What is blood in the semen?
For any man, seeing blood in his semen can be
startling. It is a rare disorder, but fortunately, it rarely signals a serious
problem, especially in men under the age of 40. Blood in the semen (hematospermia) usually does not last long, as it
is usually a self-resolving problem.
What should I look for?
The amount of blood in your semen can vary
from a small drop to enough to give your semen the look of blood. The amount of
blood in your semen will depend on the cause of your bleeding. In addition to
having blood in your semen, you might also experience:
- pain when ejaculating
- pain when urinating
- tenderness or swelling in your scrotum
- tenderness in the groin area
- pain in your lower back
- blood in your urine
Potential causes of blood in the semen
Semen passes along a series of tubes on the
way to the urethra for ejaculation. Any number of things can cause blood
vessels along this path to break and leak blood into the semen.
In many cases, the exact cause for blood in
the semen is never determined. According to Harvard Medical School, most cases
of blood in the semen are not serious and can be attributed to six causes:
inflammation/infection, obstruction, tumors, vascular abnormalities, systemic
factors, or trauma/medical procedures. The most common cause is prostate
Inflammation of the seminal vesicles is a
common cause of bloody semen. Inflammation of any gland, duct, tube, or organ
involved in the male genitals can cause blood in your semen. This includes:
- prostatitis (inflammation of the
prostate gland), which can cause pain, urination problems, and sexual
- epididymitis (inflammation of the
epididymis, or the coiled tube in the back of the testicle where sperm is
stored), most often caused by a bacterial infection, including sexually
transmitted infections (STI’s) gonorrhea or chlamydia. Symptoms include red or
swollen scrotum, testicle pain and tenderness on one side, discharge, and
- urethritis (inflammation of the
urethra), which can cause pain while urinating, itching or burning near the
opening of the penis, or penile discharge.
Inflammation can also be caused by irritation
from calculi (stones) in the prostate, seminal vesicles, bladder, or urethra.
Just as with inflammation, infections in any
gland, duct, tube, or organ involved in the male genitals can cause blood in
Sexually transmitted infections like
chlamydia, gonorrhea, or herpes can also cause blood in semen. Infections
caused by viruses, bacteria, or fungi can also lead to this condition.
If ducts like the ejaculatory duct are
blocked, surrounding blood vessels can dilate and break. If your prostate is
enlarged, it can put pressure on your urethra, which can cause hematospermia.
Benign polyps or malignant tumors in the
prostate, testicles, epididymis, or seminal vesicles could lead to blood in
Vascular abnormalities in the male genitals
such as vascular cysts could explain the blood you’ve seen in your semen.
Conditions that affect your whole body can
cause blood in your semen. These include hypertension (high blood pressure),
hemophilia (disorder that leads to easy and excessive bleeding), leukemia, and
chronic liver disease.
Physical trauma like being hit in your
testicles while playing sports can lead to blood in your semen. Trauma can
cause blood vessels to leak, and that blood may leave your body in semen. A
medical procedure like a prostate exam or biopsy or a vasectomy can cause blood
in your semen.
Knowing when to see your doctor
If you are over 40
Men age 40 or over have a higher risk of
developing illnesses like prostate cancer. Because of this, you should tell
your doctor any time you see blood in your semen. Your doctor will want to
check for the cause of the blood as soon as possible.
If you are under 40
If you are under the age of 40 and don’t have
any symptoms other than bloody semen, wait and see if the blood goes away on
its own. If your semen continues to be bloody or if you start experiencing
additional symptoms like pain or a fever, make an appointment with your doctor.
He or she might perform a prostate exam or analysis of your semen and urine to
determine the source of the blood.
Diagnosing the problem
When you visit your doctor, they’ll first
need to determine the cause of the blood in the semen. Things they may do include:
- Physical examinations. Your
doctor may examine you for other symptoms, including swollen testicles,
redness, or other visible signs of infection or inflammation.
- STI tests. Through tests
including blood work, your doctor will check to make sure you don’t have STI’s
that could be causing the bleeding.
- Urinalysis. This can help detect
bacterial infections or other abnormalities in your urine.
- PSA testing, which tests for
prostate-created antigens and evaluates the health of the prostate.
- Screening tests like ultrasounds,
CTs, and MRIs, which can help locate obstructions.
If hematospermia lasts longer than 1 month, a
transrectal ultrasound may be indicated.
Men older than age 50 may be referred to a
urologist for further evaluation
Treatment: resolving your symptoms
Depending on the cause of the blood in your
semen, you might be able to treat yourself at home. If the underlying cause
requires medical treatment, your doctor will decide the course that is right
Treatment at home
If you have blood in your semen as a result
of a trauma, simply resting and allowing your body to heal may help. If you
also have swelling in your groin, you can apply ice to the area for 10 to 20
minutes at a time, but no longer than that. Most cases of hematospermia resolve
on their own. Keep an eye on your symptoms and alert your doctor if they get
worse or persist for longer than one month.
If the blood in your semen is caused by an
infection, your doctor will probably prescribe antibiotics. Anti-inflammatory
medications are available if inflammation alone is the cause. If the blood in
your semen is caused by a blockage in your genitourinary tract, surgery may be
Potential surgeries include removal of a
bladder stone that’s obstructing the urinary tract, of surgery to remove tumors.
If cancer is causing the blood in your semen,
your doctor will probably refer you to a specialist (oncologist) who will
determine the best treatment.
As startling as blood in your semen may be,
it’s important to remember that in most cases it’s not a symptom of a serious