Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

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

Abstract

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.

Your institute does not have access to this article

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Figure 1

References

  1. Kamischke A, Nieschlag E . Treatment of retrograde ejaculation and anejaculation. Hum Reprod Update 1999; 5: 448–474.

    CAS  Article  Google Scholar 

  2. Hershlag A, Schiff SF, DeCherney AH . Retrograde ejaculation. Hum Reprod 1991; 6: 255–258.

    CAS  Article  Google Scholar 

  3. Kamischke A, Nieschlag E . Update on medical treatment of ejaculatory disorders. Int J Androl 2002; 25: 333–344.

    CAS  Article  Google Scholar 

  4. Urry RL, Middleton RG, McGavin S . A simple and effective technique for increasing pregnancy rates in couples with retrograde ejaculation. Fertil Steril 1986; 46: 1124–1127.

    CAS  Article  Google Scholar 

  5. Gerig NE, Meacham RB, Ohl DA . Use of electroejaculation in the treatment of ejaculatory failure secondary to diabetes mellitus. Urology 1997; 49: 239–242.

    CAS  Article  Google Scholar 

  6. Kovacs GT, Lawrence M, Burden J, Poulos C . A case of successful use of reproductive technology for a couple with subfertility due to retrograde ejaculation, where artificial insemination had failed. Aust NZ J Obstet Gynaecol 1994; 34: 116–117.

    CAS  Article  Google Scholar 

  7. Nikolettos N et al. The outcome of intracytoplasmic sperm injection in patients with retrograde ejaculation. Hum Reprod 1999; 14: 2293–2296.

    CAS  Article  Google Scholar 

  8. Ranieri DM . Is IVF/ICSI always the first step to treat couples with infertility due to retrograde ejaculation? Fertil Steril 1998; 69: 1160–1161.

    CAS  Article  Google Scholar 

  9. Kihara K, Sato K, Oshima H . Involvement of the adrenal medulla in ejaculatory reactions in the dog. Int J Androl 1997; 20: 104–111.

    CAS  Article  Google Scholar 

  10. Ichiyanagi O et al. Successful treatment of retrograde ejaculation with amezinium. Arch Androl 2003; 49: 215–217.

    CAS  Article  Google Scholar 

Download references

Acknowledgements

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).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P A Tomasi.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

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). https://doi.org/10.1038/sj.ijir.3901253

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901253

Keywords

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

Further reading

Search

Quick links