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Nov 25, 2015 — by Larry Lipshultz

Illustration of sperm being erasedHave you and your wife been trying, unsuccessfully, to have a baby? When you have an orgasm, do you notice little or no semen being ejaculated? It is possible that you suffer from a condition known as retrograde ejaculation. Although this condition is not harmful and does not affect your ability to achieve an erection or have an orgasm, it can lead to male fertility issues. If you suspect that you may be suffering from retrograde ejaculation, undergo treatment at Dr. Larry Lipshultz’s Houston, TX practice.

What Is Retrograde Ejaculation?

Retrograde ejaculation is a condition in which the muscle that closes the bladder during ejaculation fails to function normally. This allows all or part of the semen to travel backwards into the bladder, resulting in little to no semen exiting the tip of the penis. There are several possible causes of retrograde ejaculation, including damage from previous surgery, nerve damage, or medication side effects. If you have had prostate surgery or surgery on part of your bladder, the muscles of the bladder may have been damaged. Men with multiple sclerosis or uncontrolled diabetes are at risk for nerve damage that can lead to this condition. Medications used to treat prostate enlargement, such as Flomax or Cardura, can lead to retrograde ejaculation, as well. The condition can also be caused by selective serotonin reuptake inhibitors used to treat depression, like Prozac or Zoloft, and medications that treat psychosis, like Thorazine.

Symptoms and Diagnosis

Symptoms of retrograde ejaculation include dry orgasms, in which little or no semen exits the penis, urine that is cloudy after orgasm because it has semen in it, and the inability to contribute to a pregnancy. If you and your partner have had regular unprotected sex for over a year without conception, you should see your doctor.

The doctor will ask you about your symptoms and how long they have been present, as well as your medical history, specifically any surgeries or cancers and any medications you are currently taking. The doctor will then complete a physical exam, focusing on your penis and testicles. Finally, the doctor may test your urine for semen after an orgasm. You will be asked to empty your bladder, achieve orgasm and ejaculate, and then provide a urine sample. If the doctor finds a high level of sperm in the urine, you may be diagnosed with retrograde ejaculation.

Treatments for Retrograde Ejaculation

Typically, men suffering from retrograde ejaculation do not require treatment, as the condition is not harmful. If the condition interferes with fertility, however, there are options your doctor can pursue. If the condition is a side effect of medications you are currently taking, the doctor may switch you to a different medication that does not affect ejaculation. In cases of mild muscle or nerve problems, the doctor may elect to treat you with pseudoephedrine or imipramine, which improve muscle tone at the entrance to the bladder. For severe nerve or muscle damage, there may not be a solution to restore function. In this case, your doctor can recommend fertility treatments such as sperm extraction and in-vitro fertilization.

Contact Us for a Consultation

If you and your partner are trying to conceive but have had no success, it is time to see a doctor for help. Dr. Larry Lipshultz offers several solutions for retrograde ejaculation. Contact our office today to schedule a consultation.