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What Is Retrograde Ejaculation?

Medically Reviewed by Dan Brennan, MD on November 27, 2021

Retrograde ejaculation is when a man’s sperm goes into his bladder instead of coming out of his penis. You often still feel an orgasmic release with retrograde ejaculation, but you won’t see anything coming out.

Another name for retrograde ejaculation is dry orgasm.

What Causes Retrograde Ejaculation?

Retrograde ejaculation is caused by a problem with your bladder muscle. Ordinarily, when you have sex, a small sphincter muscle holds your bladder closed. If this muscle stays open, sperm can flow backward during orgasm and go into the bladder.

Conditions that may cause it include:

  • Some blood pressure medications
  • Some depression medications
  • Medications for prostate issues
  • Urethral surgery
  • Prostate surgery
  • Nerve damage
  • Prostate removal
  • Bladder removal
  • Problems with semen production
  • Radiation therapy in the pelvic area

What Are the Symptoms of Retrograde Ejaculation?

The main symptom of retrograde ejaculation is a lack of sperm coming out during an orgasm. Your orgasm will have less ejaculate than usual or none at all. Cloudy urine after you have sex may also be a sign of retrograde ejaculation.

You may have infertility or trouble getting your partner pregnant because your sperm can’t reach your partner's eggs to fertilize them.

How Do Doctors Diagnose Retrograde Ejaculation?

To figure out the cause of your dry orgasms, your doctor will ask about your medical history and give you a physical exam. 

They may ask you to give a urine sample shortly after orgasming. They can test the urine sample for semen.

This test is often done in the doctor's office. Your doctor may ask you to urinate, masturbate to orgasm, and then urinate again.

How Is Retrograde Ejaculation Treated?

The treatment for retrograde ejaculation depends on the cause.

If you have nerve damage, your doctor may recommend medication. But the medications most often prescribed for this condition can cause higher blood pressure and a faster heart rate. They may not be a good option if you have a history of heart disease or high blood pressure.

Common drugs that may help retrograde ejaculation include:

  • Imipramine. This is an antidepressant that may also help with bed-wetting in children.
  • Midodrine. This is a drug to help with low blood pressure. Doctors also prescribe it to help with issues with semen transport in the body.
  • Certain antihistamines. Chlorpheniramine and brompheniramine can help retrograde ejaculation, though they are often used for allergies.
  • Certain decongestants. Phenylephrine and pseudoephedrine can also help retrograde ejaculation.

When to See a Doctor for Retrograde Ejaculation

Retrograde ejaculation isn’t harmful and doesn’t affect your ability to get an erection or have an orgasm. Many people with retrograde ejaculation still have an enjoyable sex life. 

You may want to get treatment if you’re concerned about your fertility. If you’ve been trying to get your partner pregnant for a year without success, visit your doctor. You may also want treatment if dry orgasms cause psychological distress or if you don't like how it feels. 

Because dry orgasms can be a sign of other conditions, it's always a good idea to have your doctor rule out anything more serious.

How to Get Your Partner Pregnant if You Have Retrograde Ejaculation

If you want to get your partner pregnant but are struggling due to retrograde ejaculation, there are things you can do. First, you can try medication if your doctor recommends it.

Assisted reproductive technology might also help. Doctors can sometimes use methods like taking sperm from your bladder and putting it in your partner's uterus.

Show Sources

SOURCES:

‌Andrology: "Efficacy of treatment with pseudoephedrine in men with retrograde ejaculation."

Annales de Réadaptation et de Médecine Physique: "Treatment of sperm transport disturbances by midodrine (Gutron®) per os. Retrospective study about 16 subjects."

Centers for Disease Control and Prevention: “What is Assisted Reproductive Technology.”

‌Harvard Health Publishing: "Retrograde Ejaculation."

‌International Journal of Andrology: "Imipramine for successful treatment of retrograde ejaculation caused by retroperitoneal surgery."

‌Mayo Clinic: “Midodrine (Oral Route),” "Retrograde ejaculation."

‌Memorial Sloan Kettering Cancer Center: "Retrograde Ejaculation."

‌Urology: "Treatment of retrograde ejaculation with brompheniramine."

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