Retrograde ejaculation is an embarrassing problem for many men, as ejaculation occurs in the opposite direction into the penis instead of out. This phenomenon can lead to negative effects, including the possibility of causing infertility in some cases. What is the nature of this health problem? What are its causes? Does it affect sexual desire and erection? Can retrograde ejaculation lead to infertility? Most importantly, is there a treatment for this condition? And can retrograde ejaculation be temporary? We will answer all these questions and more in the following lines in Dalili Medical.

Can the condition go away on its own?

 

The duration of this problem depends on the cause behind it. If the condition is caused by side effects from taking a certain type of medication, the problem may go away once you stop taking this medication. However, if it is caused by severe nerve or muscle damage, the condition may be persistent and permanent and requires medical intervention.

Can pregnancy occur with dry ejaculation?

 

Dry ejaculation does not make pregnancy impossible, but the number of sperm available in this case is low, which reduces the chances of pregnancy. Sometimes, the treatment of this condition can be as simple as stopping a certain medication, but this solution may not be possible if the cause is nerve damage.

What is dry ejaculation, retrograde ejaculation, retrograde ejaculation, and air ejaculation?

 

Retrograde ejaculation, also known as retrograde ejaculation or retrograde ejaculation, is a condition in which semen does not come out during ejaculation, as the semen enters the bladder instead of exiting through the penis. In this case, the man reaches the peak of sexual pleasure (satiation), but he may ejaculate a small amount of semen or may not come out at all. This is sometimes known as dry ejaculation or dry orgasm, and it is not harmful and does not cause complications for the man's health, but it may lead to infertility, so treatment for retrograde ejaculation becomes necessary if the man wants to have children.

. What are the symptoms of retrograde ejaculation?

 

Symptoms include dry orgasm (no ejaculation), cloudy urine after orgasm, and possible infertility.

. What causes retrograde ejaculation?

 

Causes include diabetes, nerve damage, prostate surgery, or medications that affect the nerves responsible for ejaculation.

. How is retrograde ejaculation diagnosed?

 

Diagnosing retrograde ejaculation involves a physical exam, analyzing a urine sample after ejaculation, and reviewing your medical history to uncover possible causes.

. How is retrograde ejaculation treated?

 

Treatment can include medications to strengthen the bladder neck muscles, or in more severe cases, surgery to repair nerve damage.

. Can retrograde ejaculation be treated?

 

In many cases, retrograde ejaculation can be controlled or treated with medications or surgery, which can help improve symptoms and increase fertility.

**Retrograde Ejaculation Facts**

Here are some quick facts about retrograde ejaculation:

- Retrograde ejaculation is only responsible for about 0.3-2% of fertility problems worldwide.

- This condition is not usually considered a serious health problem, nor is it painful.

- A man may not realize he has this condition, as semen can come out during ejaculation, making him not notice that his amount is less than usual.

- A man may notice that his urine becomes cloudy immediately after intercourse, due to it mixing with semen that returns to the bladder.

**Semen Reflux and Its Effect on Infertility**

When a man learns about the causes and symptoms of semen reflux, he may wonder about the impact of this problem on his fertility and ways to treat it. So, here are some important facts about retrograde ejaculation:

- Semen reflux is not considered a serious health problem.

- Retrograde ejaculation causes fertility problems for about 0.3 to 2 percent of men worldwide.

- Men often do not realize that they have retrograde ejaculation, as they do not notice the amount of semen or the change in urine color.

- This problem may appear when a woman has been late in getting pregnant for a long time, such as a year, without experiencing any fertility problems.

- Retrograde ejaculation significantly reduces the number of sperm, preventing them from reaching and penetrating the egg, and thus preventing the formation of a fetus.

What are the effects of retrograde ejaculation or failure to release semen?

 

Retrograde ejaculation is usually considered a simple condition that does not cause major problems for patients, but it may cause a delay in conception for some young men who suffer from it, because the sperm does not reach the wife's vagina during intercourse. It is important to note that retrograde ejaculation, also known as dry or reverse ejaculation, accounts for about 1% of male infertility cases treated in fertility clinics and urology clinics around the world.

Is retrograde ejaculation a temporary condition?

 

The problem of retrograde ejaculation cannot be ignored, as it is not an emergency or temporary condition that will disappear with time, but rather a medical condition that requires treatment. Complications may become serious and may lead to infertility in men, as well as affect sexual arousal and the health of the marital relationship. The wife may not find pleasure in the absence of semen, so it is preferable to consult a specialist doctor to get the best treatment.

How long does the problem of retrograde ejaculation last?

