Retrograde Ejaculation: Everything You Need to Know
A universal fact is that our bodies do some pretty incredible and weird things — well, at least weird in that we don’t always know what’s going on.
And sometimes, those weird things affect a guy’s sex life or sexual health. One example of weird sexual dysfunction? Retrograde ejaculation (also called a dry orgasm).
Not to be mistaken with an astrological event, retrograde ejaculation is just one of several types of male orgasms (yep, there’s more than one way a guy can climax).
While this condition sounds odd, the causes of retrograde ejaculation could point to a serious underlying health issue.
Keep reading to learn how orgasm without ejaculation happens, about retrograde ejaculation treatment and, of course — what retrograde ejaculation is.
What Is Retrograde Ejaculation?
What is a dry orgasm? Put simply, it’s an orgasm that goes backward.
When a man has an orgasm, semen typically travels forward through the urethra and is expelled from the body through the contraction of the penis muscles.
A dry orgasm, on the other hand, occurs when semen travels backward (retrograde) into the bladder during ejaculation. This means there’s no obvious semen discharge during the orgasm.
In a typical orgasm, sperm moves forward because the sphincter that separates the bladder from the urethra closes and prevents semen from traveling backward.
In men with retrograde ejaculation, the bladder neck muscle (the muscle at the opening of the bladder) doesn’t tighten, allowing some or all of the semen to flow backward into the bladder.
Symptoms of Retrograde Ejaculation
If you’re affected by retrograde ejaculation, you’ll have an orgasm but won’t release any semen — or will have a weak ejaculation of less than average volume. On average, a healthy man will ejaculate around one-quarter to one teaspoon of semen when they reach orgasm, so you can expect less than that with retrograde ejaculation.
Fortunately, retrograde ejaculation isn’t painful and usually doesn’t feel different from any other orgasm — and it certainly doesn’t interfere with erectile function. The misdirected semen is later excreted from the body during urination, resulting in cloudy urine post-orgasm.
Besides the release of little or no semen during orgasm, there aren’t too many other symptoms of retrograde ejaculation.
Retrograde Ejaculation (Dry Ejaculation) Causes
There can be several retrograde ejaculation causes, from medications and medical conditions to surgeries and muscle or nerve damage. Like erectile dysfunction, premature ejaculation, and other men’s health issues, the causes can come from many sources, including:
Medications
Several medications can potentially cause retrograde ejaculation as a side effect, including those used to treat benign prostatic hyperplasia (enlarged prostate) and hypertension.
Some medications linked to retrograde ejaculation include:
Medications to treat BPH. Some alpha-blockers, a class of medications used to treat high blood pressure and benign prostatic hyperplasia (BPH), may potentially cause ejaculation disorders like retrograde ejaculation. Other medications used to treat benign prostatic hyperplasia and chronic prostatitis, such as Flomax® (tamsulosin), may also lead to retrograde ejaculation.
Antidepressants. Research suggests some antidepressants, including tricyclic antidepressants (TCAs) like imipramine and the selective serotonin reuptake inhibitors (SSRIs) Zoloft® (sertraline) and Prozac® (fluoxetine), may cause retrograde ejaculation.
Antipsychotic medications. Medications used to treat psychotic disorders, such as thioridazine, chlorpromazine and Risperdal® (risperidone), can lead to retrograde ejaculation.
Surgical Procedures
Some surgical procedures can damage the muscles and nerves near the bladder, potentially causing retrograde ejaculation.
Surgical procedures that may cause retrograde ejaculation include:
Prostate surgery. Procedures such as transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) or an enlarged prostate may cause retrograde ejaculation. A prostatectomy, for prostate cancer involves removing the prostate and often other surrounding structures which can affect ejaculation as well as the nerves and blood vessels that make erectile function possible.
Bladder surgery. Some surgeries that affect the bladder may contribute to retrograde ejaculation.
