Prostate Medication

Flomax Ejaculatory Dysfunction: Retrograde Ejaculation

Ejaculation plays a crucial role in infertility. During ejaculation, semen is moved from the seminal vesicles toward the tip of the penis. Sometimes, however, problems occur during the ejaculatory process.

Different ejaculatory dysfunctions can affect a man. Some cause the man to ejaculate too quickly, while others may result in no or only a little semen being pushed toward the tip of the penis. 

Flomax ejaculatory dysfunction is a common concern among men with benign prostatic hyperplasia. Flomax is commonly used to treat an enlarged prostate or urinary symptoms. Sometimes, however, the drug may interfere with the normal ejaculatory process.

We take a closer look at retrograde ejaculation in this post. We consider what it means and why it happens. The post will also look at whether Flomax could be the cause behind retrograde ejaculation. 

Types Of Ejaculatory Dysfunctions 

Ejaculatory dysfunction is a term that can refer to different conditions affecting the male reproductive system. Studies show that ejaculatory dysfunctions are relatively common among men. These conditions can affect young and older men. 

One study found that premature ejaculation is the most common type of ejaculatory dysfunction. This condition causes a man to ejaculate quickly after initiating sexual activity. Premature ejaculation means both the man and his sexual partner will not feel satisfied at the time of orgasm. There is no specific time to ejaculation used to diagnose this condition, although most men report ejaculation within one minute. Studies show that up to 40% of men may experience premature ejaculation. 

Apart from premature ejaculation, there are two other common types of ejaculatory dysfunctions. This includes delayed and retrograde ejaculation. 

Delayed ejaculation means it takes longer than usual for a man to ejaculate. 

What Is Retrograde Ejaculation

Retrograde is a less common form of ejaculatory dysfunction. Additional symptoms sometimes accompany it. In one study, researchers found that men with retrograde ejaculation may also experience pain. Painful ejaculation can cause problems with reproduction, as men may ward away from sexual activities. Hematospermia is another condition commonly found among men with retrograde ejaculation. 

Studies have found that retrograde ejaculation affects up to 10% of men. One study analyzed men who visited an infertility clinic. A total of 2587 patient profiles were considered. The prevalence of retrograde ejaculation among these profiles was reported as 3.2%. The study also identified a common association between hypospermia and retrograde ejaculation. 

Retrograde ejaculation refers to a condition where semen does not move through the normal route. When a man ejaculates, semen moves from the seminal vesicle through the prostate and then into the urethra. From here, the semen moves through the penis and is expelled at the tip. 

With retrograde ejaculation, semen is pushed back when it enters the urethra. This causes the semen to move into the bladder. Sometimes, only a small amount of semen enters the bladder, while the rest is still pushed out at the tip of the penis. In other cases, only a few drops of semen may leave the penis, with the rest entering the bladder.  

What Causes Retrograde Ejaculation?

There are numerous possible causes behind retrograde ejaculation. Men should ensure they understand what the causes are. This will help a man determine why they might be experiencing the condition. It also makes identifying potential treatment options easier. 

Medication is a common factor in retrograde ejaculation. This is why doctors tend to take a look at any medications that the patient uses. In many cases, switching medication may be a helpful method for improving the symptoms. 

There are other factors that can contribute to retrograde ejaculation too. Doctors will need to consider possibilities like prostate cancer. If lower urinary tract symptoms are present, the doctor will also look for signs of an enlarged prostate. This condition causes prostate tissue to increase in size. BPH symptoms can lead to abnormal ejaculation. This is because semen travels through a prostatic urethra found in the prostate gland. 

Additional questions will help the doctor further pin down a specific cause behind the condition. This includes accompanying symptoms, such as erectile dysfunction, as well as pain symptoms during sex or ejaculation. Several conditions that result in ejaculatory issues can affect erectile function. 

Can Flowmax Cause Ejaculatory Dysfunction?

Flomax is a prescription drug that men may use when they have a benign prostatic hyperplasia condition. The drug focuses on the urinary symptoms that men experience when they have an enlarged prostate. The drug is also known as Tamsulosin. It is classified as an alpha-blocker. A doctor will provide a specific dosage for the patient based on the severity of the condition. 

Flomax is helpful when a man has problems like urinary incontinence. The drug can, however, cause side-effects. Among side-effects associated with Flomax, some men report problems with their ejaculation. A lot of men who use Flomax find that it becomes harder to ejaculate.