 

The duration of the problem of retrograde ejaculation varies depending on the reason behind its occurrence. If treatments are the cause of dry ejaculation, ejaculation usually returns to normal after stopping treatment. However, if the cause is surgical operations or a dysfunction of the peripheral nerves, dry ejaculation may be permanent in the patient.

**Types of Retrograde Ejaculation**

Retrograde ejaculation can be classified into several types based on the underlying causes and severity.

**Partial Retrograde Ejaculation** In partial retrograde ejaculation, part of the semen is ejaculated through the urethra, while another part enters the bladder. It may affectThis type affects fertility, but is less severe.

**Complete retrograde ejaculation** Complete retrograde ejaculation occurs when all of the semen enters the bladder, resulting in a completely dry orgasm. This type poses a greater challenge for people trying to conceive.

**Causes of retrograde ejaculation**

A number of health problems can lead to retrograde ejaculation, including:

**Surgery:** Procedures such as prostate surgery, colon surgery, bladder surgery, or lower spine surgery can lead to retrograde ejaculation.

**Diabetes:** Although diabetes is not a direct cause of retrograde ejaculation, uncontrolled blood sugar levels can damage sensory nerves, especially peripheral nerves. This damage can affect the bladder muscles, contributing to retrograde ejaculation.

**Damage to the nervous system:**

The muscles are affected by any problems related to the nerves, and this also applies to the bladder muscle. So, any injuries to the nervous system or diseases related to it, such as multiple sclerosis and spinal cord injuries, can lead to damage to the nerves and muscles of the bladder. Surgical procedures performed on the lower part of the spine can also have a similar effect.

**Some types of surgery:** Some surgeries can lead to retrograde ejaculation, such as surgeries on the prostate, testicles, colon, rectum, bladder, or lower spine, in addition to any structural problems related to the urethra.

**Medications:** Some medications affect ejaculation, including medications for an enlarged prostate and some antidepressants and antipsychotic medications.

**Prostatectomy:** Prostatectomy is the most common cause of retrograde ejaculation. It is important to distinguish between two types of these surgeries: The first type is partial prostatectomy, which can lead to retrograde ejaculation.

Research suggests that 10 to 15 percent of patients experience retrograde ejaculation after this surgery, due to the potential for damage to the bladder muscles and nerves as a result of the surgery being performed by inexperienced surgeons.

The second type is radical prostatectomy, where the entire prostate is removed either laparoscopically or open surgery, often due to tumors. Men who undergo this type of surgery are unable to ejaculate at all, which is different from retrograde ejaculation, where the cause is the inability of the penis to transport semen.

**Diagnosis of Retrograde Ejaculation**

Diagnosis of Retrograde Ejaculation usually involves a combination of elements including the patient’s medical history, physical examination, and specialized tests.

**Medical History and Physical Examination** A detailed medical history helps identify possible causes, such as various medical conditions, previous surgeries, or medications used. A physical examination can also reveal any anatomical abnormalities that may contribute to this condition.

**Urine analysis** A urine sample is tested after ejaculation to look for sperm. If sperm is found in the urine, this confirms retrograde ejaculation.

What are the signs of retrograde ejaculation?

Retrograde ejaculation does not affect a man's erection or sexual desire. When orgasm occurs during intercourse, the following symptoms may be observed:

- Weak flow of semen from the penis, as the amount is very small.

- Change in urine color (as it is not clear) due to the presence of a quantity of semen mixed with it.

- Failure to get pregnant despite regular sexual intercourse.

When should you see a doctor?

 

Retrograde ejaculation is not considered a health problem that requires treatment unless you are trying to have children. However, if you experience dryness during orgasm, it is important to see a doctor to make sure there is no underlying health problem that needs to be treated.

If you have been having unprotected intercourse regularly for a year or more without your wife getting pregnant, it is essential to consult a doctor. Retrograde ejaculation may be the cause of this problem, especially if you ejaculate a small amount of semen or none at all.

**Complications of retrograde ejaculation**

Although retrograde ejaculation is generally not considered harmful, there are some potential complications that may result from it, including:

- Difficulty conceiving children (male infertility).

- Less enjoyable experience during intercourse due to anxiety about not ejaculating.

Retrograde ejaculation usually does not require treatment unless it affects fertility. In these cases, treatment depends on the underlying cause of the problem. Medications can be effective in treating retrograde ejaculation caused by nerve damage, which can be caused by conditions such as diabetes, multiple sclerosis, certain surgeries, or other treatments. However, medications may not be effective if retrograde ejaculation is the result of surgery that resulted in permanent physical changes, such as bladder neck surgery or transurethral resection of the prostate.

