From the Guidelines
Tamsulosin can cause retrograde ejaculation as a side effect, and the choice of alpha blocker should be based on patient age, comorbidities, and different adverse event profiles, including ejaculatory dysfunction [EjD] 1. When prescribing tamsulosin for the treatment of lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH), it is essential to consider the potential side effects, including retrograde ejaculation.
- The mechanism of action of tamsulosin, an alpha-1 adrenergic receptor blocker, can lead to relaxation of the smooth muscles in the prostate and bladder neck, potentially causing retrograde ejaculation.
- According to the American Urological Association guideline, the choice of alpha blocker should be based on patient age and comorbidities, and different adverse event profiles, including ejaculatory dysfunction [EjD] 1.
- If retrograde ejaculation is bothersome, options exist, such as reducing the tamsulosin dose or switching to a different alpha-blocker with a lower incidence of this side effect.
- It is crucial to discuss the potential side effects of tamsulosin with a doctor, especially if fertility is a concern, as retrograde ejaculation may affect fertility, but the condition is typically reversible after stopping the medication 1.
From the FDA Drug Label
Abnormal Ejaculation Abnormal ejaculation includes ejaculation failure, ejaculation disorder, retrograde ejaculation, and ejaculation decrease. As shown in Table 1, abnormal ejaculation was associated with Tamsulosin Hydrochloride Capsules administration and was dose-related in the U. S. studies.
Yes, tamsulosin can cause retrograde ejaculation, as it is listed under abnormal ejaculation, which is associated with tamsulosin administration and is dose-related 2.
From the Research
Tamsulosin and Retrograde Ejaculation
- Tamsulosin, a medication used to treat benign prostatic hyperplasia (BPH), has been associated with retrograde ejaculation in several studies 3, 4, 5.
- A study published in The Journal of Urology found that 18 patients reported retrograde ejaculation while taking tamsulosin, and that intermittent treatment with the medication led to significant improvement in retrograde ejaculation in 12 of these patients 3.
- Another study published in the Journal of Translational Medicine found that tamsulosin may cause ejaculatory dysfunction by altering the progression and emission of sperm, and that it may induce retrograde ejaculation but not other ejaculatory disorders 4.
- A review of clinical literature published in BJU International found that tamsulosin is associated with a higher incidence of ejaculatory dysfunction (10%) compared to other alpha1-adrenoceptor blockers and placebo, although this is unrelated to retrograde ejaculation or higher efficacy 5.
Mechanism of Action
- The exact mechanism by which tamsulosin causes retrograde ejaculation is not fully understood, but it may be related to a peripheral effect on seminal vesicles and/or the vas deferens, or a central effect on the brain's control of ejaculation 5.
- Tamsulosin's strong affinity for 5HT1A- and D2-like receptors, which are involved in the central command of ejaculation, may also play a role in its association with ejaculatory dysfunction 5.
Comparison to Other Medications
- Tamsulosin has been compared to other medications used to treat BPH, including alfuzosin, doxazosin, and terazosin, and has been found to have a higher incidence of ejaculatory dysfunction 5, 6.
- A systematic review and meta-analysis published in The Journal of Sexual Medicine found that tamsulosin was associated with a significantly higher risk of ejaculatory dysfunction compared to placebo, and that combination therapy with alpha-blockers and 5-alpha reductase inhibitors resulted in a 3-fold increased risk of ejaculatory dysfunction compared to alpha-blockers or 5-alpha reductase inhibitors alone 6.