Retrograde ejaculation

Retrograde ejaculation is when semen flows back into the bladder, instead of emerging through the penis, during an orgasm. Therefore, very little semen will come out despite climax (hence why it’s sometimes referred to as a “dry orgasm”). Retrograde ejaculation can have an adverse effect on fertlity as sperm does not make its way into the partner’s reproductive system.

What is retrograde ejaculation?

Retrograde ejaculation is when semen flows into the bladder, rather than emerging from the penis, during an orgasm. In most cases, very little semen comes out of the penis after climax. This is why it is colloquially referred to as a “dry orgasm.”
Retrograde ejaculation has no impact on a man’s ability to obtain or maintain an erection or reach climax. While retrograde ejaculation is mostly harmless, it can result in infertility. In retrograde ejaculation, sperm fails to leave the urethra, allowing it to travel through the female reproductive system and fertilize an egg.

Retrograde ejaculation in male fertility

While retrograde ejaculation does not cause health problems in general, it does have an adverse effect on male fertility. In many cases, little to no semen emerges after climax. Patients with this condition will likely be infertile and struggle to fertilize their partner’s eggs. Patients experiencing retrograde ejaculation should consult a fertility specialist to explore treatment options.

Retrograde ejaculation can be diagnosed by the presence of a “dry” orgasm, in which very little semen is ejected from the penis after climax. It can further be confirmed with a post-orgasm urine test to identify the presence of sperm in the bladder.

Causes and symptoms of retrograde ejaculation

Common symptoms of retrograde ejaculation include dry orgasms and male infertility. Retrograde ejaculation is caused by a dysfunctional bladder neck muscle. Typically, during climax, the bladder neck muscle (a muscle at the opening of the bladder) tightens, preventing the semen from entering the bladder from the urethra. With retrograde ejaculation, however, the bladder neck muscle fails to tighten, causing sperm to enter the bladder rather than emerging from the penis. Therefore, upon climax, semen flows back into the bladder instead of up and out the penis.

Dysfunction of the bladder neck muscle can be caused by nerve damage, surgery, medication, or injury.

Treatment of retrograde ejaculation

In cases where it’s caused by nerve damage, retrograde can be treated with medications. In addition, patients experiencing retrograde ejaculation can turn to fertility specialists and assisted reproductive technology (ART) procedures, such as testicular sperm extraction, to have biological children. 

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