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Successful treatment of retrograde ejaculation with the α1-adrenergic agonist methoxamine: case study


We treated two patients affected by retrograde ejaculation (RE) with the pure α1-adrenergic agonist methoxamine; the drug was self-administered intramuscularly by the patients 30 min prior to intercourse or masturbation. A previous trial with oral imipramine had been ineffective in both patients. Sperm count increased substantially, particularly in the first patient who had insulin-dependent diabetes and was seeking fertility. In this patient, total ejaculated sperm increased from 22 millions to 488 and 419.5 millions on two different occasions, with good motility; two clinical pregnancies were obtained in the partner of this patient after 3 and 4 months of treatment, respectively. The second patient did not desire fertility. In both patients, no side effects were seen except for slight piloerection; blood pressure values increased slightly, and heart rate was unchanged. We conclude that self-administered methoxamine can be a useful, noninvasive and inexpensive treatment of RE, when oral agents are ineffective.

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We sincerely thank Robert Oates, MD, from Boston University Medical School, Boston MA (USA), for his very helpful comments and assistance in reviewing the manuscript. This work has been made possible by a grant awarded from Fondazione Banco di Sardegna, Sassari, Italy, to one of us (PA Tomasi).

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Correspondence to P A Tomasi.

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Tomasi, P., Fanciulli, G. & Delitala, G. Successful treatment of retrograde ejaculation with the α1-adrenergic agonist methoxamine: case study. Int J Impot Res 17, 297–299 (2005).

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  • methoxamine
  • retrograde ejaculation
  • male infertility
  • imipramine
  • pregnancy

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