The Many Potential Causes of Dry Ejaculation in Men
If a man orgasms but fails to ejaculate, he may have experienced a dry orgasm. Also known as orgasmic anejaculation, a dry orgasm occurs when a man climaxes but doesn't release any semen.
"Dry orgasms are when semen is produced, however, during the process of a sexual climax, it doesn't ejaculate out of the penis. Instead, it goes into a retrograde fashion back into the bladder," said Justin Houman, M.D., a reproductive urologist and men's health specialist at Tower Urology in Los Angeles.
An orgasm could also be dry if there is no semen after a radical prostatectomy or the ejaculatory ducts are blocked, added Raevti Bole, M.D., a urology fellow at the Glickman Urological & Kidney Institute at Cleveland Clinic.
While a dry orgasm may sound uncomfortable, it's usually not painful and does not affect your ability to get an erection or partake in sexual activity. But is a failure to ejaculate something to worry about?
Causes of dry orgasm in men
Male dry orgasm, or dry climax, can be caused by a number of factors. According to Bole, the most common explanations include the following:
- Previous prostate surgery, such as a prostatectomy (partial or complete removal of the prostate gland)
- Previous prostate radiation
- Bladder removal
- Retroperitoneal surgery for testicular cancer
- Spinal cord injury
- Neurological conditions, such as multiple sclerosis or Parkinson's disease
- Obstruction of the ejaculatory ducts
- Certain medications, such as drugs that help with urination or high blood pressure
- Diabetes, most commonly type 1
Sometimes, though, the root cause isn't necessarily physiological. Relationship issues, stress, depression and anxiety could also play a role, according to Hana Patel, M.B.B.S., a general practitioner and mental health coach in London.
What does it mean to have a dry orgasm?
Generally speaking, Houman said dry orgasms aren't a cause for concern because they usually don't cause any long-term problems. However, for men interested in achieving conception, a lack of semen during ejaculation could become an issue.
Bole advised men who are experiencing dry orgasms consistently and unexpectedly to talk to a doctor.
"It's usually a common side effect of a medication or surgery, but it's still important to know why it's happening," she said.
Bole also mentioned that even though it is possible to have an orgasm without ejaculating, this condition affects the perception of sexual pleasure for some men. Studies have highlighted the psychological effects of retrograde ejaculation and dry orgasm, confirming they are under-discussed and poorly understood.
Treatment for dry orgasm
Patel explained that treatment for dry orgasm depends on the cause. Once a patient and doctor have narrowed down the "why," they can find a treatment option for most situations. What are those potential treatments?
"Typically, the most common cause is medication-induced, where patients are on a typical medication that relaxes the prostate, and in doing so, you get retrograde ejaculation," Houman said. "However, stopping that medication typically corrects the problem within a few days."
Sometimes your healthcare provider may prescribe a medication to help keep the bladder neck muscle closed during orgasm, which can work if the dry orgasm is due to ejaculate going backward into the bladder.
In most cases, the issue can be easily treated, Houman explained. When more serious conditions are the underlying cause, however, treatment becomes more complicated. A neurological issue such as multiple sclerosis, for example, makes treatment more difficult, but even so, there are still options for managing those long-term causes.
"If someone is trying to conceive a child but can't ejaculate due to a problem like a spinal cord injury, we have several treatment options to help with fertility," Bole said.
Clinicians can retrieve sperm through procedures such as testicular sperm aspiration (TESA) to use in assisted reproductive technology treatments. But if you don't want children, your doctor may deem treatment unnecessary.
Dry ejaculation long-term outlook
Dry orgasms can be a short-term blip in your sex life or a chronic condition. It all depends on the cause.
"If it's due to medication, then the ejaculatory problem should resolve once the man stops the medication," Bole explained. "However, if the dry orgasm is due to a prostatectomy or radiation, then it is permanent."
A 2020 study identified that although newer prostatectomy techniques result in lower rates of retrograde ejaculation, most men who undergo a prostatectomy develop the issue permanently. In a radical prostatectomy, when the seminal vesicles are removed along with the prostate gland, dry ejaculation is permanent. However, with surgery for benign prostatic hyperplasia (BPH), the seminal vesicles are not removed and dry orgasm isn't inevitable.
The overall prognosis for dry orgasm is positive, and for men trying to start a family, fertility treatments are available to help. However, if the issue is causing discomfort, it's best to talk to your doctor to determine the best care option.