Retrograde ejaculation typically doesn't require treatment unless it interferes with fertility. In such cases, treatment depends on the underlying cause.
Medications might work for retrograde ejaculation caused by nerve damage. This type of damage can be caused by diabetes, multiple sclerosis, certain surgeries, and other conditions and treatments.
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.
If your doctor thinks drugs you are taking might be affecting your ability to ejaculate normally, he or she might have you stop taking them for a period of time. Drugs that can cause retrograde ejaculation include certain medications for depression 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, including:
- Imipramine (Tofranil)
- Chlorpheniramine (Chlor-Trimeton, others) and brompheniramine (Veltane, others)
- Ephedrine (Akovaz, others), pseudoephedrine (Sudafed, others) and phenylephrine (Vazculep, others)
These medications help keep the bladder neck muscle closed during ejaculation. While they're often an effective treatment for retrograde ejaculation, medications can cause side effects or adverse reactions 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.
If you have retrograde ejaculation, you'll likely need treatment to get your female partner pregnant. In order to achieve a 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 to get your partner pregnant. In some cases, sperm can be recovered from the bladder, processed in the laboratory and used to inseminate your partner (intrauterine insemination).
Sometimes, more-advanced assisted reproductive techniques are needed. Many men with retrograde ejaculation are able to get their partners pregnant once they seek treatment.