If your doctor thinks your medications may be affecting your ability to ejaculate normally, he or she may recommend stopping them for a period of time. Some medications that can cause retrograde ejaculation include some medications used to treat mood disorders and alpha blockers, which are used to treat high blood pressure and some prostate conditions. To determine the cause of your condition, your doctor will:

A series of questions will be asked about your symptoms and how long they have been present, as well as any previous health problems, surgeries or cancers you have had, and the medications you are taking.

A physical exam will be performed, which will likely include an examination of your penis, testicles and rectum.

A urine test will also be performed to check for semen after an orgasmSexual intercourse, usually done in the doctor's office. Your doctor will ask you to empty your bladder, masturbate, and then provide a urine sample for laboratory analysis. If a large amount of semen is found in your urine, it may indicate that you have retrograde ejaculation.

If you have dry orgasm and your doctor doesn't find any semen in your bladder, you may have a problem with semen production. This can happen as a result of damage to your prostate or the glands responsible for producing semen, due to surgery or radiation therapy to treat cancer in the pelvic area.

**How ​​to treat reflux of semen into the bladder**

 

**Diagnosis and tests** Treatment of reflux of semen into the bladder begins with determining the correct diagnosis. During your discussion with your doctor, he or she may ask some important questions, such as:

- What medications are you taking?

- Do you have any chronic diseases?

- How long have you had weak semen flow?

- Have you had any previous surgeries?

- Are you receiving radiation therapy?

After that, the doctor performs a physical examination, examining the penis, testicles, and prostate. He may also request some tests, such as:

- **Semen analysis**: to determine its quantity, the number of sperm and their health.

- **Urine analysis**: to ensure that it is free of semen.

**Treatment of reflux of semen into the bladder**

Regurgitation of semen into the bladder can be treated with medications, especially if the cause is due to a nerve disorder due to certain diseases such as diabetes or some neurological diseases. However, if retrograde ejaculation is the result of surgery or anatomical changes in the bladder muscle, medications may not be effective in this case.

**Some medications used to treat retrograde ejaculation:**

- Imipramine (Tofranil)

- Midodrine

- Chlorpheniramine (Chlor-Trimeton) and brompheniramine (Veltan)

- Ephedrine (Acovaz), pseudoephedrine (Sudafed), and phenylephrine (Vazcolep)

**Testicular sperm aspiration (TESA):** This procedure is performed under local anesthesia, where a needle is used to extract sperm from the testicles.

**Percutaneous sperm aspiration (PESA):** This procedure uses a needle to remove sperm from the epididymis (the tube connecting the testicles) under local anesthesia.

**Testicular sperm extraction (TESE):** This method is similar to TESA, where sperm are extracted directly from the testicles under anesthesia. However, this technique may require an incision in the testicle. After removing the semen, advanced artificial insemination techniques can be used to help the wife conceive, such as in vitro fertilization (IVF) or intrauterine insemination (IUI).

**Surgical interventions** In cases where medications are not effective, surgical interventions may be considered. Available options include:

- **Bladder neck reconstruction**: This procedure aims to restore normal bladder neck function and prevent retrograde flow.

- **Prostate surgery modifications**: In some cases, modifications to previous prostate surgeries may help relieve retrograde ejaculation.

**Assisted reproductive techniques** For couples who are having difficulty conceiving due to retrograde ejaculation, assisted reproductive techniques can provide an effective solution. These techniques include:

- **Intrauterine insemination (IUI)**: Sperm extracted from urine can be used in the intrauterine insemination process, which increases the chances of pregnancy.

- **In vitro fertilization (IVF)**: In vitro fertilization is an effective option for couples with severe retrograde ejaculation.

**Prevention of retrograde ejaculation**

There are now innovative techniques and minimally invasive surgery for enlarged prostate (non-cancerous) that may reduce the incidence of retrograde ejaculation compared to traditional procedures. These new techniques include transurethral resection of the prostate (TUNA) and transurethral microwave thermal therapy (TUMT). Although these procedures may result in fewer cases of retrograde ejaculation, they may not be suitable for all patients.

**Exercises to treat retrograde ejaculation**

Kegel exercises are an effective way to control the pelvic floor muscles, which play an important role in ejaculation in men. You can practice these exercises by following these steps for three months and notice the difference:

1. Start by emptying your bladder to ensure that you are fully prepared to perform the exercise effectively.

2. Lie on your back on the floor for a few seconds, and try to concentrate on the exercise.

3. Bend your knees towards your body in a tilted position.

4. Use your abdominal and thigh muscles to lift your lower body up, and hold for two seconds.

5. Return to relax on your back again and rest for two seconds.

6. Repeat the exercise 10 to 15 times in each set, and practice two to three sets daily.

The effectiveness of Kegel exercises in treating retrograde ejaculation and premature ejaculation problems in men depends largely on the continuity of practicing the exercises daily.

