence of semen after an orgasm.  Depending on what the cause is determined to be, will determine on if or any treatment is required.