Loss of interest in sex after stress or depression — what to do?

Retrograde ejaculation is where semen passes backwards into the bladder instead of out through the urethra, because the bladder neck does not close during ejaculation. The typical presentation is orgasm with little or no semen produced, and cloudy urine afterwards. Diagnosis is straightforward — a urine sample taken immediately after ejaculation is examined for sperm. Causes include diabetes (through nerve damage, and it is among the more common causes), previous prostate or bladder neck surgery, spinal injury, multiple sclerosis, and certain medications, particularly alpha-blockers used for prostate symptoms and some antidepressants and antipsychotics. Where a medication is responsible, changing it may resolve the problem — worth asking about before anything else. Where it is due to nerve damage, medications that improve bladder neck closure are sometimes effective. For conception, sperm can be retrieved from urine after ejaculation and used for IUI or IVF, with the urine alkalinised beforehand to protect the sperm. This works well and is a routine procedure. Please see a urologist or andrologist — this is very manageable, and it does not mean you cannot have children.