Question
I noticed my urine flow was weak, so I visited a urologist and started taking medication for BPH. After a month on the medication, I realized my semen volume had decreased. Initially, I thought it might be my imagination, but my doctor explained it could be due to retrograde ejaculation and adjusted my prescription. What exactly is retrograde ejaculation?
Answer
Retrograde ejaculation is when semen flows backwards into the bladder during ejaculation, instead of out through the urethra. To understand this condition, we need to know how erections and ejaculations work.
1. Erection
Visual, olfactory, and sexual memories often play a role in mental arousal, while physical contact with the skin of the penis can trigger reflexive arousal through peripheral nerves. This means that even patients with spinal cord injuries can still achieve erections. It’s possible to enjoy a fulfilling sex life, even with physical challenges.
2. The ejaculation process
Ejaculation begins when the penis receives sufficient stimulation. Nerve signals travel through the pudendal nerve to sympathetic nerve centers in the upper lumbar spine, which then trigger contractions in the epididymis, vas deferens, seminal vesicles, and prostate. This moves the semen toward the urethra. Simultaneously, a sphincter between the bladder and prostate tightens, while another at the base of the urethra relaxes, allowing semen to collect at the bulb of the urethra. Strong muscle contractions around the anus then expel the semen from the body at a high rate. The volume of semen and the openness of the urethra can influence the intensity of the climax.
Why Do Some BPH Medications Cause Retrograde Ejaculation?
Does BPH medication affect semen volume?
Alpha-blockers are often used to treat BPH. They relax muscles in the prostate and bladder neck, improving urine flow. Tamsulosin is a common alpha-blocker. It can cause ejaculation problems, including retrograde ejaculation, in 5-10% of cases. Silodosin, another alpha-blocker, also carries this risk because it relaxes the muscles that normally close the bladder during ejaculation.
Other alpha-blockers, such as terazosin, doxazosin, or alfuzosin, may help prevent reduced semen volume. These drugs work well, but can cause dizziness or low blood pressure. It's important to watch for these reactions.
Other BPH Medications Affecting Ejaculation
If you are taking a 5-alpha reductase inhibitor, you may notice a decrease in semen volume or libido. These medications shrink the prostate. About 5% of patients may experience sexual side effects at first. However, these symptoms often improve after six months.
If you need more information about BPH medications and semen volume, discuss with your urologist to find the best option for you.
Here's to your health and a full life!
Are you a male over the age of 50?
Notice any of these signs?
✔️ A weak or interrupted urine flow
✔️ Frequent, urgent trips to the bathroom
✔️ Difficulty fully emptying your bladder
If any of these apply to you, you may have benign prostatic hyperplasia(BPH).
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*Disclaimer: This article is not intended to provide any medical advice. This information should not be relied upon as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or other qualified healthcare provider with any questions you may have regarding a medical condition.