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Retrograde Ejaculation: Causes, Symptoms & Treatment

Katelyn Brenner FNP

Reviewed by Katelyn Hagerty, FNP

Written by Nicholas Gibson

Published 12/07/2020

Updated 09/01/2023

A universal fact is that our bodies do some pretty incredible and weird things — well, at least weird in that we don’t always know what’s going on.

And sometimes, those weird things affect a guy’s sex life or sexual health. One example of weird sexual dysfunction? Retrograde ejaculation (also called a dry orgasm).

Not to be mistaken with an astrological event, retrograde ejaculation is just one of several types of male orgasms (yep, there’s more than one way a guy can climax).

While this condition sounds odd, the causes of retrograde ejaculation could point to a serious underlying health issue.

Keep reading to learn how orgasm without ejaculation happens, about retrograde ejaculation treatment and, of course — what retrograde ejaculation is.

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A dry orgasm occurs when semen travels backward into the bladder during ejaculation rather than forward through the urethra.

Retrograde ejaculation can result in either a weak ejaculation or no semen during ejaculation at all.

When a man has an orgasm, semen typically travels forward through the urethra and is expelled from the body through the contraction of the penis muscles.

This forward motion of the sperm happens because the sphincter separating the bladder from the urethra closes, preventing semen from traveling backward.

In men with retrograde ejaculation, the bladder neck muscle (the muscle at the opening of the bladder) doesn’t tighten, allowing some or all the semen to flow backward into the bladder.

You might be wondering if there are benefits to not ejaculating. Though the practice of semen retention has become trendy (whether through abstaining from masturbation or sexual intercourse with a partner), there isn’t much evidence to support refraining from orgasm.

Still, having ejaculation problems like a dry orgasm could be distressing to you or your partner and potentially lead to other issues.

So, is retrograde ejaculation harmful? Although not harmful to your health, retrograde ejaculation could lead to infertility. Between 0.3 to 2 percent of male infertility is caused by this condition.

And while having trouble coming (or delayed ejaculation) is never a great thing to deal with, dry ejaculation causes could point to an underlying health issue.

Besides the release of little or no semen during orgasm, there aren’t too many other symptoms of retrograde ejaculation. On average, a healthy man will ejaculate around one-quarter to one teaspoon of semen when they reach orgasm.

If you’re affected by retrograde ejaculation, you’ll have an orgasm but release no semen — or only a very small amount. You may or may not experience a change in the pleasurable sensation associated with the orgasm.

Semen is excreted from the body during urination, resulting in cloudy urine post-orgasm.

Fortunately, retrograde ejaculation isn’t painful and usually doesn’t feel different from any other orgasm — and it certainly doesn’t interfere with erectile function.

There can be several retrograde ejaculation causes, from medications and medical conditions to surgeries and muscle or nerve damage.

Medications That Cause Retrograde Ejaculation

Several medications can potentially cause retrograde ejaculation, including those used to treat benign prostatic hyperplasia (enlarged prostate) and hypertension.

Some medications linked to retrograde ejaculation include:

  • Alpha-blockers. Some alpha-blockers, a class of medications used to treat high blood pressure and benign prostatic hyperplasia (BPH), may potentially cause ejaculation disorders like retrograde ejaculation. Other medications used to treat benign prostatic hyperplasia and chronic prostatitis, such as tamsulosin (Flomax®), may lead to retrograde ejaculation.

  • Antidepressants. Research suggests some antidepressants, including the SSRIs sertraline (Zoloft®) and fluoxetine (Prozac®), may cause retrograde ejaculation.

  • Antipsychotic medications. Some medications used to treat psychotic disorders, such as thioridazine, chlorpromazine and risperidone (Risperdal®), might also cause retrograde ejaculation.

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Surgical Procedures

Some surgical procedures can damage the muscles and nerves near the bladder, potentially causing retrograde ejaculation.

Surgical procedures that may cause retrograde ejaculation include:

  • Prostate surgery. Known as a prostatectomy, surgery to remove the prostate after a prostate cancer diagnosis may cause retrograde ejaculation. The nerves and blood vessels that make erectile function possible can also become affected.

  • Bladder surgery. Some surgeries that affect the bladder may contribute to retrograde ejaculation.

  • Cancer staging surgery. Some surgical procedures to determine the stage of cancer near the lower abdomen or pelvis, such as the removal of lymph nodes in the pelvis, may cause retrograde ejaculation.

