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Retrograde Ejaculation

Retrograde ejaculation occurs when the semen is released into the bladder rather than exiting via the penis during orgasm. People who experience retrograde ejaculation can still reach sexual climax or orgasm but they may ejaculate a very small amount of semen or possibly no semen at all. 

Retrograde ejaculation is also referred to as “dry orgasm”.

Retrograde ejaculation is not painful or, generally speaking, harmful. However, it can cause infertility so those who want to reproduce will need to seek treatment. 

Causes of Retrograde Ejaculation

Retrograde ejaculation is often due to weak bladder neck muscles or nerve damage. During climax, the bladder neck muscles typically contract to prevent the flow of semen into the urinary bladder, thus forcing it to exit via the urethra. In retrograde ejaculation, these muscles fail to perform this task.

Several conditions can cause this to happen, including:

  • Medication side effects. Particularly with medications used to treat depression, enlarged prostate, and high blood pressure.
  • Nerve damage as one might experience with medical conditions like spinal cord injury, Parkinson’s disease, diabetes,  or multiple sclerosis.
  • Surgery including surgeries one might have to treat prostate or testicular cancers 

The primary symptom of retrograde ejaculation is dry orgasm, an orgasm where ejaculation includes very little or even no semen, but it is important to know that other things can also cause dry orgasm. Dry orgasm can also occur in someone who has undergone surgical removal of the bladder or the prostate or someone who has had radiation therapy to treat cancer in the pelvic area. 

Some people are at higher risk for developing retrograde ejaculation, including:

  • Those with multiple sclerosis or diabetes
  • Those who have undergone bladder or prostate surgery
  • Those who take medications for mental health conditions or high blood pressure 
  • Those who have had spinal cord injuries

Symptoms of Retrograde Ejaculation

Retrograde ejaculation is not an obvious condition as it does not impact one's ability to become erect or to orgasm.

The symptoms of retrograde ejaculation include:

  • Dry orgasms or orgasms where very little to no semen exits the penis 
  • Cloudy urine after orgasm because the urine contains semen
  • Infertility

Retrograde Ejaculation Diagnosis and Treatment 

To diagnose retrograde ejaculation a doctor will need to do a couple of things:

  • Ask about  symptoms and health history including any medications, health issues, past surgeries, and illnesses the patient had. 
  • Administer a physical exam.
  • Test both urine and ejaculate for the presence of semen. If semen is found in the urine sample, the patient has retrograde ejaculation. 

As for treatment, retrograde ejaculation generally does not require treatment unless the patient is dealing with infertility. If that is the case, treatment options and reproductive techniques will be discussed. According to the Mayo Clinic, most who pursue treatment for retrograde ejaculation-related infertility are able to successfully reproduce after treatment.

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