The delayed ejaculation could interfere with a man’s ability to reproduce. When the man has difficulty ejaculating, he may start to develop other complications too. In addition to delayed ejaculation, some men have reported retrograde ejaculation. 

Thus, patients should be aware that Flomax can be a reason for their retrograde ejaculation. If the patient experiences this condition and takes Flomax, they should report it to the doctor. The doctor may remove the patient from Flomax. A different prescription may help to reduce urinary symptoms of an enlarged prostate without causing problems with ejaculation. 

Alpha-Blockers

Alpha-blockers include different drugs that are often prescribed to men who have high blood pressure. Hypertension is a serious condition that causes damage to blood vessel walls.

Alpha-blockers inhibit the function of a hormone. The hormone targeted by alpha-blockers is known as norepinephrine. This hormone causes veins and arteries to tighten. The hormone affects the muscles that run through these vessels. When they tighten, blood pressure starts to increase. 

This results in a reduced blood pressure level. The drugs are also often prescribed for men who have problems with their prostate gland. The medication is useful for improving the function of the bladder when the prostate gland is enlarged. 

Flomax, as stated, is classified as an alpha-blocker. There are, however, several other drugs that also fall within this category. When men take an alpha-blocker, whether that is for their prostate or hypertension, they may experience side-effects. Retrograde ejaculation is one of the side-effects associated with alpha-blockers. 

5-Alpha-Reductase Inhibitors

Sometimes, alpha-blockers do not help the symptoms a man experiences when he has an enlarged prostate. If this is the case, the doctor may prescribe a different drug class. This usually includes a 5-alpha-reductase inhibitor. This is another common drug used by men with benign prostatic hyperplasia. This drug class is also helpful for men who experience signs of male pattern baldness. 

Two main drugs are classified as 5-alpha-reductase inhibitors. These include dutasteride and finasteride. Dutasteride is sold under the brand name Avodart. Finasteride is promoted as Propecia and Proscar. Jalyn is another brand name that combines both 5-alpha-reductase inhibitors and Tamsulosin.

Some studies show 5-alpha-reductase inhibitors tend to have numerous adverse effects among the male population. 

In one study, researchers report that erectile dysfunction seems to be a common side-effect associated with these drugs. Other side-effects noted by the men included in the study consisted of a reduction in their libido. Some men also reported reduced ejaculate. The data collected shows that up to 15.8% of men who use a 5-alpha-reductase inhibitor will experience sexual side-effects

Retrograde ejaculation is another possible side-effect associated with this drug class. This explains the reduction in ejaculate experienced by some men. The drug may cause the ejaculate to push toward the bladder instead of toward the tip of the man’s penis. 

Surgical Procedures

In a majority of cases, men find that drugs are the reason behind retrograde ejaculation. This, however, is not always the cause. Certain types of surgical procedures can also lead to an increased risk for retrograde ejaculation. 

These surgical procedures are usually ones that require surgery to the prostate gland or the bladder. Numerous conditions may require surgery in these areas of the man’s body. 

A common surgical procedure that leads to retrograde ejaculation is a prostatectomy. This procedure is often performed among men who have prostate cancer. The prostatectomy allows surgeons to remove a part of the prostate gland. When the cancer is more advanced, then the entire prostate may be removed during the surgical procedure. A prostatectomy is sometimes also used as a treatment for benign prostatic hyperplasia.

When the prostate becomes enlarged, it pushes against the bladder and urethra. This can lead to several complications. When drugs do not help, a surgeon may remove part of the prostate gland to ease the tension placed on the urethra and bladder neck. 

There are cases where surgery to the prostate gland causes damage to the bladder neck. When this happens, the bladder neck may not properly close when a man ejaculates. This could result in semen pushing into the bladder. 

Other surgical procedures have also been found to carry risks of damaging the bladder neck or causing other problems that may contribute to retrograde ejaculation. Any surgical procedure that involves the bladder is susceptible to increase the risk of retrograde ejaculation. This is especially the case when surgery involves the neck of the bladder or the surrounding areas. 

Patients who undergo an extensive surgical procedure in the pelvis also find themselves at risk. These surgeries are usually performed to assist in the treatment of cancer. The surgery may involve the colon, rectum, testicles, and prostate gland. 

Treatment Options For Retrograde Ejaculation

Before treatment can be initiated for retrograde ejaculation, a thorough inspection of the patient is needed. A doctor needs to determine why the man is experiencing retrograde ejaculation. The treatment provided will usually focus on addressing the underlying cause. 

