Retrograde Ejaculation and Prostate Cancer

I received a question from a community member about male orgasm after prostate cancer (PC) surgery and treatments. The question was different because it was related to painful orgasms and "retrograde orgasms."

After a bit of research, I discovered a trend in the information related to prostate cancer and retrograde ejaculation (RE). Depending on what treatments people have, some may report less semen during their orgasms.

What is retrograde ejaculation?

During orgasm and ejaculation, a small muscle called the bladder sphincter usually closes the opening to the bladder so that semen can exit the body (instead of going into the bladder).^1,2

When you experience retrograde ejaculation, this muscle does not close the way it should. Because of this, semen can flow backward and enter the bladder instead of leaving your body as it would normally during ejaculation.¹

What causes a retrograde ejaculation?

There are many conditions that can cause you to experience retrograde ejaculation, including:^3,4

• Surgery – This can include surgeries such as a transurethral resection of the prostate (TURP), which can cause damage to the bladder valve, resulting in retrograde ejaculation.
• Medicines – Some drugs that treat high blood pressure, prostate enlargement, or depression can cause retrograde ejaculation.
• Nerve damage – Nerve damage caused by conditions such as diabetes or Parkinson's disease might also cause retrograde ejaculation.

A dry orgasm is the ejaculation of little to no semen. A "dry orgasm" is the main sign of a retrograde ejaculation, but it can also appear after:⁴

• The prostate is surgically removed (prostatectomy)
• The bladder is surgically removed
• Radiation therapy to treat cancer in the pelvic area

What can you do?

Experiencing RE can be a shock. Keep in mind that it is not a serious medical condition and is usually not painful. Most cases of retrograde ejaculation do not need a specific treatment. For example, if your RE is caused by a medicine, you may ask your doctor to change to a different drug.^1,4

Retrograde ejaculation can interfere with your ability to get your partner pregnant. Talk with your doctor regarding RE, infertility, and possible solutions to this issue.⁴

If the muscles or nerves of the bladder are severely damaged, it may never be possible to have normal ejaculations. But with the assistance of a fertility specialist, you may still be able to have a child.^2,3

Talk to a specialist for more guidance

Retrograde ejaculation can be caused by many issues, and for the most part it is not a serious problem. If you are interested in becoming a father and are experiencing RE, speaking to the right specialist can help. If you suspect you are dealing with RE, contact your doctor and let them know what you are experiencing.