Retrograde Ejaculation: Causes, Symptoms, Diagnosis, & Treatment

Retrograde Ejaculation is a male sexual issue that can happen to some men during sexual activity, but it is not very common and is often misunderstood. It occurs when semen, which is usually pushed out of the body via the urethra when a man ejaculates, takes a separate path and proceeds into the bladder instead of leaving the body.

man with retrograde ejaculation

Even though this disease doesn’t hurt the person’s health directly, it can cause problems like infertility, making it hard for partners to get pregnant. Retrograde Ejaculation can also cause mental discomfort because men may feel embarrassed, frustrated, or anxious when they think they aren’t performing well in bed. [1] [2]

This long piece tries to thoroughly explain backward Ejaculation and shed light on its many different aspects. We will talk about all the other parts of this condition, such as what causes it, its signs, how it is diagnosed, and how it can be treated. We will also discuss the psychological effects of backward Ejaculation and how people who have it and their partners can deal with it.

By giving a complete look at backward Ejaculation, we hope to raise knowledge and understanding, providing people with this condition the power to make intelligent decisions about their sexual health and general health. Knowledge is power, and understanding the problems and answers related to backward Ejaculation can help people and couples move through their journey with confidence and support. [3] [4] [5]

Causes of Retrograde Ejaculation

Retrograde Ejaculation can happen because of several different things. These things are:

  1. Nerve damage: Retrograde Ejaculation may occur as a result of nerve damage affecting the muscles involved in Ejaculation and bladder control. Diabetes, spinal cord wounds, and multiple sclerosis are all medical diseases that can damage nerves. [6] [7]
  2. Surgery: Retrograde Ejaculation can be caused by surgery on the lower urinary tract, like prostate or bladder surgery, if the nerves and muscles that control Ejaculation are damaged. In addition, retrograde Ejaculation can be caused by treatments like radical prostatectomy, transurethral removal of the prostate (TURP), and retroperitoneal lymph node dissection (RPLND). [8]
  3. Medications: Some medicines, like alpha-blockers, antidepressants, and medication for high blood pressure, can stop Ejaculation from happening the way it should and cause it to happen backward. These drugs include tamsulosin, terazosin, fluoxetine, and clonidine. [9]
  4. Congenital abnormalities: Retrograde Ejaculation can sometimes be caused by congenital disabilities that affect the neck of the bladder or the urethra. These structural problems are present at birth and can make it hard for the muscles and valves that control the flow of sperm during Ejaculation to work correctly. So, the sperm might go into the bladder instead of coming out through the urethra. The exact nature of the genetic abnormality can vary. For example, some men have problems with their bladder neck not shutting correctly or with the structure of their urethra, making it hard for them to ejaculate normally. If you think you might have backward Ejaculation, you should talk to a doctor. They can help determine what’s going on and suggest the best way to treat it. [10] [11] [12] [13] [14]

Symptoms of Retrograde Ejaculation

Retrograde Ejaculation is marked by a drop in the amount of semen that comes out during Ejaculation or a complete lack of semen, also called a “dry orgasm.” Some other signs could be:

  1. Cloudy urine after sexual activity: Having pee that looks cloudy or white after sexual activity is a typical sign of backward Ejaculation. This change in how urine looks is caused by semen entering the bladder instead of leaving through the urethra. The semen combines with the urine and makes it look cloudy. [15]
  2. Infertility: Infertility is one of the most essential effects of backward Ejaculation. Since sperm doesn’t leave the body when a man ejaculates, it can’t get to the female reproductive system to fertilize an egg. As a result, couples trying to start a family can get frustrated and sad if they can’t get pregnant. This makes it a significant problem to solve. [16] [17]
  3. Emotional distress: Having backward Ejaculation can also make a person feel upset on an emotional level. Because of the condition, men may feel embarrassed, angry, or worried about how well they do in bed, which can worsen their relationships and general health. Recognizing and discussing these feelings is essential to stay mentally healthy and converse well with your partner. [18] [19] [20] [21]


To identify backward Ejaculation, a doctor or nurse usually takes an entire medical history and does a physical check. There may be a need for more tests, such as:

