Retrograde Ejaculation: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Retrograde Ejaculation?
A urologist, a doctor for the urinary tract and male sex organs, usually diagnoses and treats retrograde ejaculation. If you want a child, a fertility doctor may also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is retrograde ejaculation?
Retrograde ejaculation happens when semen goes backward into the bladder. Normally, semen moves forward and out of the penis through the urethra. The urethra is the tube that carries semen out of the penis. This condition is also known as dry climax.
The forward flow of semen can be partly or completely missing. Retrograde ejaculation is uncommon.
Symptoms
The main signs are:
- Little or no semen comes out during ejaculation.
- The urine looks cloudy after orgasm.
This is most often not a problem unless you are trying to conceive. It may cause infertility, which means trouble having a child. It can also cause significant distress for some men.
Causes and who gets it
It most often happens when the bladder neck does not close. The bladder neck is the opening of the bladder. Semen then goes backward into the bladder instead of forward out of the penis. Common causes include:
- Diabetes, a disease that raises blood sugar.
- Some medicines, including medicines for high blood pressure and some mood-altering medicines.
- Medicines or surgery to treat prostate or urethra problems.
- Nerve damage from multiple sclerosis or a spinal cord injury.
BPH is an enlarged prostate. Most men who have classic surgery for BPH through the urethra have permanent retrograde ejaculation.
How doctors diagnose it
Diagnosis is usually simple. Doctors use your history and lab tests. A urine test soon after ejaculation will show a lot of sperm in the urine.
Treatment
Treatment depends on the cause. Doctors first look for causes that can be fixed. One example is a medicine linked to the problem. Your provider may suggest you stop a medicine that causes it. This can make the problem go away. Follow your provider's instructions, and do not stop a medicine on your own.
If no reversible cause is found, medicine is typically the main approach. These medicines help the bladder neck stay closed so semen cannot flow backward. When diabetes or surgery caused the problem, medicines such as pseudoephedrine or imipramine may be used.
They can cause side effects, such as dizziness, dry mouth, nausea, a fast heartbeat, and high blood pressure. Doctors use them with care in people with diabetes. These people may be at risk for heart problems. Results are not the same for everyone.
If you want a child, semen can often be taken from the bladder. It can then be used in assisted reproductive techniques. These help a couple conceive. Doctors suggest trying sperm retrieval before surgery.
When to see a doctor
Contact your provider if you are worried about this problem or are having trouble conceiving a child. If a medicine caused it, normal ejaculation often comes back once the medicine is stopped.
If you have diabetes, good blood sugar control may help prevent it.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can check your medicines for ones that may cause it and arrange the urine test. They can also refer you to a urologist or a fertility specialist when needed.
Common questions
Is retrograde ejaculation harmful?
It is most often not a problem unless you are trying to conceive. Some men do not like how it feels and seek treatment.
Can retrograde ejaculation cause infertility?
Yes, it may cause infertility. However, semen can often be taken from the bladder and used in assisted reproductive techniques.
Can retrograde ejaculation go away?
It depends on the cause. If a medicine caused it, normal ejaculation will often come back after the medicine is stopped. If surgery or diabetes caused it, it often cannot be corrected.
What causes retrograde ejaculation?
Retrograde ejaculation most often happens when the bladder neck does not close. Then semen goes backward into the bladder. Diabetes, some medicines, and some prostate or urethra surgeries are common causes.
Sources
- MedlinePlus - Retrograde ejaculation
- National Library of Medicine (PubMed Central) - Recent Advances in the Diagnosis and Management of Retrograde Ejaculation: A Narrative Review
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