Cancer staging surgery. Some surgical procedures to determine the stage of cancer near the lower abdomen or pelvis, such as the removal of lymph nodes in the pelvis, may cause retrograde ejaculation.
Other surgeries. Other surgeries may also cause retrograde ejaculation, including surgery for colon, rectal, or testicular cancer and surgery for the lower spine.
Medical Conditions
Certain medical conditions can damage the nerves and muscles around the bladder and cause retrograde ejaculation to develop. These include:
Multiple sclerosis
Spinal cord injury, like a pinched nerve
Blood disorders
Strokes
Birth defects of the penis, testicles, or other organs
Is Retrograde Ejaculation Harmful or Dangerous?
So, is retrograde ejaculation harmful? Although it’s not dangerous for your health, retrograde ejaculation could lead to infertility. Between 0.3 to 2 percent of male infertility is caused by this condition.
Having ejaculation problems like a dry orgasm can also be distressing to you or your partner and potentially lead to other issues.
While “having trouble coming” (or delayed ejaculation) is never a great thing to deal with, dry ejaculation causes could also point to an underlying health issue.
If you’re wondering if there are benefits to not ejaculating, the answer is not really, at least in this case. Though the practice of semen retention has become trendy — whether through abstaining from masturbation or sexual intercourse with a partner — there isn’t much evidence to support refraining from orgasm.
Retrograde Ejaculation Treatment
If you’re curious about how to fix retrograde ejaculation, fortunately, there are several treatment options.
To figure out which treatment for retrograde ejaculation is best for you, it helps to know the cause. Your prognosis and treatment will depend on the cause of your dry orgasms.
To diagnose retrograde ejaculation, your healthcare provider or a urologist will test your urine (called urinalysis) to see if sperm is found in the sample.
The urology specialist will then ask questions about your medical history, previous surgeries, sexual history, and current medications to narrow down possible causes.
Your healthcare provider may recommend any of the following, based on their diagnosis:
Changing medications. If your dry orgasm is linked to a medication you currently use, such as an alpha-blocker or antidepressant, your healthcare provider may recommend adjusting your dosage or switching to a different prescription. After stopping your medication use or changing to another one, normal ejaculation may slowly return.
Taking new medications. While there’s no specific medication for retrograde ejaculation, some prescription drugs might help. Several medications can improve muscle tone in the bladder, allowing you to ejaculate normally and avoid retrograde ejaculation. These medications may be used if you have muscle or nerve damage around your bladder and urethra.
Treating the underlying cause. If a medical condition is causing your retrograde ejaculation. For example, if your retrograde ejaculation is caused by diabetes, your doctor may recommend that you maintain your blood sugar levels.
Doing nothing. If you’re okay with not ejaculating when you orgasm, your healthcare provider might not suggest any specific treatment.
If you have retrograde ejaculation and would like to have children in the near future, it’s best to talk to a fertility specialist. Several fertility procedures — including intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), and in-vitro fertilization (IVF) — may be effective.
Living With Retrograde Ejaculation
Retrograde ejaculation may be a strange ejaculatory experience, but dry orgasms can be managed and reversed.
Here’s what to keep in mind if you’ve experienced one:
A dry orgasm happens when semen travels backward into the bladder during ejaculation rather than forward through the urethra, resulting in little to no visible semen.
Besides a lack of semen, retrograde ejaculation symptoms can include cloudy urine. Otherwise, you’ll still be able to engage in sexual activity and achieve orgasm.
Dry orgasms can happen because of certain medications like alpha-blockers or antidepressants, surgical procedures such as prostate surgery, or medical conditions like diabetes or spinal cord injury.
Treatment of retrograde ejaculation will depend on the cause. It can range from changing your current medications if they cause dry orgasms, managing your health, or just learning to live with retrograde ejaculation. This condition isn’t harmful but may affect fertility in men.
If you’d like to learn how to increase ejaculation, our guide has some information worth checking out.
You can also learn more about ejaculation from our men’s sexual health resources.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.