  • Other surgeries. Other surgeries may also cause retrograde ejaculation, including surgery for colon, rectal or testicular cancer and surgery for the lower spine.

Medical Conditions

Certain medical conditions can damage the nerves and muscles around the bladder and cause retrograde ejaculation to develop. These include:

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If you’re curious about how to fix retrograde ejaculation, fortunately, there are several treatment options.

To figure out which treatment for retrograde ejaculation is best for you, it helps to know the cause. Prognosis and treatment will depend on the cause of your dry orgasms.

To diagnose retrograde ejaculation, your healthcare provider or a urologist (a specialist in urinary tract problems) will test a urine sample (called urinalysis) to see if sperm is found in the sample.

The urology specialist will then ask questions about your medical history, previous surgeries, sexual history and current medications to narrow down possible causes.

Treatment of retrograde ejaculation depends on the cause, but your healthcare provider may recommend any of the following:

  • Change medications. If your dry orgasm is linked to a medication you currently use, such as an alpha-blocker or antidepressant, your healthcare provider may recommend adjusting your dosage or switching to a different prescription. After stopping your medication use or changing to another one, you may slowly return to normal ejaculation.

  • Medications. While there’s no specific medication for retrograde ejaculation, some prescription drugs might help, depending on the cause. Several medications can improve muscle tone in the bladder, helping you ejaculate normally and avoid retrograde ejaculation. These medications may be used if you have muscle or nerve damage around your bladder and urethra.

  • Other options. If your retrograde ejaculation is caused by a medical condition like diabetes, you may be recommended to maintain your blood sugar levels. If you’re okay with not ejaculating when you orgasm, your healthcare provider might not suggest any specific treatment. If you have retrograde ejaculation and would like to have children in the near future, it’s best to talk to a fertility specialist. Several fertility procedures, including intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI) and in-vitro fertilization (IVF), may be effective.

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Of all the things our bodies can do, some can throw you for a bit of a loop. Retrograde ejaculation may be one of those conditions. But fortunately, dry orgasms can be managed and reversed.

  • What is retrograde ejaculation? Also called dry orgasm, it happens when semen travels backward into the bladder during ejaculation rather than forward through the urethra, resulting in little to no visible semen.

  • Besides no semen, retrograde ejaculation symptoms can include cloudy urine. Otherwise, you’ll still be able to engage in sexual activity and achieve orgasm.

  • Dry orgasms can happen because of certain medications like alpha-blockers or antidepressants, surgical procedures such as prostate surgery, or medical conditions like diabetes or spinal cord injury.

  • Retrograde ejaculation treatment will depend on the cause and can range from changing your current medications if they cause dry orgasms, managing your health or living with retrograde ejaculation. This condition isn’t harmful but may affect fertility in men.

If you’d like to learn how to increase ejaculation, our guide has some information worth checking out.

You can also learn more about ejaculation from our men’s sexual health resources.

9 Sources

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  2. What factors determine semen volume? (2015, May 25). ISSM. Retrieved from https://www.issm.info/sexual-health-qa/what-factors-determine-semen-volume/
  3. Koren, G., & Koren, D. (2020). Retrograde Ejaculation-a Commonly Unspoken Aspect of Prostatectomy for Benign Prostatic Hypertrophy. American journal of men’s health, 14(2), 1557988320910870. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7065283/
  4. Lepor H. (2007). Alpha blockers for the treatment of benign prostatic hyperplasia. Reviews in urology, 9(4), 181–190. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213889/
  5. Flomax®. (n.d.). Accessdata.fda.gov. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020579s033lbl.pdf
  6. Retrograde Ejaculation. (2022, February 28). Harvard Health. Retrieved from https://www.health.harvard.edu/a_to_z/retrograde-ejaculation-a-to-z
  7. Shanmugasundaram, N., Nivedhya, J., Karthik, M. S., & Ramanathan, S. (2019). Risperidone-induced retrograde ejaculation and lurasidone may be the alternative. Industrial psychiatry journal, 28(1), 152–154. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929214/
  8. Jefferys, A., Siassakos, D., & Wardle, P. (2012). The management of retrograde ejaculation: a systematic review and update. Fertility and Sterility, 97(2), 306-312.e6. Retrieved from https://www.sciencedirect.com/science/article/pii/S0015028211027956
  9. InformedHealth.org. (2008). Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Benign enlarged prostate: What are the pros and cons of surgery?. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK481492/
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