Blood in Semen (Hematospermia)

Blood in semen usually isn’t a symptom of a serious health problem. The most common causes are an injury or a popped blood vessel. It often goes away on its own without treatment. But you should see a healthcare provider for an exam and to discuss your concerns.

Overview

What is blood in semen?

Hematospermia is the presence of blood in your semen (ejaculate). Semen is the whitish-gray fluid that releases when someone with a penis orgasms. It can be alarming to see blood in your semen. But it’s usually not a sign of a major health problem.

Another name for hematospermia is hemospermia.

Should I worry about blood in my semen?

You may feel frightened to see blood in your semen. But it’s rarely a symptom of a major health problem. Seeing blood in your semen once isn’t usually a sign of cancer. However, it’s a good idea to see a healthcare provider to fully discuss it.

Is blood in semen a common condition?

Healthcare providers and medical researchers aren’t sure how common hematospermia is because many people don’t examine their semen after ejaculation or aren’t comfortable talking to a provider about it.

Anyone can have blood in their semen at any age. But it’s more common in people between 30 and 40.

Is seeing blood in my semen normal?

Seeing blood in your semen isn’t normal. It’s a good idea to talk to a healthcare provider if you notice blood in your semen, especially if you notice it more than once.

Possible Causes

Why would I have blood in my semen?

The most likely causes of blood in your semen are:

• A small blood vessel that bursts during ejaculation, like how you might get a nosebleed after blowing your nose.
• Trauma from a medical procedure on your urinary or reproductive systems, such as a vasectomy or biopsy on your prostate. You may see blood in your semen for over a week after a vasectomy or up to four weeks after a prostate biopsy.
• An injury to part of your reproductive system, such as your testicles (testes), epididymis (a tube at the back of your testicle that stores and transports sperm), vas deferens, seminal vesicle or prostate.
• A seminal tract infection or inflammation.
• Prostate cancer treatment, including external beam radiation therapy and brachytherapy.

Other potential causes or associated conditions may include:

• Sexually transmitted infections (STIs), including gonorrhea, chlamydia or other viral or bacterial infections.
• Prostate conditions, including benign prostatic hyperplasia (BPH), acute bacterial prostatitis, cysts (abnormal growths that contain fluid or pus) and polyps (growths on a mucus membrane).
• Testicular and epididymis conditions, including orchitis and epididymitis.
• Seminal vesical disorders, including stones (calculi) and cysts.
• Blood disorders, including blood clotting disorders and sickle cell disease.
• Long-lasting (chronic) infections, including tuberculosis and schistosomiasis.
• Cancers, including testicular/epididymal cancer, prostate cancer, bladder cancer, seminal vessel cancer or a urethral tumor. It’s rare for the first symptom of these cancers to be hematospermia.
• Other medical problems, including unmanaged high blood pressure, HIV, liver diseases and leukemia.

Can a hernia cause blood in my semen?

No, a hernia can’t cause blood in your semen. A hernia doesn’t affect the parts of your reproductive system that transport semen.

What does brown blood in semen mean?

Blood in your semen can look:

• Red.
• Pink.
• Brown.
• Reddish-brown.

Brown blood in your semen is usually a sign that old blood in your reproductive system is clearing out.

Care and Treatment

How is blood in semen diagnosed?

A healthcare provider will review your medical history, conduct a physical exam and ask questions, including:

• When did you first notice blood in your semen?
• How often do you see blood in your semen?
• What are your sexual activities or practices?
• What medications are you taking?
• Have you had any recent medical procedures?

They may also conduct or order tests, including:

• Digital rectal exam. A digital rectal exam checks your prostate for swelling, tenderness or a lump.
• Urinalysis (urine test). A urinalysis (urine test) checks for infections.
• STI test. These tests detect the presence of any sexually transmitted infections.
• Prostate specific antigen (PSA) test. A PSA test checks for prostate cancer.
• Transrectal ultrasound. A transrectal ultrasound helps diagnose problems in your prostate, including cysts, calculi, swollen veins (varices) and inflammatory changes.
• Imaging tests. A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan helps produce images of soft tissues.

How do you treat bloody semen?

Treating blood in semen varies according to:

• How much blood is in your semen.
• How long blood has been in your semen.
• Your age.
• Any other symptoms you may have.

You probably won’t need treatment if you:

• Are under 40.
• Have no symptoms in your urinary tract.
• Have no risk factors for any medical conditions.
• Only had blood in your semen once.

If a healthcare provider identifies a cause, they’ll prescribe an appropriate treatment. Treatment may include:

• Antibiotics if you have an infection.
• Anti-inflammatory drugs.
• Finasteride (Proscar®). Finasteride is a medication that helps shrink an enlarged prostate. It can often help stop hematospermia that occurs due to fragile blood vessels on your prostate.
• Medications to treat other conditions.

Should I stop masturbating if I have blood in my semen?

Injuries from rigorous sexual activity can sometimes cause blood in your semen. If you have an injury, it’s a good idea to wait a few days for it to heal before you masturbate or have sexual intercourse.

What are the possible complications or risks of not treating hematospermia?

In most cases, hematospermia goes away on its own without treatment. But serious and/or permanent complications can develop if an STI or another condition causes blood in your semen. Talk to a healthcare provider as soon as you notice blood in your semen.

When To Call the Doctor

When should hematospermia be treated by a doctor or healthcare provider?

Hematospermia is usually not a serious problem. But it’s always a good idea to see a healthcare provider any time you develop a new symptom, especially one that’s as alarming as blood in your semen.

A note from Wockr

It can be shocking to notice blood in your semen, and you may feel uneasy at the idea of talking to someone about it. But you don’t have to feel nervous or embarrassed to talk to a healthcare provider about it, because it might be your body’s way of telling you something isn’t right. Even though most causes of blood in semen aren’t serious and go away without treatment, a provider should still determine its cause.