**Exercises to treat retrograde or dry ejaculation**

There are a group of exercises that can help treat retrograde or dry ejaculation. Here are some tips that can be followed:

**. Kegel exercises** These exercises help strengthen the pelvic muscles and enhance control over ejaculation. They can be practiced using the mind or with tools designed for this purpose. Kegel exercises aim to strengthen the small pelvic muscles, which are muscles that play a key role in supporting sexual functions and controlling ejaculation. Here's how to do Kegel exercises in detail:

**Identify your pelvic floor muscles:** Before you begin, it's important to identify the muscles you want to strengthen. You can do this in one of two ways:

1. While urinating, try to stop the flow of urine suddenly. The muscles you use for this purpose are the pelvic floor muscles.

2. During ejaculation, try to stop ejaculation suddenly. These are alsoA. Pelvic floor muscles.

**Preparation:** Sit or lie down in a comfortable position. Tense your pelvic floor muscles slowly and forcefully, as if you were trying to stop urinating. Hold the tension for about 5 seconds.

4. Relax: After contracting, relax those muscles at the same pace and rest for 5 seconds.

5. Repetition: Repeat the cycle (contraction and relaxation) 10 to 15 times in each session. You can gradually increase the number over time.

6. Regularity: Make sure to practice these exercises regularly, preferably several times a day, such as in the morning and evening.

7. Note: Avoid tensing the rest of your body’s muscles while performing these exercises. Focus only on your pelvic floor muscles.

Remember that Kegel exercises may take some time to show results, but they can be effective in enhancing ejaculation control and improving overall sexual function. If you feel any pain or abnormal tension while doing these exercises, it is best to consult a medical professional

**Delayed Ejaculation** You can have regular intercourse without ejaculating, which helps to enhance self-control and delay ejaculation. Delay techniques are strategies and exercises that aim to help men delay ejaculation and increase sexual desire. These techniques may be useful for men who suffer from premature ejaculation or dry ejaculation. Here is a detailed explanation of some of these techniques:

1. **Start-Stop Technique**

- Begin sexual activity as usual. 

- When you feel like you are about to ejaculate, stop completely and refrain from any movement or attempt. 

- Wait until the feeling of ejaculation goes away, then resume activity. 

- Repeat this process several times during intercourse to delay ejaculation.

2. **Squeeze Technique**

- Begin sexual activity as usual.

- When you feel like you're about to ejaculate, stop and ask your partner or yourself to gently squeeze the bottom of your penis (base of your penis). 

- Hold the pressure for about 30 seconds until the urge to ejaculate goes away. 

- Resume activity after releasing the pressure.

3. Deep breathing:

Practice deep breathing during intercourse. Breathe slowly and deeply through your nose, then slowly exhale through your mouth.

Focusing on your breathing can help reduce stress and increase control over ejaculation.

4. Edging:

Start sexual activity as usual and focus on enjoying the moment without rushing to ejaculate.

When you feel like you're about to ejaculate, stop completely and wait until the urge goes away.

Then resume activity again and repeat this process several times.

5. Use thick condoms:

You can use a thick condom to reduce sensitivity and increase the time it takes to reach ejaculation.

Remember that delay techniques require practice and patience. These techniques can be useful for improving control over ejaculation and enabling the man to enjoy longer periods of time during intercourse. These techniques should be practiced comfortably and without pressure, with the partner involved in the process to ensure comfort and mutual understanding.

(3) Distraction Technique** This technique can be applied during sexual intercourse, focusing on sensations and pleasure without being preoccupied with the idea of ​​ejaculation. The Distraction Technique is known as one of the delay methods that helps the man delay ejaculation and increase the pleasure of the relationship. This technique depends on diverting the person’s attention away from ejaculation and focusing on other things during intimate moments.

Here is a detailed explanation of how to practice this technique:

 

. **Communication with your partner**: Before starting intimate relations, introduce your partner to the idea of ​​using the withdrawal technique and discuss together how this technique can enhance your experience. Make sure to have open communication about your feelings and desires.

. **Focus on physical sensations**: During intercourse, try to focus on sensations and physical pleasure instead of worrying about ejaculation. Learn how to enjoy touch, movements, and feelings in general.

. **Diverting attention**: When you feel like you're about to ejaculate, try to divert your attention to things other than sex. You can think about exciting or interesting topics, or even engage in mathematical calculations.

