Retrograde Ejaculation

Retrograde Ejaculation: When Everything “Cums” Out Wrong

Written by: Joshua Gonzalez

What is Retrograde Ejaculation

I think I speak for most men when I say that we generally take ejaculation for granted. It’s as natural and inevitable as the sun rising in the east and setting in the west. Until it isn’t. If you’ve never had any problems with ejaculation, the thought of semen “cumming” out the wrong way has probably never entered your mind. However, ejaculatory problems do exist, and in this post, we’re going to talk about one in particular – retrograde ejaculation or RE. RE happens when part or all of your ejaculate fluid is expelled backward into the bladder instead of forward and out the tip of the penis. This usually occurs because the bladder’s internal sphincter fails to close completely, which can lead to a backflow of semen into the bladder during ejaculation. If this is all news to you, RE may seem nothing short of a horror show, but in reality, RE rarely causes pain, and it’s generally not considered dangerous at all. Because RE involves the bladder, many symptoms are apparent during urination. One telltale sign of RE is whitish urine after sex. Dry orgasms (orgasms without semen) or orgasms with low semen volume could be a sign of RE as well. Infertility can also be a tip-off since there isn’t enough semen ejaculated to carry sperm to its final destination. RE isn’t particularly common, but it has been reported in .3% to 2% of patients who attend fertility clinics, a setting where many ejaculatory disorders are studied. Let’s take a look at some of the causes of RE and treatments that have been known to help.

Common Causes of RE

Unfortunately, retrograde ejaculation can be caused by treatment for other conditions. Radiation and surgery for prostate, bladder or testicular cancer can cause nerve damage to the prostate, the bladder and the seminal vesicles, all of which can lead to RE. This type of nerve damage can also occur as a complication of diabetes, multiple sclerosis, Parkinson’s disease, spinal cord injuries, blood disorders, strokes, birth defects, abdominopelvic surgery or retroperitoneal lymph node dissection surgery. Another culprit is transurethral resection of the prostate (TURP), a surgery that’s often recommended for an enlarged prostate that has failed to be effectively treated by medication. During this surgical procedure, a section of the prostate is cut away, and RE can occur as a result. Unfortunately, not everyone is adequately informed of the risk of RE prior to these procedures, so make sure to be your own advocate, and ask a lot of questions before opting for a specific treatment. Also make sure to check your medicine cabinet because many prescription medications have been associated with the incidence of RE. Alpha blockers, a common type of medication used to treat high blood pressure and enlarged prostate is one common culprit. Flomax, another medication prescribed to treat common prostate issues has also been shown to contribute to the risk of RE. It may come as a surprise, but many popular medications used to treat mental health issues can cause retrograde ejaculation, too. These can include antidepressants like Zoloft and Prozac and antipsychotic medications like Risperdal, chlorpromazine and thioridazine.

Treatments for RE

As we mentioned earlier, RE is not considered dangerous. However, if you’re having infertility issues or if dry orgasms and low semen volume are causing you mental distress, you’re probably slightly desperate for a cure. There are retrograde ejaculation treatment options out there, so don’t despair. If your RE is being caused by prescriptions that you take, your doctor may be able to adjust your meds to alternatives that don’t carry the same risk of RE. Another retrograde ejaculation treatment that we recommend to the patients is our very own Popstar supplement. When we created Popstar, we had our RE patients in mind. Suffering from low semen volume during ejaculation can cause significant emotional stress, and it can diminish the overall pleasure and satisfaction that comes from having sex. Our supplement contains zinc, L-arginine, pygeum and lecithin, all of which can increase sperm production and improve semen volume. Popstar is also made from vegan, non-GMO ingredients from organic sources, and they’re not associated with any serious side effects, which makes them a safe and easy treatment solution for RE. If your RE is not caused by permanent changes in your physiology, you may be prescribed medicines that are often used for the common cold like pseudoephedrine, phenylephrine and ephedrine. Antihistamines, including chlorpheniramine and brompheniramine may also help, and other medications, including Tofranil (an antidepressant) and midodrine (a blood vessel constrictor) have been shown to be beneficial as well. These medications work by keeping the bladder neck constricted during ejaculation, which prohibits the backflow of semen. Many of these medications do come with side effects so make sure your doctor has a good overall view of your health, your medical conditions and your medications. Above all, know that RE is something that we see in our offices on the reg, and it’s no cause for fear or alarm. If you suspect your juices are flowing the wrong way, making an appointment with your doctor is the first step towards turning things around. We’re here to help make sure your ejaculatory health outcomes “cum” out the right way.

References:

https://www.mayoclinic.org/diseases-conditions/retrograde-ejaculation/diagnosis-treatment/drc-20354896#:~:text=Drugs%20that%20can%20cause%20retrograde,Imipramine%2C%20an%20antidepressant


https://www.healthline.com/health/mens-health/retrograde-ejaculation


https://www.nhs.uk/conditions/transurethral-resection-of-the-prostate-turp/#:~:text=A%20transurethral%20resection%20of%20the,the%20bladder%20to%20the%20penis


https://www.mayoclinic.org/diseases-conditions/retrograde-ejaculation/symptoms-causes/syc-20354890


https://www.forhims.com/blog/retrograde-ejaculation-causes-treatments#:~:text=Some%20medications%20used%20to%20treat,)%2C%20may%20cause%20retrograde%20ejaculation

Dr. Joshua Gonzalez

Dr. Joshua Gonzalez

Dr. Joshua Gonzalez is a board-certified urologist who is fellowship-trained in Sexual Medicine and specializes in the management of male and female sexual dysfunctions. He completed his medical education at Columbia University and his urological residency at the Mount Sinai Medical Center. Throughout his career, Dr. Gonzalez has focused on advocating for sexual health and providing improved healthcare to the LGBTQ+ community.