Retrograde Ejaculation - Causes and Symptoms

Retrograde ejaculation is when semen enters the bladder during orgasm. Here's what to know about it.

The Promescent Team
Hands on, practical experience – this is our expertise
by The Promescent Team Last updated 12/11/2023
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Ejaculation is the discharge of semen as a result of orgasm. It occurs when men engage in masturbation or sexual intercourse.

Normally, semen is expelled through the penis. But in some cases, it may enter other places. Retrograde ejaculation is a condition that affects men's reproductive and urinary systems.

Quick FAQs

Retrograde ejaculation is when semen enters the bladder instead of exiting the penis during orgasm.

Common symptoms of retrograde ejaculation include cloudy urine, infertility, and dry orgasm.

The causes of this condition include nerve damage from bladder neck surgery, spinal cord injuries, and diabetes.

It’s important to know the symptoms, causes, and available treatment options. Additionally, we'll discuss the potential complications and ways to manage this condition effectively.

Understanding Retrograde Ejaculation

Retrograde ejaculation occurs when semen enters the bladder instead of being expelled through the penis during orgasm. This can lead to a decrease in fertility, as sperm is not being released in the typical manner.

Although not harmful in itself, retrograde ejaculation may cause distress and concern for those experiencing it.

It should be noted that men are still able to achieve sexual climax. There just may not be any semen released, which this is referred to as a dry orgasm.

Identifying the Symptoms

There are a few symptoms that are common with those who experience retrograde ejaculation. Those signs include:

  • Cloudy urine after sexual activity, as the semen mixes with urine in the bladder
  • Infertility due to the reduced amount of sperm released during ejaculation
  • Little or no semen released during orgasm, also known as dry orgasm

It should be kept in mind that the condition only accounts for less than 2% of all cases of infertility.

While dry orgasm is a common sign for retrograde ejaculation, be mindful that other conditions can cause this symptom, such as:

  • Removal of the prostate
  • Radiation therapy in the pelvic area
  • Removal of the bladder

It is essential to recognize that retrograde ejaculation is not the same as erectile dysfunction or premature ejaculation. These are separate conditions that require distinct treatments.

Common Causes of Retrograde Ejaculation

There are various factors that can contribute to the development of retrograde ejaculation. Some common causes include:

  • Nerve damage from prostate or bladder neck surgery
  • Diabetes, which can lead to nerve damage affecting the muscles that control ejaculation
  • Spinal cord injuries, resulting in impaired nerve function
  • Certain medications, including alpha-blockers or antidepressants
  • Aorto-iliac vascular surgery
  • Multiple sclerosis
  • Myelodysplasia
  • CVA

Diagnosis and Tests

To diagnose retrograde ejaculation, a healthcare professional will typically begin with a thorough medical history and physical examination. They may also perform the following tests:

  • Urinalysis: A post-ejaculatory urine sample can reveal the presence of semen in the urine.
  • Semen analysis: This test helps assess the volume of semen.

Treatment Options

The appropriate treatment for retrograde ejaculation depends on the underlying cause. Some possible treatments include:

  • Medication: Drugs such as pseudoephedrine, imipramine, or phenylephrine may help the bladder neck muscle stay closed during ejaculation.
  • Adjusting current medications: If medication is the cause, your doctor may recommend switching to an alternative prescription.
  • Assisted reproductive techniques: In cases where fertility is a concern, options like intrauterine insemination (IUI) may be explored.

An important thing to remember with taking medications for retrograde ejaculation is that they can come with side effects, such as increased blood pressure and heart rate. 

They may even cause adverse reactions with other medications. Be sure to consult with a physician before taking any drugs for retrograde ejaculation.

Managing the Condition

Living with retrograde ejaculation can be emotionally challenging, especially for those concerned about fertility. It is crucial to communicate openly with your partner and healthcare provider to address any concerns. 

Additionally, follow up with regular medical appointments to ensure proper management of any underlying conditions. Maintaining a healthy lifestyle can also help support overall reproductive health. Some steps to consider include:

  • Eating a balanced diet, rich in fruits, vegetables, whole grains, and lean proteins
  • Exercising regularly to maintain a healthy weight and reduce stress
  • Avoiding tobacco and excessive alcohol consumption
  • Managing chronic health conditions, such as diabetes, through regular check-ups and medication adherence

When to See a Doctor About Retrograde Ejaculation?

It’s not always clear when it’s time to see a doctor about conditions such as retrograde ejaculation. If any of the following are true, it may be a good time to speak with a healthcare provider:

  • You’re uncomfortable with how your orgasm feels
  • Attempting to have children
  • Treatment for retrograde ejaculation isn’t working

Preparing for the appointment

Your family doctor will likely be the first physician you will see. Based on the cause of the issue, and whether the issue is causing infertility, a doctor will refer a patient to a urologist. Here are some tips to follow before the doctor’s visit:

  • Write down all symptoms
  • List all current medications, supplements, and vitamins being taken
  • Write down questions for the doctor
  • List all prior surgeries, pelvic radiation, and any current stresses.


Retrograde ejaculation is a condition where semen enters the bladder rather than being expelled through the penis during orgasm. Potential causes of the condition include nerve damage, diabetes, and spinal cord injury.

While not harmful in itself, it can lead to fertility issues and emotional distress. Recognizing the symptoms, understanding the potential causes, and seeking appropriate diagnosis and treatment are essential for managing this condition effectively.

By following the advice of healthcare professionals and adopting a healthy lifestyle, individuals can successfully navigate the challenges of retrograde ejaculation and maintain their overall well-being.

The Promescent Team

The Promescent Team

Our team has over a decade of experience in the sexual wellness field and are experts in sexual dysfunctions, like premature ejaculation. We help couples and individuals better understand treatment options available for different types of sexual needs and educate the public on all things related to intimacy. All of our authored content is medically reviewed for accuracy and reliability.


Absorption Pharmaceuticals LLC (Promescent) has strict informational citing guidelines and relies on peer-reviewed studies, academic or research institutions, medical associations, and medical experts. We attempt to use primary sources and refrain from using tertiary references and only citing trustworthy sources. Each article is reviewed, written, and updated by Medical Professionals or authoritative Experts in a specific, related field of practice. You can find out more about how we ensure our content is accurate and current by reading our editorial policy.

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The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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