. **Using imagination**: Instead of thinking about ejaculation, use your imagination to focus on another sexual scene that interests you and helps you delay ejaculation.

. **Delaying emotions**: Remember that you can postpone sexual emotions by reminding yourself that you have enough time and there is no need to rush.

. **Ensuring comfort**: Make sure that you are both comfortable and relaxed during intercourse. Comfort plays a vital role in improving sexual performance.

**Isolation technique** helps enhance self-awareness and increase control over ejaculation by diverting attention away from the stresses and tensions associated with this process. Practicing this technique may require training and continuous practice, but it can be effective in improving the intimate experience and avoiding dry ejaculation.

**Aerobic exercises** These exercises include abdominal breathing and muscle relaxation techniques, which help reduce the stress and anxiety associated with premature ejaculation. Aerobic exercises focus on deep breathing and relaxation, and can play a role in improving sexual performance by reducing stress and anxiety levels.

Here's an explanation of these exercises:

 

1. **Belly Breathing Exercises**

- Start by sitting or lying down in a comfortable position.

- Place your hand on your belly.

- Breathe slowly and deeply through your nose, focusing on expanding your abdomen rather than your chest as you inhale.

- Hold the air for a few seconds and then slowly exhale through your mouth.

- Repeat this exercise for at least 5-10 minutes daily.

**. Deep Relaxation Exercises**: You can find muscle relaxation exercises online or through a certified trainer. These exercises aim to relax all of the muscles in your body comprehensively.

This involves directing your attention to different areas of your body, feeling the tension, then relaxing and sending the feeling of relaxation to those areas.

.** Meditation**: Meditation is an exerciseMentally, it can help reduce stress and anxiety levels.

You can use meditation techniques to enhance self-awareness and increase feelings of relaxation.

**Yoga**: Yoga combines deep breathing and muscle relaxation exercises.

You can practice simple yoga exercises regularly to help relieve stress and improve overall health.

**Walking**: Walking is an effective aerobic exercise that can help improve overall health and reduce stress levels. If possible, try taking a walk in nature to promote relaxation.

Aerobic exercise helps calm the mind and relieve stress and anxiety, which may help improve sexual performance and increase the ability to control ejaculation. It is best to practice these exercises regularly as part of a healthy and balanced lifestyle.

**Physical exercise**: Physical exercise is an essential component of general health care, and has a positive effect on sexual function in men. These exercises include improving overall physical fitness and increasing blood flow in the body, which can improve sexual performance and enhance the ability to control ejaculation. Here are more details:

. **Impact on general health:** Regular exercise contributes to improving physical fitness and general health, which reduces the risk of chronic diseases such as heart disease, diabetes and high blood pressure.

**Enhancing blood flow:** When exercising, muscle activity increases, which requires increased blood flow. This leads to improved blood flow in the body in general, including the pelvic area and genitals.

**. Improving sexual fitness:** Physical fitness contributes to enhancing the body's ability to endure and perform well, which is positively reflected in sexual performance. It also enhances the production of hormones associated with sexual pleasure and improves blood circulation, which contributes to enhancing sexual response.

**Increasing self-confidence:** Regular exercise can raise levels of self-confidence and feelings of attractiveness, which has a positive impact on sexual relationships.

**. Controlling emotions and responses:** Physical fitness helps improve the ability to control emotions and responses during intercourse, which can contribute to reducing the risk of premature ejaculation.

. **Choosing the right sports**: Swimming and running are sports that help improve physical fitness and the ability to control ejaculation. You can choose sports that give you a sense of comfort and enjoyment.

**Can lifestyle affect retrograde ejaculation?**

Although retrograde ejaculation is often the result of medical or psychological factors, there are some aspects of lifestyle that may play a role in the occurrence of this condition or worsen the symptoms associated with it.

One lifestyle factor that may contribute to retrograde ejaculation is drug use. For example, some medications, such as alpha blockers and antidepressants, can affect the normal functioning of the muscles responsible for ejaculation. In addition, the use of recreational drugs such as marijuana, cocaine, and methamphetamine may also affect ejaculation by changing the nervous system’s response to sexual stimulation.

Another lifestyle factor that can contribute to retrograde ejaculation is an unhealthy diet and lack of physical activity. A sedentary lifestyle and a diet high in processed foods and sugar can lead to weight gain and other health problems that affect sexual function, including retrograde ejaculation. Stress and anxiety are also common lifestyle factors that may contribute to retrograde ejaculation. High levels of stress can affect sexual performance and increase the likelihood of this condition.