What is Retrograde Ejaculation?

Click here to learn about the possible causes, symptoms, and treatments for retrograde ejaculation.

Typically, when a man has an orgasm semen is ejected out of the urethra. In some circumstances, the semen instead travels backward into the bladder, otherwise known as retrograde ejaculation. The muscle that closes the bladder normally keeps sperm from entering the bladder, but in retrograde ejaculation this muscle doesn’t function normally and allows the semen to travel backward at the time of ejaculation. This results in less semen (or none at all) in the ejaculate.

A common symptom of retrograde ejaculation is a “dry orgasm” - the release of little to no semen during orgasm. The urine may look cloudy after orgasm due to the presence of semen mixed with urine in the bladder. Low semen and sperm in the ejaculate can cause challenges in trying to conceive a child.

Retrograde ejaculation can have many causes, including:

  • Medications such as alpha-blockers, antidepressants, antipsychotics, and medications used to treat benign prostatic hyperplasia
  • Surgical procedures, especially prostate and bladder surgery
  • Diabetes mellitus
  • Multiple sclerosis
  • Spinal cord injuries

Retrograde ejaculation can cause challenges in conceiving children, but there may be effective treatments available, including:

  • Correcting the source: Sometimes, treating an underlying condition like diabetes can improve symptoms of retrograde ejaculation.
  • Medications: Some medications, called sympathomimetics and antimuscarinics, can improve the bladder’s muscle tone to prevent sperm from flowing backward.
  • Assisted reproductive technologies: Procedures like TESE (testicular sperm extraction) and ICSI (intracytoplasmic sperm injection) make it possible to fertilize an ovum outside of the body.

Some people who do not want to father children and whose sex life is not impacted by retrograde ejaculation may simply not seek treatment. It’s a good idea to discuss your fertility goals with your partner and your healthcare provider if you experience retrograde ejaculation.