Seeing blood in your semen doesn’t usually signal a serious medical problem. Most of the time, it goes away on its own within days or weeks.
Inflammation or irritation from any of the tubes, glands, or ducts that produce or pass semen—the seminal vesicles, urethra, epididymis, or prostate gland—can cause this condition, known as hematospermia.
Infections
Blood in semen, also known as hematospermia, can be caused by problems in the bladder, prostate, or tubes that carry semen from the testicles to the penis (known as the vas deferens). Hematospermia can occur in men of all ages. It is most often the result of a small blood vessel rupturing in the seminal vesicles or prostate during an erection and ejaculation. The same thing can happen in the testicles, epididymis, or along the urethra. Inflammation of these areas is a common cause of blood in semen, such as from prostate disease or irritation from stones (calculi) in the urethra, bladder, or seminal vesicles.
Sometimes, hematospermia occurs as the result of a sexually transmitted infection like gonorrhea or chlamydia. Other times, it may be a result of physical trauma to the testicles or epididymis or from a medical procedure like a prostate exam, biopsy, or vasectomy.
A man who notices blood in semen should see his doctor to determine the cause. He will perform a physical examination and ask questions about symptoms, including pain in the scrotum or on the testicles, and the frequency of episodes. He will also perform a urinalysis and other tests to check for STIs and other infections. He will probably also order a PSA test to evaluate his prostate health. He will most likely refer the patient to a urologist for further testing and treatment, depending on the results of the examination and tests.
Inflammation
Men who experience blood in their semen (hematospermia) may worry that it’s a sign of serious health issues, including prostate cancer. But most of the time, it’s a normal symptom and nothing to worry about. The most important thing is to get it checked out, so the cause can be diagnosed and treated.
Any gland, duct, or tube involved in the production and passage of semen can become irritated or inflamed, causing surrounding blood vessels to break and leak. This can happen in the seminal vesicles, vas deferens, testis, epididymis, or the prostate. Infections — including sexually transmitted diseases (STDs) such as gonorrhea and herpes — can also lead to this problem. So can enlarged prostates, which can pinch the urethra.
If it’s a simple case of inflammation or infection, your doctor will likely prescribe antibiotics and the problem will resolve on its own. But if the condition is more serious, your doctor may refer you to a specialist like a urologist. This type of doctor specializes in treating conditions that affect the urinary tract, male reproductive system, and genitals, including infertility, low testosterone, Peyronie’s disease, and vasectomy reversal. He or she will ask you about your symptoms and medical history, perform a physical exam, and order tests such as a urine sample, blood test, and an imaging scan of the scrotum or prostate.
Blockage
All of the organs that produce or pass semen (including the testicles, epididymis, prostate, and urethra) contain blood vessels. Damage to these blood vessels can lead to leaking of blood into the ejaculatory duct and/or urine.
Most people who notice blood in their semen have a mild case of hematospermia and don’t need treatment. In fact, most episodes of blood in semen are self-limited for people under 40 and don’t occur often enough to cause serious problems or impair fertility.
Hematospermia can also be a sign of an infection, including a sexually transmitted disease such as gonorrhea or chlamydia. Irritation or injury to any of the organs involved in the production and passage of semen can also cause inflammation and leakage of blood into the ejaculatory or urinary ducts.
Seeing blood in the semen can be very unsettling, but it’s important to know that most cases don’t signal a serious problem. A GP will usually examine the patient, do a urinalysis or urine culture to identify an infection, and run other tests to rule out serious conditions that may be causing the blood. He or she may also refer the patient to a specialist, such as a urologist who treats patients with problems of the urinary tract. The urologist will check for the cause of the blood and treat it as needed.
Cancer
It’s a bit of a shock to see blood in your urine or semen, but it is usually harmless and goes away within days or weeks. It’s usually caused by leaking blood vessels from the prostate or testes. It can also be caused by blockages in the tubes and ducts that carry semen and urine, such as a blocked bladder or urethra. Rarely, it can be a sign of cancer in the testes or prostate, which may need treatment with chemotherapy drugs.
If you’re under 40 and don’t have any other symptoms or a family history of serious illnesses, your doctor might not recommend treatment for a single incident of blood in the semen (hematospermia). Your doctor can try to find out what’s causing it by asking about your medical history and doing some tests. These can include blood tests and a pelvic ultrasound. They can also involve a procedure called cystoscopy, which involves putting a thin tube with a camera through your rectum and into the bladder and urethra.
If your GP can’t find any obvious causes for your hematospermia, they might refer you to a specialist doctor called a urologist. This specialist can help treat any serious underlying problems. In some cases, he might suggest surgery to remove a clot or a tumour from the genital tract.
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