Retrograde Ejaculation: Therapy

By Mayo Clinic staff

Retrograde ejaculation typically doesn't require treatment unless it interferes with fertility. In such cases, treatment depends on the underlying cause. Drugs may work for retrograde ejaculation caused by certain conditions. Surgery isn't a treatment option for retrograde ejaculation.

Drugs generally won't help if retrograde ejaculation is due to surgery that causes permanent physical changes of your anatomy. Examples include bladder neck surgery and transurethral resection of the prostate.

Drugs may work if retrograde ejaculation is due to nerve damage. This can be caused by diabetes, multiple sclerosis, certain surgeries and other conditions and treatments.

If your doctor thinks drugs you are taking may be affecting your ability to ejaculate normally, he or she may have you stop taking them for a period of time. Drugs that can cause retrograde ejaculation include certain medications for mood disorders and alpha blockers — drugs used to treat high blood pressure and some prostate conditions.

Drugs to treat retrograde ejaculation are drugs primarily used to treat other conditions. They include:

Imipramine, a tricyclic antidepressant
Chlorpheniramine and brompheniramine, antihistamines sometimes used to treat cold symptoms
Ephedrine, pseudoephedrine and phenylephrine, used in some decongestant medications

These medications help keep the bladder neck muscle closed during ejaculation. While they're often an effective treatment for retrograde ejaculation, all of these medications can cause side effects. Some of the side effects are minor, but others can be more serious.

Some medications used to treat retrograde ejaculation can cause serious reactions when combined with other medications.
Certain medications used to treat retrograde ejaculation can increase your blood pressure and heart rate, which can be dangerous if you have high blood pressure or heart disease.
Infertility
If you have retrograde ejaculation, you'll likely need treatment to get your partner pregnant. In order to achieve pregnancy, you need to ejaculate enough semen to carry your sperm into your partner's vagina and into her uterus.

If medication doesn't allow you to ejaculate semen, you will likely need infertility procedures known as assisted reproductive technology (ART) to get your partner pregnant. With ART, sperm can be recovered from the bladder, processed in the laboratory and used to inseminate your partner (intrauterine insemination). Occasionally, more advanced assisted reproductive techniques may be needed. Most men with retrograde ejaculation don't have any trouble getting their partner pregnant once they seek treatment.