Ejaculatory Issues: Causes and Treatment Options

Q: Ejaculatory Issues: Causes and Treatment Options

Hello： Diuretic medications can potentially affect ejaculation, but the impact varies from person to person, especially with prostate medications, where the incidence can be quite high. <br>It is possible to change medications. <br>Wishing you good health.

Anejaculation?

Hello Doctor, I recently experienced difficulty urinating and visited a urologist.
The doctor prescribed Alfuzosin, which I took for 1 or 2 days.
During a subsequent masturbation session, I noticed that the semen during ejaculation was abnormally low, only 1 or 2 drops.
I stopped taking Alfuzosin after 4 days because I felt it wasn't effective.
A few days later, I saw another doctor at the same hospital, who prescribed three medications: Tamsulosin, Silodosin, and Urecholine.
After taking these for about 2 days, I noticed some improvement in my urinary difficulties.
However, the more concerning issue is that after taking the medications for 2 days, during oral sex, I experienced ejaculation and pleasure but felt no semen, only a small amount of clear fluid.

Doctor, what is happening to me? Is it as the internet suggests, a side effect causing retrograde ejaculation into the bladder? However, my urine hasn't shown any cloudiness afterward, so could it be caused by the medication? Should I stop taking the medication? Which specific pill might be causing this? I seek your advice, thank you.

Lin Sen, 40~49 year old female. Ask Date: 2019/04/03

Dr. Du Shixi reply Urology

Hello: Diuretic medications can potentially affect ejaculation, but the impact varies from person to person, especially with prostate medications, where the incidence can be quite high.
It is possible to change medications.
Wishing you good health.

Reply Date: 2019/04/03

More Info

Ejaculatory issues can be a source of significant concern and discomfort for many individuals. In your case, it appears that you are experiencing a reduction in the volume of ejaculate, which can be distressing. This condition is often referred to as "dry orgasm," where ejaculation occurs, but little to no semen is expelled. This can be caused by various factors, including medications, medical conditions, and psychological issues.

From your description, it seems that you were prescribed medications such as Alfuzosin (活路利淨) and a combination of other drugs, including Uroselective agents and Cholinergic medications. Alfuzosin is an alpha-1 adrenergic blocker commonly used to treat urinary symptoms associated with benign prostatic hyperplasia (BPH). While effective for alleviating urinary difficulties, one of the potential side effects of this medication, as well as other similar drugs, is retrograde ejaculation. This occurs when semen is redirected into the bladder instead of being expelled through the urethra during orgasm.
The fact that you noticed a significant decrease in ejaculate volume after starting these medications suggests that retrograde ejaculation could indeed be a possibility. However, it is important to note that not all individuals will experience this side effect, and the severity can vary based on individual physiology and the specific medication used.

Regarding your concern about the medications you are taking, it is crucial to consult with your healthcare provider before making any changes to your medication regimen. Stopping medications abruptly can lead to a resurgence of your original symptoms or other complications. Your healthcare provider can help determine which medication may be contributing to your symptoms and whether an alternative treatment option is available.

In addition to medication-related causes, other factors may contribute to ejaculatory issues, including psychological stress, hormonal imbalances, or underlying medical conditions such as diabetes or neurological disorders. If you have not already done so, it may be beneficial to discuss these aspects with your healthcare provider to ensure a comprehensive evaluation of your symptoms.

In terms of treatment options, if the medications are indeed causing retrograde ejaculation, your doctor may consider adjusting your treatment plan. This could involve switching to a different class of medication that does not have this side effect or exploring non-pharmacological interventions. Additionally, pelvic floor exercises, counseling, and lifestyle modifications may also help improve your symptoms.

In conclusion, while it is possible that the medications you are taking are contributing to your ejaculatory issues, it is essential to have an open dialogue with your healthcare provider. They can help you navigate your treatment options and address any concerns you may have about your sexual health. Remember, you are not alone in experiencing these issues, and there are effective strategies to manage them.

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