Retrograde Ejaculation: Means, Treatment, Causes & Symptoms

Retrograde Ejaculation, also commonly known as dry orgasm, occurs when the semen doesn’t leave the body through the penis during the sexual climax. Instead, it gets pushed back into the bladder. Normally, sexual pleasure isn’t affected in this condition, but the patient may not ejaculate a proper amount of semen, causing infertility. Retrograde ejaculation is usually diagnosed during fertility tests. 

However, it is important to note that retrograde ejaculation causes only about 0.3 to 2 per cent of infertility problems. This shows that retrograde ejaculation is not a common cause of infertility in males. Read on to learn more about retrograde ejaculation, its symptoms, causes, diagnosis, prevention, treatment, and other important details.

1. Dry Orgasms - Little or no ejaculation upon orgasm
2. Cloudy urine after orgasm due to the presence of semen
3. Male infertility - Inability to get a woman pregnant

1. Ejaculation is triggered during sexual climax and is controlled by the central nervous system. One of the critical phases of the male orgasm involves the contraction of the vas deferens (the long muscular tube that transports the mature sperm to the urethra for ejaculation) to move the sperm to the prostate gland, which releases other secretions. These secretions and sperm together make semen. 
2. Near the neck of the bladder, there is a muscle or sphincter that contracts at the time of orgasm to prevent the semen from entering the bladder so that it can pass through the tip of the penis. In case of retrograde ejaculation, this muscle fails to contract, and the semen gets pushed back into the bladder. 

1. The patient has undergone any of the following surgeries:
   1. Bladder neck surgery
   2. Retroperitoneal lymph node dissection for cancer treatment 
   3. Prostate surgery 
   4. Pelvic or rectal surgery 
   5. Transurethral resection of the prostate - causes damage to the bladder valve
2. Nerve damage caused due to any of the following conditions:
   1. Diabetes 
   2. Multiple sclerosis
   3. Parkinson’s disease
   4. Spinal cord injury 
3. Structural issues related to the urethra. 
4. Side effects of certain medications used to treat high blood pressure and some prostrate conditions.  
5. Dry orgasm is usually the symptom of Retrograde ejaculation, but there could be several other underlying reasons, such as:
   1. Prostatectomy - surgical removal of the prostate 
   2. Cystectomy - surgical removal of the bladder 
   3. Radiation therapy used to treat cancer in the pelvic region 

1. Diabetes or multiple sclerosis 
2. Prostate or bladder surgery 
3. Taking anti-depressants or medicines that are used to treat high blood pressure 
4. A spinal cord injury 

1. In the case of diabetes, it is crucial to maintain steady blood sugar levels. 
2. If the patient takes medications that can lead to retrograde ejaculation, he must consult a doctor to find substitutes to reduce the risk.
3. If the patient needs to undergo any surgery that can affect the bladder neck muscle, such as prostate or bladder surgery, he must consult the doctor about the risks involved. 
4. If the surgery can increase the risk of retrograde ejaculation, the patient can talk to the doctor about preserving semen so that future attempts for conception don’t get affected.

1. Physical examination :  to check for any abnormalities in the penis, testicles, and rectum. 
2. Urine Sample : The doctor may ask the patient to provide a sample of his urine right after orgasm to identify the presence of semen in it. This examination is usually carried out in the hospital or doctor’s office. For the test, the patient needs to empty the bladder, masturbate to reach the climax, and provide a urine sample for examination. If the laboratory tests detect any presence of fructose in the urine, it may indicate the risk of retrograde ejaculation. The lab also counts the number of sperms in the urine to confirm the condition.
3. Semen samples : The doctor may also ask for a semen sample. If there is little or no production of semen in at least two samples, the patient can have retrograde ejaculation. 

1. Home Remedies :The patient can try Kegel exercises to strengthen the muscles that control urination. These exercises are done by squeezing and releasing the muscles that help in ejaculation and urination. The patient can identify these muscles by stopping and starting the flow of urine while peeing. 
2. Medication: 
   1. Retrograde ejaculation treatment often involves medications if it is caused due to nerve damage. Diabetes, multiple sclerosis, and some surgeries can lead to this nerve damage. The medicines help in contracting the bladder neck muscles during ejaculation. 
   2. However, in some cases, surgeries like bladder neck treatment or the transurethral resection of the prostate can cause permanent alterations or damage to the patient’s anatomy. In this case, medications will not be able to treat the condition.  
   3. Medications are often considered the most effective treatment for retrograde ejaculation, but these medications can cause side effects like increase in blood pressure and heart rate. 
   4. If these medicines don’t help treat retrograde ejaculation, the patient can discuss other infertility treatment options with the doctor. 
3. Infertility Treatment 
   1. There are other ways to treat retrograde ejaculation if medicines are not helping semen ejaculation. If the patient is trying for a baby, the ejaculation of a sufficient amount of semen is vital to carry sperm in the uterus of the female partner through the vagina. For this, the patient may require infertility procedures known as assisted reproductive technology to achieve pregnancy. 
   2. These methods can involve recovering sperms from the bladder and processing them in the laboratory to inseminate the partner. This method is known as intrauterine insemination. There are more advanced methods of treatment available to achieve pregnancy. 

1. Emotional Distress - If dry ejaculation causes the patient to worry, it can interfere with sexual pleasure. 
2. Male Infertility - Inability to achieve pregnancy with a female partner. 

When to consult a doctor for Retrograde Ejaculation?

1. If the patient is experiencing frequent dry orgasms, consulting a doctor becomes necessary to rule out any underlying health condition that may need medical attention. 
2. If the patient and his partner have been trying for a child for more than a year and have been unsuccessful in conceiving, they must talk to a doctor to identify if retrograde ejaculation is the reason.