IASH India: Institute of Andrology & Sexual Health India
Retrograde Ejaculation Causes, Symptoms & Treatment

What is Retrograde Ejaculation?

Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of coming out of the tip of the penis. Although a man with retrograde ejaculation can still achieve sexual climax, he ejaculates little or no semen during this time. That’s why it is also called dry orgasm.

The most common causes of retrograde ejaculation include side effects of depression medications, prostate infection or cancer surgery, bladder removal surgery, as well as certain medical conditions such as diabetes and multiple sclerosis. Retrograde ejaculation seems to be a major problem for men but it is not dangerous. However, it can lead to male infertility issues.

Nevertheless, most retrograde ejaculation cases related to surgery, infection, and injury can be corrected with fertility restoration. Also, below you can learn more about the causes of retrograde ejaculation and its treatment procedures.

What Causes Retrograde Ejaculation?

Retrograde Ejaculation Causes are mainly associated with the problem of muscle (called bladder sphincter) that seals the bladder during Ejaculation. As the sphincter doesn’t work properly, the bladder neck remains open, and the sperm flow backward during the orgasm. However, there are several Causes & conditions that lead to Retrograde Ejaculation. These conditions consist of the following:

Different Causes of Retrograde Ejaculation
  • Neck Bladder Surgery
  • Prostate Surgery
  • A side effect of some drugs used to treat depression, prostate enlargement, and high blood pressure.
  • Medical illnesses, such as diabetes, multiple sclerosis, Parkinson’s disease, 
  • Spinal Cord Injury
  • Nerve Damage
  • Radiation therapy for the treatment of pelvic cancer
  • Prostate Removal
  • Bladder Removal
  • Problem with semen production

The key indicator of retrograde ejaculation is a dry orgasm. However, the symptoms of retrograde ejaculation can easily be identified and must be treated on time.

What Are The Symptoms Of Retrograde Ejaculation?

Retrograde ejaculation doesn’t interfere with getting an erection or experiencing an orgasm, but when you climax, semen enters your bladder rather than leaving your penis. However, the Retrograde Ejaculation Symptoms & signs include:

  • Orgasms in which your penis produces little to no ejaculate at all (dry orgasms)
  • Semen-containing urine that is hazy after an orgasm
  • not being able to make a woman pregnant (male infertility)

How Common Is Retrograde Ejaculation?

Retrograde ejaculation is a common condition, especially in patients who have undergone TURP surgery. TURP surgery is performed to treat benign prostatic hyperplasia. In most of the cases, men face dry orgasms after TURP surgery.

Further, Diabetes is one of the conditions that might result in retrograde ejaculation; it is also somewhat prevalent. People who use medications for depression or high blood pressure may experience retrograde ejaculation.

What Are the Risk Factors Of Retrograde Ejaculation?

These are some of the factors that may put you at high risk of developing Retrograde Ejaculation:

  • Diabetes or multiple sclerosis
  • if you have had prostate or bladder surgery
  • if you have a spinal cord injury
  • if you take certain drugs or high blood pressure or a mood disorder

How Does It Affect Fertility?

Although retrograde ejaculation reduces fertility, this is not a typical cause of infertility. Only 0.3 to 2 percent of infertility issues are brought on by it. Your sperm is still viable even if you ejaculate backward. Instead, infertility arises as a result of your sperm not reaching your partner.

When To See Doctor

Retrograde ejaculation is only medically necessary if you’re trying to father a child; otherwise, it’s not harmful. However, if you experience dry orgasms, consult a medical professional to be sure that there isn’t an underlying issue that has to be addressed.

Consult your doctor if you and your female partner have been trying to conceive for a year or more after engaging in regular, unprotected sexual activity. If you only ejaculate a tiny amount or none at all, retrograde ejaculation may be the root of your issue.

How Is Retrograde Ejaculation Diagnosed?

Seeking medical attention from your doctor may be a smart option if you experience frequent dry orgasms. Retrograde ejaculation is not unhealthy for you, but there may be other causes of dry orgasm. It’s also possible that you have a problem that needs to be treated on the inside.

