Question:

Flomax has a side effect of dry ejaculation. Are dry ejaculations harmful to the associated anatomy? 

Answered by urologist Chris Deibert, MD:

Dry ejaculation occurs when sexual climax is reached, but little to no visible ejaculate (semen) is released.

This side effect, called retrograde ejaculation, can happen when taking the medication Tamsulosin (Flomax). Tamsulosin is a first-line therapy for urinary flow problems caused by an enlarged prostate. Dry ejaculation occurs in approximately 10% of men who take the medication.

As an alpha-blocker, tamsulosin works by relaxing the bladder neck to improve urine flow. This relaxation prevents the bladder neck from tightly closing during an orgasm, causing the ejaculate to flow backward into the bladder instead of out through the urethra. This is why you may notice that your urine appears cloudy when you empty your bladder.

While this side effect may negatively impact intimacy for some couples, dry ejaculation is not harmful to the anatomy and does not impact the sensation of an orgasm. There is no risk of pain or urinary tract infection. Once you stop taking the medication, dry ejaculation will stop too.

Other beta-blocker medications can also have an impact on ejaculation in different ways, such as metoprolol and SSRI antidepressants, which can cause delayed ejaculation.

If you are trying to conceive or are frustrated by an unwanted side effect, talk with your doctor about what medication alternatives may be right for your situation.