Retrograde ejaculation is a condition that refers to sperm that travels into the bladder instead of flowing out through the urethra. This can cause a reduction or absence of sperm during orgasm.
Although retrograde ejaculation does not cause any pain and is not harmful to health, it can have emotional implications, as men may have the feeling that they are unable to ejaculate. In cases of a total absence of ejaculation, infertility may also occur.
If you suspect that you may be experiencing retrograde ejaculation, it is very important to see a urologist for assessment to determine why it's occurring and how it can be treated.
Main symptoms
The most common signs and symptoms of retrograde ejaculation are:
- Reduction or absence of sperm during ejaculation
- Cloudy or slightly whitish urine
- Difficulty getting your partner pregnant
Retrograde ejaculation does not cause pain. Men with retrograde ejaculation are also able to achieve and feel orgasm, and will typically have a satisfactory erection.
Confirming a diagnosis
Retrograde ejaculation can be diagnosed through a urine test, which is done after achieving an orgasm. The presence of sperm in the urine sample confirms the presence of sperm in the urine confirms the existence of the problem.
Common causes
During orgasm, a sphincter at the bladder entrance closes, so that that semen can flow during its normal path to be expelled through the urethra, at the tip of the penis.
However, when this sphincter is not working correctly, it can remain open during orgasm, which can cause sperm to enter the bladder. Some causes for this abnormality can include:
- Injuries to the muscles around the bladder caused by prostate or bladder surgery
- Diseases that affect nerve endings, such as multiple sclerosis or uncontrolled chronic diabetes
- Side effects of medications, especially those used to treat psychological disorders such as depression or psychosis.
Depending on the cause, treatment for retrograde ejaculation can vary in complexity. For this reason, it is best for treatment to be guided by a urologist.
Treatment options
Treatment for retrograde ejaculation is usually only necessary when it interferes with a man's fertility. In these cases, the main treatment options include:
1. Medications
The most commonly used medications include imipramine, midodrine, chlorpheniramine, bronpheniramine, ephedrine, pseudoephedrine, or phenylephrine. These medication can regulate the functioning of the nerves in the pelvic area, which can become compromised with conditions like diabetes or multiple sclerosis.
These medications may not have the expected effect on injuries caused by surgery, as treatment effect and condition severity will depend on the level of the injury.
2. Fertility treatments
These types of treatments are recommended for men who are trying to have children, but have been unable to through medications. The urologist may recommend sperm collection or the use of assisted reproduction techniques, such as intrauterine Insemination, where a small sample of sperm is inserted into the woman's uterus.
3. Psychological support
Psychological support is very important for all men, regardless of the type of treatment they are undergoing. This is because not having an effective ejaculation can greatly reduce a man's emotional and physical satisfaction, which can be stressful and cause anxious feelings.
The problem of retrograde ejaculation can be a bigger psychological problem in couples who are trying to get pregnant and, therefore, psychological and emotional support is very important.