Let’s Talk Sex | Not Releasing Semen During Orgasm: Understanding Retrograde Ejaculation

In this article, we will explain what retrograde ejaculation means for your sex life and what are the possible causes and available treatment options.

So, you’ve noticed that when you orgasm, nothing comes out. No semen, no ejaculate, nothing. You might be worried that something’s wrong with your penis, but don’t panic just yet. What you’re experiencing could be a condition called retrograde ejaculation.

Urine and ejaculate both pass through the urethra in males. A sphincter, or muscle, near the neck of the bladder, helps to keep urine in until you’re ready to urinate. That same muscle contracts during orgasm to prevent ejaculate from entering the bladder. This allows it to pass through your urethra and exit through the tip of your penis. This muscle does not contract during retrograde ejaculation. The ejaculate ends up in your bladder because it remains relaxed. A dry orgasm occurs as a result. Despite the absence of ejaculate, it feels like a normal orgasm and has no effect on sexual pleasure.

With retrograde ejaculation, you’ll still experience the sensation of an orgasm, but little to no semen will come out. Instead, the semen is redirected into the bladder, where it’s later flushed out when you urinate. For many men, retrograde ejaculation is not harmful and requires no treatment. However, it can cause infertility since the semen does not exit the penis. If you notice you’re not ejaculating during orgasm, see your doctor. They will check if any underlying health issues are involved and run tests like a urine test after orgasm to look for semen or evaluate how your bladder muscles are working.

Causes and Risk Factors for Retrograde Ejaculation

Retrograde ejaculation happens when semen enters the bladder instead of exiting the penis during orgasm. There are a few possible causes for this condition:

• Medications: Certain medications like alpha-blockers for high blood pressure or prostate problems can cause the valves that control ejaculation to relax, allowing semen to flow backwards. If you’re on any prescription drugs, talk to your doctor about alternative options or dosage adjustments.
• Surgery: Procedures like transurethral resection of the prostate (TURP) or radical prostatectomy for prostate cancer can sometimes damage the nerves and muscles responsible for ejaculation. In many cases, normal ejaculation may return over time. Pelvic floor therapy or medications can also help.
• Diabetes: High blood sugar levels can damage the nerves that control ejaculation. Getting your diabetes under control through medication, diet, and exercise is key to managing retrograde ejaculation from this cause.
• Age: The muscles and nerves involved in ejaculation naturally weaken with age. For some men, retrograde ejaculation becomes more common starting in their 50s and 60s. Treatment options are similar to those for medication- or surgery-induced retrograde ejaculation.

Signs and Symptoms of Retrograde Ejaculation

Some signs and symptoms to be aware of include:

Lack of Ejaculate: The most obvious sign is little to no semen being released during orgasm. You may feel the sensations of orgasm but with no visible ejaculate. This can understandably be distressing, but the good news is retrograde ejaculation is often treatable and usually not dangerous.

Cloudy Urine: After orgasm or ejaculation, your urine may look cloudy or milky. This is caused by the semen flowing into the bladder. The semen will usually clear from your urine over time. If your urine remains consistently cloudy, see your doctor.

Reduced Fertility: Since little to no semen is released during sex or masturbation, retrograde ejaculation can temporarily reduce fertility. The semen is not able to enter the vagina to potentially fertilise an egg. If you and your partner are trying to conceive, retrograde ejaculation will need to be treated.

Treatment Options for Retrograde Ejaculation

If retrograde ejaculation is interfering with your ability to conceive a child, there are a few treatment options available. The goal of these treatments is to strengthen the closure of the bladder neck muscles during orgasm so that semen is expelled forward into the urethra instead of back into the bladder.

• Medications: Certain medications have been used to treat retrograde ejaculation. These drugs are taken orally and work by constricting the bladder neck muscles. However, the effects tend to wear off over time and the medications need to be taken before sexual activity. Side effects may also occur.
• Bladder Neck Surgery: For some men, minor bladder neck surgery may provide a more permanent solution. The procedure involves pinching the closed part of the bladder neck to create resistance so that semen travels forward during orgasm instead of entering the bladder. While usually very effective at restoring normal ejaculation, it does come with risks like infection, bleeding and damage to nearby structures.
• Sperm Retrieval: If other treatments are not options or do not work, sperm retrieval procedures can be performed to harvest sperm from a man’s urine, testicles or ducts that carry sperm. The sperm is then used for intrauterine insemination (IUI) or in vitro fertilization (IVF) to achieve pregnancy. These minimally invasive procedures have high success rates for sperm retrieval but also additional costs for assisted reproductive technology.

The treatment approach will depend on several factors, including a man’s fertility goals, health conditions, and personal preferences. Speaking with a urologist who specialises in male infertility and sexual health can help determine the best options and develop an effective plan for restoring ejaculatory function or achieving pregnancy.

The good news is retrograde ejaculation often resolves once any underlying conditions have been addressed. But if fertility is a concern, treatment may be needed to ensure semen exits properly during orgasm. Discuss all options with your doctor to determine the best approach based on your unique situation. Otherwise, take a deep breath and try not to stress over your unconventional orgasms. Our bodies often have a mind of their own, so do your best to accept yourself as you are.

Remember that every climax, dry or otherwise, is a gift. Your pleasure and intimacy with partners matter more than outdated societal expectations about how ejaculation “should” work. Focus on what feels good for you and try to release any shame or judgment. However, your orgasm expresses itself, you’ve got this!