Your doctor may want a physical examination to look for any visible problems. Your doctor will examine signs and symptoms like these to analyze your condition further:

  • not ejaculating during an orgasm
  • after an orgasm, murky urine,
  • infertility

Tell your doctor the following:

  • How frequently and for how long have you experienced dry heaves?
  • any additional symptoms you may have observed,
  • any previous chronic conditions or injuries,
  • any medication you may be on,
  • if you’ve been treated for cancer, and what those treatments were

A urine test can help determine whether the absence of ejaculation results from retrograde ejaculation. Before submitting a urine sample, you can be requested to masturbate. It will be the diagnosis if there is much sperm in your pee.

If there is no semen in your post-orgasm pee, there may be a problem with semen production or another issue. You might need to consult an infertility specialist or another doctor for more testing.

Retrograde Ejaculation Treatment

Retrograde Ejaculation doesn’t require any treatment until and unless it affects fertility. In such a case, it can be treated either by medication or by infertility treatment such as IVF.


Medications are generally given when Retrograde Ejaculation is caused by nerve damage. The nerve damage can occur because of diabetes, multiple sclerosis, surgeries, or other treatments. However, in such cases, there are a variety of medications that can help in treating retrograde Ejaculation:

  • brompheniramine (Ala-Hist, J-Tan, Veltane)
  • chlorpheniramine (Aller-Chlor, Chlor-Trimeton, Polaramine, Teldrin)
  • ephedrine
  • imipramine (Tofranil)
  • midodrine
  • phenylephrine (Children’s Sudafed, Pediacare, Vazculep)
  • pseudoephedrine or phenylephrine (Silfedrine, Sudafed, SudoGes, Suphedrin)

Moreover, if Retrograde Ejaculation is caused by the side effects of medicines like depression and alpha-blockers, in a case doctor is advised to stop these medicines for some time, and you might start ejaculating normally again. 

Infertility Treatment

If you have retrograde Ejaculation, you won’t be able to make your female panther pregnant. In order to make her pregnant, you can try some medication, and if medication also doesn’t help, then you will need infertility procedures such as In-vitro Fertilization.

Further, to get the best treatment for retrograde Ejaculation, consult Dr. Chirag Bhandari at IASH Jaipur.

Are There Any Complications?

Retrograde ejaculation doesn’t cause pain or is not harmful. The compilations of Retrograde Ejaculation include:

  • It enables the women to get pregnant which ultimately results in male infertility.
  • Less Pleasurable orgasm because of worrying about ejaculation.

How To Prevent Retrograde Ejaculation?

There is no such way to prevent Retrograde Ejaculation, 

Consider less invasive procedures like transurethral microwave thermotherapy (TUMT) or transurethral needle ablation (TUNA) of the prostate for men who need treatment for an enlarged prostate. There is less chance of nerve and muscle injury as a result of these operations.

Controlling medical issues that can harm your nerves can also stop you from Retrograde Ejaculation. Such as, if you have diabetes, it is crucial to keep your sugar level steady. This is essential for overall penis health.

Frequently Asked Questions

Q1. What are the Side Effects of Retrograde Ejaculation?

Ans: Retrograde Ejaculation is not harmful. However, the side effects of retrograde Ejaculation are, it enables the woman to conceive a child (male infertility) and Less pleasurable orgasm because of worries about absent ejaculation.

Q2. Can retrograde ejaculation fix itself?

Ans: Yes, the retrograde Ejaculation gets fixed on its own if it is typically caused by medication. However, Normal ejaculation will come back once the medication is stopped. Often, retrograde ejaculation brought on by diabetes or surgery cannot be recovered. Most of the time, this is not a problem unless you are trying to get pregnant.

Q3. How Common is Retrograde Ejaculation after TURP?

Ans: Retrograde ejaculation after TURP is considered to occur between 70% and 90% of the time, as per the study. Retrograde ejaculation risk may be reduced if the bladder neck is preserved after TURP.

Q4. Are there any exercises that can help with Retrograde Ejaculation?

Ans: Yes, you can perform kegel exercises that will help you to control some problems related to urination and ejaculation during retrograde Ejaculation. You should work on the muscles that control urination. Stopping and starting your flow while you’re urinating will allow you to identify these muscles. Kegel Exercise for these muscles includes squeezing and releasing these muscles.


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