If the doctor finds that the patient is using medication that contributes to the condition, then there may be a change in the patient’s prescription. By removing drugs that cause retrograde ejaculation, the ejaculatory function may return to normal. The doctor may ask the patient to use the new drugs for some time and monitor for changes in ejaculation.

There are a few drugs that doctors prescribe that may possibly help with retrograde ejaculation. These drugs are not specifically developed for this condition but rather as a treatment for other illnesses. 

The drugs that may help men with retrograde ejaculation include:

  • Midodrine

  • Imipramine

  • Chlorpheniramine

  • Brompheniramine

  • Pseudoephedrine

  • Phenylephrine

  • Ephedrine

The use of these drugs may improve the function of the muscle that controls the bladder neck. When a man ejaculates, this muscle should contract. This causes the bladder neck to close, ensuring semen cannot push back into the bladder. 

It is important to note that there are some drugs that may cause side-effects. Blood pressure may increase when the patient uses some of these medications. There is also a risk of a fast heart rate. Thus, men with existing heart diseases may not be able to take these drugs. 

There are cases where medication does not help. This is often the case when a surgical procedure causes retrograde ejaculation. If this is the case, the options available may be limited or ineffective. 

If the man wants to reproduce, assistive procedures might be needed. Intrauterine insemination is a possibility when fertility is a problem due to retrograde ejaculation. In this case, a doctor may attempt to recover semen from a man’s bladder. The semen is then sent to a laboratory for processing. The processed semen is then used as a means of inseminating the man’s partner. 

Coping With Retrograde Ejaculation

It is important that men realize retrograde ejaculation is not a dangerous condition. The major concern lies with fertility. With this in mind, men should understand how they can cope with this condition. 

Drugs used to treat retrograde ejaculation may be helpful, but men should understand the risks of these medications. The drugs should not be used if the man is taking medicine to treat high blood pressure. Some drugs used to treat retrograde ejaculation can cause blood pressure to drop suddenly. Combined with drugs that treat hypertension, the drop in blood pressure may cause dangerously low readings. 

If a man wants to implement a method to fix retrograde ejaculation, they should ensure they understand all of the options that are available. The man should talk to their doctor. The doctor will be able to provide support to the patient. When the patient understands all of the options, he will be able to make a more informed choice. 

Since retrograde ejaculation does not cause harm when there are no associated diseases, some men may prefer to leave it for the time being. This can be the case when fertility is not something that the man worries about. The man can still experience a climax during sexual activity – he will just need to get used to dry orgasm. The term dry orgasm refers to the moment climax is reached, but no semen comes out of the penis. 

Conclusion

Retrograde ejaculation is an ejaculatory dysfunction that causes problems with fertility. When semen is pushed into the bladder, it can result in other complications too. There are numerous causes for this ejaculatory dysfunction.

Flomax ejaculatory dysfunction is one possibility that men should consider. Other medications, injury, and previous surgery are other potential causes that men need to look at too. Treatment options for retrograde ejaculation are available. 

Sources

  1. Harvard Health Publishing. (2018) Retrograde Ejaculation. [online] Available at: https://www.health.harvard.edu/a_to_z/retrograde-ejaculation-a-to-z
  2. Mayo Clinic. Retrograde Ejaculation. [online] Available at: https://www.mayoclinic.org/diseases-conditions/retrograde-ejaculation/diagnosis-treatment/drc-20354896
  3. International Journal of Impotence Research. (2006) Premature ejaculation: definition and prevalence. [online] Available at: https://www.nature.com/articles/3901507
  4. Translational Andrology and Urology. (2016) Retrograde ejaculation, painful ejaculation and hematospermia. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002007/
  5. Pubmed. (2011) Prevalence of retrograde ejaculation in infertility associated to hypospermia. [online] Available at: https://pubmed.ncbi.nlm.nih.gov/21966785/
  6. WebMD. Flomax. [online] Available at: https://www.webmd.com/drugs/2/drug-4154/flomax-oral/details
  7. Healthline. (2018) Side Effects of Flomax. [online] Available at: https://www.healthline.com/health/enlarged-prostate/flomax-side-effects#side-effects
  8. The Journal of Clinical and Aesthetic Dermatology. (2016) Adverse Effects and Safety of 5-alpha-Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5023004/

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