If you are having sex or engaging in masturbation, but no semen is expelled after ejaculation, then you might be experiencing retrograde ejaculation (RE). To learn more about the causes and symptoms of retrograde ejaculation, as well as what to do if the semen does not flow smoothly, we interviewed experts.
What is retrograde ejaculation (RE)?
Before explaining what retrograde ejaculation is, we need to understand what "normal" ejaculation looks like.
According to Dr. James Hook, a medical expert from Neurogan Health, during normal ejaculation, "the sperm exits the testicles through the vas deferens, mixes with the semen in the prostate and seminal vesicles, and then is expelled through the urethra."
However, due to RE, the sperm cannot be expelled normally from the urethra.
Causes and symptoms
Common symptoms of retrograde ejaculation include:
Reduced ejaculation
Dry orgasm (an orgasm that produces little or no semen)
Cloudy urine (semen in the bladder)
Infertility
There are a few reasons why you might experience internal ejaculation. More than 80% of retrograde ejaculation cases are caused by:
Diabetes
Dysautonomia
Certain medications, such as psychotropic medications and alpha-adrenergic blockers
Bladder neck surgery
Transurethral resection of the prostate (for prostate cancer)
Is retrograde ejaculation harmful?
Thankfully, retrograde ejaculation doesn’t cause any pain or physical damage, nor does it affect sexual pleasure or performance.
However, RE may lead to fertility issues for men and people assigned male at birth (AMAB).
“Retrograde ejaculation may induce infertility by means of the sperm not exiting the body in the usual manner,” Dr. Hook says.
According to research published in the World Journal of Men's Health, when sperm travels back into the bladder, it can lead to a lower sperm count, which can reduce the chances of conceiving.
If you’re starting or expanding your family and you have RE, there are several techniques that can help encourage fertility, including:
Centrifugation and re-suspension of post-ejaculatory urine specimens
The Hotchkiss technique
Ejaculation with a full bladder
