Retrograde ejaculation: what it is, symptoms and treatment

Retrograde ejaculation is the reduction or absence of sperm during ejaculation that happens because sperm goes to the bladder instead of exiting the urethra during orgasm.

Although retrograde ejaculation does not cause any pain, nor is it dangerous to health, it can have emotional implications, as a man has the feeling that he is unable to ejaculate as expected. In addition, in cases where there is a total absence of ejaculation, it can even cause infertility.

So, whenever there are changes in ejaculation, it is very important to go to the urologist to make an assessment, identify the problem and start the most appropriate treatment.

Possible symptoms

The main symptom of retrograde ejaculation is reduced or absent sperm during ejaculation. Retrograde ejaculation does not cause pain, as what happens is that the semen is sent to the bladder, being later expelled in the urine, which can make it slightly more cloudy.

Men with retrograde ejaculation are able to achieve and feel orgasm, as well as having a satisfactory erection, however, they may not have ejaculation and therefore may also suffer from infertility.

How to confirm the diagnosis

Retrograde ejaculation can be diagnosed through a urine test, performed after an orgasm, in which the presence of sperm in the urine, confirms the existence of the problem. Despite having a simple diagnosis, retrograde ejaculation must first be identified by the man, who in these cases observes a reduction or the complete absence of sperm during the climax.

What causes retrograde ejaculation

At the entrance of the bladder there is a small sphincter that closes during orgasm, allowing the semen to make its normal course, being expelled through the urethra and through the opening of the penis.

However, when this sphincter is not working properly, it may end up opening and, therefore, the sperm is able to enter the bladder, not going through its normal path. Some causes that can cause this change in the sphincter include:

• Injuries to the muscles around the bladder, caused during surgery on the prostate or bladder; Diseases that affect nerve endings, such as multiple sclerosis or uncontrolled chronic diabetes; Side effects of medications, especially those used to treat psychological disorders like depression or psychosis.

Depending on the cause, the treatment for retrograde ejaculation can be more or less complicated and, therefore, it is very important to consult the urologist.

How the treatment is done

Treatment of retrograde ejaculation is usually only necessary when it interferes with a man's fertility. In such cases, the main treatment options include:

1. Remedies

The most used remedies include Imipramine, Midodrina, Chlorpheniramine, Bronpheniramine, Ephedrine, Pseudoephedrine or Phenylephrine. These are some medication options that regulate the functioning of the nerves in the pelvic region and, therefore, are used when there is degradation of the pelvic nerves, as can happen in cases of diabetes or multiple sclerosis.

These remedies may not have the expected effect on injuries caused by surgery, as it will depend on the level of the injury.

2. Infertility treatments

These types of treatment are used when the man intends to have children, but has not obtained results with the medicines indicated by the doctor. Thus, the urologist can recommend the collection of sperm or the use of assisted reproduction techniques, such as Intrauterine Insemination, where a small portion of sperm is inserted into the woman's uterus, for example.

See other ways to treat and deal with male infertility.

3. Psychological support

Psychological support is very important for all men, regardless of the type of treatment they are undergoing. This is because the absence of an effective ejaculation can greatly decrease the emotional and physical satisfaction of men, which ends up generating stress.

The problem of retrograde ejaculation can be a bigger problem in couples who are trying to conceive and, therefore, psychological and emotional monitoring is very important.