Prisoner, 25, is left unable to ejaculate because of a never-before-seen side effect of his anti-psychotic medication
- The man was treated at a mental health unit in Hackney, East London
- He described the dry orgasms when masturbating as ‘strange and unnatural’
- Sexual side effects from anti-psychotic medication are common, doctors said
A prisoner taking anti-psychotic medication lost his ability to ejaculate in a bizarre side effect which medics said had never been reported before.
The 25-year-old man was admitted to a forensic psychiatry ward in East London after he began hearing things and having delusions while in jail.
Diagnosed with psychosis, he was put onto medication to control his symptoms but soon realised he was unable to ejaculate when he masturbated.
Doctors investigated the issue and found the unidentified man’s semen had been leaking into his bladder instead of out of his penis.
They switched the medication and his problem improved, but many anti-psychotic drugs are known to have ongoing sexual side effects.
A prison inmate in London found he lost the ability to ejaculate after masturbating because of the anti-psychotic drugs he was put on when he started hearing things (stock image)
Medics at the East London NHS Foundation Trust, which looks after people in the Hackney area of the city, revealed the man’s problem in a case report.
The team, led by Dr Matthew Roughley, wrote: ‘Sexual side-effects are common among those using anti-psychotic medication.
‘They are infrequently enquired about however and may result in non-compliance and reduced quality of life.’
The man had been taking a drug called quetiapine, which comes in pill form and is prescribed to treat schizophrenia, bipolar disorder, severe depression and mania.
He had been hearing things, feeling like people were out to get him and feeling like thoughts which weren’t his own were being put into his head.
His quetiapine dose was gradually increased over two months and, when it hit 600mg per day, the unusual side effect began.
According to Dr Roughley’s team around one in 10 people taking the drug suffer some kind of sexual problem as a result.
WHAT IS RETROGRADE EJACULATION?
Retrograde ejaculation is a condition in which a man can’t ejaculate when he orgasms and the semen instead travels up into his bladder – retrograde means to go backwards.
The condition is caused by the inability of the bladder’s exit tube to contract and keep the semen out.
This weakness or failure may be a result of medication side-effects or nerve damage from a spinal injury or illness such as diabetes or Parkinson’s disease.
During normal ejaculation, semen is forced out of the seminal vesicles – glands where it’s produced – and mixed with sperm before travelling down the urethra and out of the penis.
It has to pass the opening to the bladder on this journey – and this would usually contract to prevent leakage.
Retrograde ejaculation happens when the opening is unable to close and the semen takes the first exit it finds and ends up in the bladder.
The man may then notice urinating the semen out later on.
If the condition is being caused by medication, switching drugs may be able to stop it happening. If it’s caused by nerve damage, however, it is more difficult and potentially impossible to repair if it doesn’t heal on its own.
Past research has suggested retrograde ejaculation is uncommon and responsible for only around two per cent of fertility problems.
It does not usually cause any serious health problems but may leave the man infertile.
Sources: Harvard Health and Healthline
They said in the journal BMJ Case Reports: ‘9.8 per cent of users report some form of sexual dysfunction, most frequently erection or lubrication difficulties (4.9 per cent) or decreased libido (3.7 per cent).’
The prisoner in the case report, whose crime is not known, told doctors he could achieve an erection and orgasm normally, and his sex drive hadn’t changed, but nothing came out of his penis when he masturbated.
He ‘expressed dissatisfaction’ with the issue and described it as ‘strange and unnatural’.
There was, however, ‘cloudy debris’ in his urine after he had masturbated – which he admitted to doing less often now he was in prison.
This, the doctors discovered, was semen and they diagnosed him with a condition called retrograde ejaculation.
Sometimes known as a ‘dry orgasm’, retrograde ejaculation is when sperm and semen leak into the bladder instead of out of the urethra as they would in a healthy man.
It is caused by dysfunction of the bladder neck – the tube which carries urine out of it and into the urethra.
Anti-psychotic medication, Dr Roughley and colleagues said, can cause this part of the bladder to loosen up, meaning the flow of semen cannot be properly controlled.
Instead of being forced out of the glands which produce them and along the penis, the semen may instead move into the bladder, essentially because the natural barrier to direct it isn’t working properly.
Retrograde ejaculation is not a serious health problem and only causes around two per cent of male infertility, according to past research.
As well as medication side effects it can also be caused by nerve damage from conditions like diabetes, multiple sclerosis or a spinal cord injury.
Dr Roughley’s team wrote: ‘This is the first report of RE occurring with quetiapine…
‘Reducing dose or switching antipsychotic to one less associated with sexual side-effects are strategies to address treatment-emergent sexual dysfunction that should be considered in the first instance.’
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