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Question:
I am a 32-yr old male and I would like to ask you a question about something that I'm embarassed to discuss with my doctor: I have noticed that in the past 5 years the amount of semen produced and the "distance it covers" have drastically decreased. I have diabetes and I use insulin.I have read in a medical encyclopedia that men with diabetes often suffer from "retrograde ejaculation". If this is the cause in my case, is it curable? Does it mean I'm sterile? Thanks for your king attention.

Answer:
by Annette Owens: (05/15/2004)
It sounds to me as if you are experiencing beginning "retrograde ejaculation". This is not a dangerous condition, and it happens in many men with diabetes, in men following prostate surgery, and others. Most men claim that their orgasms are otherwise unchanged from before their "dry orgasms" started. The ejaculation mechanism (expulsion of semen from the penis) is a complicated event that involves a number of intact nerves and muscles. Normally, a muscle sphincter at the bladder neck closes off during ejaculation, and allows the semen only to travel forward and out of the penis. If this muscle is not quite tight enough during ejaculation, the semen will flow backwards into the bladder instead of out of the penis ("dry orgasms"). You are not sterile, since you are still producing semen, and it sounds as if you are still ejaculating. There are several methods available for harvesting semen if a man has completely dry orgasms. However, if you are interested in having children now or later, I would recommend that you look into having some of your sperm frozen at a sperm bank. "Retrograde ejaculation" can not be cured, and is a condition that many men learn to live with. The major concern is related to fertility. I hope that I have answered your question. You can find more information about diabetes and sexuality in my newly established web site www.cvillewellness.com or www.annetteowens.com in the essay section. Please do not hesitate to ask me further questions through my web site. Sincerely, Annette Fuglsang Owens, MD PhD Charlotteville Sexual Health & Wellness Clinic 901 Preston Avenue, Suite 403 Charlottesville, VA 22903 tel.: (804) 971 7355

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