Retro Ejaculation (RE) what to blame ?
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Hi all, I am 63 years old and have been suffering symptoms of BPH since 2010. I have been taking doxazosin which is an alpha blocker, (similar to flowmax, tamsulosin, etc. ) almost about the same time, starting with 2mg and ended with 4 mg in 2016. I also experienced retro ejaculation (RE). 6 months ago I discovered that I have urinary retention and the result was my kidney was backed up with urine, causing mild decline in kidney functions. Uro wanted to do TURP. I decided to self cath (CIC) instead, waiting for something better.
The issue here is every where I look, every thing is blamed for RE, including all procedures as well as all meds, without any explanations (mechanism) on how they should be blamed for. As far as I understand, the culprit here should be the prostate. It enlarges at the wrong place and squeezes the urethra and prevents the semen from reaching the penis during ejaculation. Having no place to go, the semen ended up going nowhere or going up to the bladder if there is less obstruction that way.
I did not have any procedures so I did not have any experience to share. However, all the meds try to is to relax the prostate. That should helps, not hurts the normal ejaculation. Right ? I feel that the meds have been falsely accused. Some people even stopped taking their meds and found out that RE did not go away. So they started saying things like "It may take months after stopping meds for RE to go away." Sure. This scares many men from taking drugs into suffering needlessly and/or having some procedures that outcomes are uncertain or could be worse.
My experience with doxazosin is whenever I increase its dosage, to 6mg or 8mg, RE is improved significantly, to the point of normal ejaculation. So I proved my point to myself. However, I keep wondering perhaps there is some better explanations or experiences out there that I am missing that any of you can share.
Another experience that I can share is that CIC also improves my RE. This makes sense since the catheter open up the obstruction and may keep it open for a while. During this time, especially very soon after the CIC, there is a path for the semen to reach its supposed destination. So for men out there who are doing the self cathing, reach out for the catheter before sex.
Hank
0 likes, 43 replies
uncklefester hank1953
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hank1953 uncklefester
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Hank
uncklefester hank1953
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I got a sample of 5mg calls from doc. I just started taking it. Too soon to tell if it helps with BPH symptoms. I did have more erections during the night though. I didn't think that dose would have that effect until you have it built up in your system
richp21 uncklefester
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Let us know if it ends up helping. Off to VA for Dr B on Monday.
Rich
uncklefester richp21
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Best of luck to you Rich for a safe trip and a successful procedure. You have one of the most experienced PAE Dr. In the country. You'll be peeing like a race horse in no time.
richp21 uncklefester
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paul96555 hank1953
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hank1953 paul96555
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Motoman hank1953
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I used to take Flomax and did not get RE. When that stopped working, I moved on to Rapaflo and learned what RE was all about. I was on Terazosin for about 4 years, and never got RE with it, plus it worked better than the others. It also seemed to give me better and more frequent erections, kind of like cialis, which I also tried.
I just got off the Terazosin last week, and the erections don't seem to be a frequent, but don't have any of the other side effects now either.
hank1953 Motoman
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Thanks Motoman for sharing. Your case is what I was looking for. I guess some AB work, some don't. Some AB cause RE, some don't. Just like coude works for some, but not for you and I.
Hank
jimjames hank1953
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Hi Hank,
Smooth muscle relaxants like doxazosin, Tamsulosin, etc., cause retro ejaculation in men who previously had normal antegrade ejaculation. It can be dose dependent and can vary with the individual but it's more the rule than the exception. Normal ejaculation returns after you stop taking the drugs although it may take a little time.
Surgical procedures like TURP, GL, HOLEP, etc, also have a very high incidence of retro ejaculation, but for different reasons.
If you want to know the technical reasons why, you can do some online research, but those are the facts. Neither the meds or the named procedures have been "falsely accused" as you suggest. That doesn't mean everyone who takes a smooth muscle relaxant or has a TURP will have retro, but a significant per cent will.
As to CIC helping with your retro, sounds like in your case the doxazosin puts you into borderline retro which I also experienced on a certain dose of a smooth muscle relaxant. Sometimes I had it, sometimes I didn't. And, yes, it's very possible that performing CIC right before ejaculation helps in that it pushes you over the border to the non-retro side, probably because an empty bladder will be exerting less pressure. That still doesn't mean CIC is a solution to retro, just that it could make the difference in someone with borderline retro from drugs. If you had retro from TURP, for example, CIC would not make any difference.
Glad though that you have taken up CIC instead of rushing to a TURP. That is the choice I made over three years ago and through CIC my bladder has gotten better to the point where now where I am able to stop CIC for long periods of time.
How many times a day do you self cath? Are you able to have a natural void first? If so, how much comes out of the catheter after a natural void?
Jim
hank1953 jimjames
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Hi Jim, thanks for the confirmation that meds cause RE. From the responses that I was looking for, it seems to indicate some meds do cause RE, some don't, also depending a lot on individual situations.
I currently am cathing 3 times daily: 10PM before bed, cath volume : 200-250ml, 3AM, CV : 250-300ml, 4PM, CV : 150-200ml. Yes I can void naturally, the volume depends on how long I have been holding it. It can go as high as 300ml sometimes when I was busy.
Hank
arlington hank1953
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Hi Hank,
Your case seems atypical.
I'm on an alpha-blocker which definitely causes RE (I was previously on finasteride which did also). All docs I've talked to say this is the case and that it will go away almost immediately when the drug is discontinued. As a matter of fact if I have sex 2--23 hours after I take the alpha-blocker (before taking the next one) I very often DO NOT have RE. Timing is everything!
Good luck!
hank1953 arlington
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arlington hank1953
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