From the Guidelines
Gabapentin can potentially cause retrograde ejaculation as a sexual side effect, though it is not among the most commonly reported sexual adverse effects of this medication. Retrograde ejaculation occurs when semen enters the bladder instead of being expelled through the penis during orgasm. While gabapentin is primarily known to cause erectile dysfunction, decreased libido, and anorgasmia, retrograde ejaculation has been documented in some cases, as noted in the context of managing sexual dysfunction in male survivors, where treatments such as SSRIs (e.g., paroxetine, sertraline, citalopram, fluoxetine) dosed daily or clomipramine dosed on-demand may relieve problems with ejaculation (dry, retrograde, delayed, or climacturia) 1. Gabapentin works by affecting calcium channels and GABA neurotransmission in the nervous system, which can influence the autonomic nervous system that controls ejaculation. If you experience retrograde ejaculation while taking gabapentin, you should discuss this with your healthcare provider. They may consider adjusting your dosage, switching to an alternative medication, or implementing strategies to manage this side effect. Do not stop taking gabapentin abruptly as this can lead to withdrawal symptoms. The risk of sexual side effects may be dose-dependent, so using the lowest effective dose for your condition might help minimize these effects.
Some key points to consider:
- The mechanism of gabapentin and its potential effects on sexual function, including retrograde ejaculation, should be taken into account when managing patients on this medication.
- Treatment options for sexual dysfunction, including retrograde ejaculation, are available and may involve lifestyle modifications, psychological support, and medical therapies such as PDE5i or SSRIs 1.
- The evidence from studies on sexual dysfunction in survivors, such as those discussed in the NCCN clinical practice guidelines, can inform the management of sexual side effects in patients taking gabapentin 1.
- It's crucial to weigh the benefits and risks of gabapentin treatment and to monitor patients for any adverse effects, including sexual dysfunction, to ensure the best possible outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Gabapentin and Retrograde Ejaculation
- There is limited direct evidence on the relationship between gabapentin and retrograde ejaculation.
- A study on gabapentin-induced sexual dysfunction found that it can cause total sexual dysfunction, including anejaculation, at a total daily dose of 300 mg 2.
- However, anejaculation is not the same as retrograde ejaculation, and there is no direct mention of retrograde ejaculation in the study.
- Other studies have investigated the effects of alpha-blockers on retrograde ejaculation, suggesting that these medications can cause abnormal ejaculation, including retrograde ejaculation 3, 4.
- Additionally, pregabalin, a medication similar to gabapentin, has been found to induce sexual dysfunctions, including erectile dysfunction, anorgasmia, and loss of libido, but not specifically retrograde ejaculation 5.
- There is no direct evidence to suggest that gabapentin causes retrograde ejaculation, but it may cause other sexual dysfunctions.