Question for the men: MS, Flomax and lack of semen

[dwbruce]

I'm a 50-year old male, who was diagnosed with MS in 2000.  I've had two major flare-ups (exacerbations), primarily related to balance, spasticity, optic neuritis, and lack of sensation from the waist down.  I've not had any lasting nerve damage, other than slightly off-kilter balance, occasional optic disturbances in my left eye, and dampened sensations from my knees to my feet.  I'm still ambulatory and work 40 hours a week.  I'm on daily Copaxone, and have had doese of Prednesol (nasty stuff) and infusions of Solumederol.  But, the combination of being a cresting 50 and having multiple sclerosis, I've developed urinary problems (i.e., extensive need to urinate, and leakage).

My neurologist recently put me on a  Detrol LA for a week, then had me add  Flomax.  I noticed a slight improvement with the Detrol, but when I added the Flomax things urinary got dramatically better.  But, shortly after starting the Flomax, I discovered that I did not produce any ejaculate!  Not that sex is a big thing with me (staying upright while standing takes precidence), but it is still an important part of life (if only rarely).  Needless to say, I found this to be disconcerting, and discovered (through onling research) that a decrease in semen production was a common side effect of Flomax.  But, I kept on using this combination hoping things would improve with the semen.  Needless to say, after approximately 3 weeks, I had the same experience, but this time followed by pain in my lower abdomen (during the end of orgasm sensations).  I stopped, and when the urinary issues seemed to be more problematic again, I returned to the added Flomax, and immediately discovered the same lack of semen and abdominal pain (during the 2 months not taking Flomax, ejaculatory function returned to normal).

My question (after all that build up) is are any other men here on Flomax combined with Detrol LA?  And, if so, has anyone had the same experiences that I previously explained?  Finally, does the body seem to adapt to Flomax, and return to semen production (without abdominal pain after orgasm)?

I apoogize if my language seems quite blunt, but I'm extremely concerned (especially the abdominal pain after, even though short-lived).  I will be presenting the same questions to my neurologist the next time I see him, but that won't be for 6 weeks.

I will appreciate any and all responses.

Thanks,
David

[Quixotic1]

(Assuming my best male voice here)  My MS clinic has a group of urologists as part of it who see basically only MS and neurology patients.  (In reality they are UroGynecologists and are fantastic, but I digress.)  I believe that a Urologist associated with a Nerology Department would be your best bet for getting these questions answered.  They are the ones who deal daily with the urologic side effects and actions of those meds.  The neuro uses them for the neurogenic bladder problem.

There is also a Urology Forum both for asking a physician and for patient-to -patient info.  You also might ask there.

And... About the preoccupation with remaining vertical.  That is not to be under-rated!  Gravity is not necessarily our friend.  Do you also use doorjams in much the same way as a pinball machine uses the little flippers?  I don't think I could turn to go through a doorway and not hit at least one side of it if not both.  I believe God gave us walls, furniture and doorjams to guide us through life.

I didn't know then (1970's) that "Tommy" would be prophetic!  I now see my movement through life as if in a great cosmic pinball machine, lol.

Now, turning this question over to the men..

Good luck

Quix, MD (pediatrician in a former life and owner of the "other" set of organs)

ps.  I'll see also if I can come up with an answer to this.

[Heather3418]

Hi David.  Welcome to the Forum.  We are so glad that you posted and hope that you will continue to.

We have a couple of guys on the Forum (wish we had more male contributors) that maybe can offer you some help with your questions.  As a female and no medical background, I do not have any answers.  I do understand your concerns..

Okay guys, can you help David out on this one?

Again, Welcome David,

Heather

[Quixotic1]

We've discovered on our forum that there are no topics too delicate or sensitive to be discussed by both sexes, so I hope you are not bothered by me discussion what I have found.

Also, I, too, am glad you have joined us and hope you stay.

It appears to me that what you are having is not a lack of semen production, but rather the ejaculate is being misdirected.  In a condition called "retrograde ejaculation" the semen is directed into the bladder rather than down the urethra.  Retrograde ejaculation is described as being painless and harmless.  The diagnosis is made by finding the "missing" sperm in the next urine void.  Also, the urine may appear cloudy from the addition of semen.

It can be caused both by neurologic abnormalities (MS, diabetes) and as a side effect of some meds and Flomax is one.  

So, the only part that I was not able to find any information on was the pain you are also having.  That question should be put to a urologist.  Given the abnormal neurology you also may have, I wonder if it is a painful spasm of some kind associated with climax.

You might want to look at retrograde ejaculation in general and see if it matches what you are experiencing.  Here is one link:

http://www.mayoclinic.com/health/retrograde-ejaculation/DS00913

I hope this helps,  Quix

[landman]

Since your post have you found out anymore info your question. I recently experienced retrograde ejaculation followed by discomfort. I started flomax 2 weeks ago for prostatitis and started taking detrol la 2 days ago. Thank goodness I found this website, as I don't feel so embarrased now, but I am still very concerned. Thanks

[michael1028]

Hello David,
    I have just started the detrol la about three weeks ago to combat incotinence. In the past six months I have had a few problems with it. I too work a 40 hour week and somedays balance and numbness all over present quite a challenge. I have no dx yet. I do suffer from double vision. I have not had any issues with the ejaculate problems however the last time I have had any interest in sex has been sometime ago.
I wish I could offer you a bit more info, however I am one of the males, who like so many others, am glad I have found this fourm. It is a place that as Quix said, no topic is too delicate. I hope you can find answers for your problem. Welcome.
Mike