  1. Urinalysis: A urinalysis is a medical test that can find sperm in the pee after Ejaculation. For this test, the person is usually asked to ejaculate into a cup or a pee sample container. The sample is then checked for sperm. [22]
  2. Imaging studies: Imaging tests like ultrasound or cystoscopy can be used to figure out how well the bladder and reproductive systems are working. These diagnostic tests can help determine any internal problems or issues causing the man to ejaculate backward. [23]
  3. Post-ejaculation urine test: Conducting a post-ejaculation urine test involves obtaining a urine sample immediately following Ejaculation. The piece is then examined for the presence of sperm. If sperm is detected within the urine, it serves as a strong indicator that retrograde Ejaculation is occurring. This test aids healthcare professionals in confirming a diagnosis and determining the appropriate course of treatment. [24]
  4. Semen analysis: A semen study can tell you about the amount and quality of sperm and if there are any signs of an illness or disease. This thorough review of sperm health can help doctors determine what’s wrong and how to treat backward Ejaculation. [25]

Treatment Options

The treatment of retrograde Ejaculation depends on the underlying cause. Some potential treatment options include:

  1. Medication adjustments: If your medicines are causing you to ejaculate backward, your doctor may suggest changing the amount or moving to a different drug. It would help to talk to your doctor about any changes you want to make to your drug schedule to ensure they won’t hurt your general health. [26]
  2. Medications to improve muscle function: Some medicines, like pseudoephedrine and imipramine, can help the muscles that control Ejaculation work better. These medicines work by tightening the muscles around the neck of the bladder. This keeps sperm from getting into the bladder when the man ejaculates. [27]
  3. Assisted reproductive techniques: In situations where backward Ejaculation is causing infertility, assisted reproductive methods like intrauterine insemination (IUI) or in vitro fertilization (IVF) may be suggested. These ways can help improve the chances of getting pregnant by getting around the problem of the sperm not leaving the body. [28] [29]
  4. Reconstructive surgery: In some cases, like when congenital disabilities are to blame for backward Ejaculation, cosmetic surgery may be required to address the problem. However, this choice is usually only used in severe cases and may not always solve the problem completely. [30]
  5. Behavioral therapies: Some men may be able to deal with backward Ejaculation with the help of methods like biofeedback, pelvic floor muscle movements, and calm techniques. These techniques are meant to improve muscle control and awareness, which may make it less likely that sperm will get into the bladder when a man ejaculates. [31] [32]

Psychological Implications and Coping Strategies

Retrograde Ejaculation can have significant psychological effects on the person who has it and can lead to feelings of low self-esteem, embarrassment, inadequacy, and anger. Men who think these things may gain from the following ways to deal with them:

  1. Education: It may be possible to lessen feelings of shame or humiliation by fully understanding retrograde Ejaculation, including its causes and the therapeutic options available. In addition, individuals are provided with empowerment, control, and optimism about their situation when they are educated about prospective outcomes.
  2. Communication: Talking sincerely and honestly to your mate about the condition can help clear any confusion and build a helpful environment. Sharing your feelings and worries with your partner can make you feel reasonable and help you feel closer to them.
  3. Counseling: Psychological therapy, alone or as a pair, can help with the mental effects of ejaculating backward. In addition, professionals in mental health can help people deal with feelings of failure or anger that may arise because of the condition.
  4. Support groups: Participating in support groups for men with backward Ejaculation or other sexual health problems gives them a safe place to talk about their experiences, learn from others, and feel like they are part of a group. In addition, these groups are a great source of mental support and motivation during tough times.


Retrograde Ejaculation is a problem that some men have during sexual activity. It causes the sperm to go into the bladder instead of the urethra. Even though it is not dangerous, it can cause problems with pregnancy and mental stress. Those who have it can make better choices about their sexual health and pregnancy if they know what caused it, what the signs are, and what treatments are available. If you think you might be having backward Ejaculation, you should see a doctor immediately to be appropriately diagnosed and treated. Men with backward Ejaculation can keep their sexual life and general health in good shape by dealing with the condition and its psychological effects.


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